CLEAR Component Cost ACOG Credit SDMS Credit
Image Review
$150 2.5 3.0

The CLEAR program consists of the following:


The lectures listed below are available on line on video and handouts may be downloaded as Adobe PDF or Power Point.

  • Lecture 1: Why Measure Cervical Length
  • Lecture 2: How to Measure Cervical Length
  • Lecture 3: Tips & Tricks

Cervical Length Education and Review (CLEAR) is an integrated web-based lecture, exam, and image review program designed to improve sonographic cervical length measurements.

CME credit is awarded upon completion of the entire program. Participants may choose to receive ACCME CME through joint providership with the American College of Obstetricians and Gynecologists (ACOG) or CME through the Society of Diagnostic Medical Sonography (SDMS). Completion of the program also provides credit for American Board of Obstetrics and Gynecology (ABOG) Maintenance of Certification (MOC) Part IV: Improvement un Medical Practice.

To access the lectures and other aspects of the CLEAR program, create a username and password while registering above.


The CLEAR program includes an examination consisting of multiple choice and image-based questions. The participants must pass the examination with a score of 70%. A participant who fails the examination may retake it.

Cervical Image Quality Review

One or more batches of cervical length images taken by the participant are submitted. A batch of images must pass for the participant to complete the image review process. Initially a batch of five cervical length images from separate patients is required. The participant inputs specific information about each image online then submits the batch by upload or mail.

The images are reviewed by experienced reviewers and graded based on the nine criteria discussed in the CLEAR lectures and provided under IMAGE CRITERIA above. A second senior scorer reviews image batches that are borderline or failing. Reviewers provide specific comments and critiques on each image.

If the first batch of five images fails to pass the image review, additional batch submissions are required. The comments and critiques provided with each batch provide encouragement and assistance as participants master the sonographic techniques required to produce accurate cervical length measurements.

For further information contact the Perinatal Quality Foundation at

News Alert


We are happy to report that successful completion of the CLEAR web course education, examination and image requirements has been accepted by the American Board of Obstetrics and Gynecology (ABOG) for Maintenance of Certification (MOC) Part IV: Improvement in Medical Practice.

Measurement of the CervixNormal Cervix
Cervix Measurement Image Criteria
  • Transvaginal Image
  • Field of View is Optimized for Measurement
  • Anterior Width = Posterior Width
  • Maternal Bladder Empty
  • Internal Os Seen
  • External Os Seen
  • Cervix Canal Visible Throughout
  • Caliper Placement Correct
  • Report Shortest Best of Three Acceptable Measurements
Shortened Cervix
Pregnant Woman

The Perinatal Quality Foundation convened a cervix education task force in November 2011. The goal of the task force was to develop consensus education that presented in a widely available format the standard criteria for sonographic cervical measurements during pregnancy.

The Cervical Length Education and Review (CLEAR) program is a product of task force discussions.

Members of the task force and the organizations represented were the following:

Vincenzo Berghella, MD co-chair
Jay Iams, MD co-chair
Richard Berkowitz, MD Perinatal Quality Foundation
Eric Carlson, DO American College of Osteopathic OB/GYN
Helen Feltovich, MD Perinatal Quality Foundation
James Goldberg, MD Perinatal Quality Foundation
Gerald Joseph, MD American College of Obstetricians and Gynecologists
Hytham Imseis, MD Perinatal Quality Foundation
Deborah Levine, MD American College of Radiology
George Saade, MD Society for Maternal Fetal-Medicine
Jill Trotter, RDMS Society of Diagnostic Medical Sonography
Joseph Wax, MD American Institute of Ultrasound in Medicine