Iran Medical Council Journal of Iranian Medical Council 2645-338X 9 3 2026 07 01 Cervical Effacement is More Prognostic than Cervical Dilation in Outcome of Pregnancy in Pregnant Women with Incompetent Cervix 795 798 245119 10.18502/jimc.v9i3.21864 EN Fatemeh Golshahi Maternal, Fetal and Neonatal Research Center, Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Behrokh Sahebdel Maternal, Fetal and Neonatal Research Center, Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-3862-2262 Nafiseh Saedi Maternal, Fetal and Neonatal Research Center, Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Nooshin Faraji Maternal, Fetal and Neonatal Research Center, Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2025 04 30 Cervical dilation and effacement are critical components of the cervical ripening process during pregnancy. According to Williams Obstetrics textbook, cervical effacement refers to the thinning and shortening of the cervix as it prepares for labor, usually expressed as a percentage ranging from 0% (no effacement) to 100% (complete effacement). Cervical dilation, on the other hand, describes the opening of the cervical canal and is measured in centimeters from 0 cm (closed) to 10 cm (fully dilated). Effacement typically begins earlier, around 37-38 weeks of gestation, whereas dilation usually occurs closer to delivery, often within 24 hr before labor onset (1,2). <br>Cervical effacement is most commonly assessed through clinical examination rather than sonography. Although transvaginal ultrasound can measure cervical length and may provide some indirect information about cervical changes, it does not directly quantify effacement in the same manner as a manual examination. Specifically, cervical effacement refers to the thinning and shortening of the cervix described as a percentage, while cervical length is measured in centimeters via ultrasound.<br>In clinical practice, a combination of manual assessment and ultrasound may be utilized in certain high-risk pregnancies to monitor cervical changes. However, in this study, all assessments of cervical dilation and effacement were performed exclusively by clinical examination at the bedside by a single experienced senior resident clinician, who is also the author of this manuscript. This examiner personally evaluated and followed all the patients throughout the study, ensuring consistency and minimizing inter-observer variability. The choice to rely on manual examination was deliberate to maintain accuracy and standardization in the assessment.<br>Prophylactic cervical cerclage is performed to reduce the risk of miscarriage in women with cervical insufficiency, typically between 14 and 18 weeks of gestation, although it may be performed later if clinically indicated (3,4). https://www.jimc.ir/article_245119_5b1b5b2a4652e34fc8e9eca5bcdc3c64.pdf