CLEAR Component Cost ACOG Credit SDMS Credit
Image Review
$150 1.0
  2016 2016
Total Cost/CME $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: The CLEAR Program
  • Lecture 4: Translating Knowledge Into Clinical Practice

Web-based Examination

The CLEAR program includes a web-based examination consisting of twenty 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.The questions are drawn randomly from a larger question pool that currently has 31 questions. The questions are multiple choice and many are image-based.

Cervical Image Quality Review

The participant submits a batch of five cervical length images. The participant is required to input specific data for each image. Data required includes the following:

The images are reviewed by experienced reviewers and graded based on the nine criteria discussed in Lecture 2. 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.


The CLEAR program is an integrated lecture, exam, and image review program designed to improve sonography cervical length measurements.

We would like to give 1.5 to 2 credits of CME for the lecture and exam. This includes 61 minutes of videotaped lecture and an examination with 20 questions that may be retaken if failed.

We would like to provide an additional 1 hour of CME (for a total of 2.5-3 credits) for those who complete the entire three-part program including successful completion of the image review. This hour of CME credit would not be awarded by itself but only upon completion of the entire program.

To access the lectures and other aspects of the CLEAR program, create a username and password above. 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
  • Cervix Mobility Considered
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 are 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