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Important 2023 Dates

November 1: Last date to request refunds from practice administrator accounts; Last date to enroll in the CLEAR online course
November 10: Last day to use practice administrator funds to pay fees; Last date for participants to submit images

2023 Update:The Perinatal Quality Foundation (PQF) including the Cervical Length Education and Review (CLEAR) program will close at the end of 2023.

2022 Update: The Perinatal Quality Foundation board and staff are pleased to report that approximately 55% of eligible participants have chosen to engage in the re-credentialing image review process. The CLEAR program continues to offer a valuable credential in a healthcare environment where quality and accountability are ever more important.

CLEAR Registration Options Cost ACCME Credit or SDMS Credit
Lectures / Examination/ Image Review included 2.5 3
Approval Effective Dates   Jan 1 - Dec 31, 2021 2019-2023
Total Program Cost / CME $150 2.5 hours CME 3 hours CME
Re-Credentialing Image Review (Every 3 years) $50 N/A N/A

The Cervical Length Education and Review (CLEAR) program integrates an online course with an examination and image review. CME credit and a displayable certificate of program completion is available for those who pass all components including the image review. 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.

Online Course

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

To access the lectures and other aspects of the CLEAR program, login with your username and password.

Online Examination

The CLEAR examination consists of multiple-choice questions. A passing score is 70%. There is no limit on the number of attempts an applicant may make to pass the exam.

Image Review

To complete the program, an applicant must submit an image “batch”. The initial batch consists of 5 images, from 5 separate patients, demonstrating accurate measurement of cervical length. The applicant uploads each image and inputs specific information about the image in the appropriate question boxes. (A mail-in option is available, but discouraged.) The batch is randomly assigned to one of the CLEAR reviewers and scored according to the 9 criteria explained in the course. It is preferable for practitioners to obtain the images that they submit for CLEAR image review. However, physicians who do not normally scan may upload images from other clinical providers under their supervision.

If the batch receives a borderline or failing score, a second senior reviewer also evaluates the batch. Applicants can see how each image fared on the 9 criteria. Specific helpful comments offered by the reviewers will also be available to the applicant. If the initial batch does not pass image review, the applicant will be invited to submit another batch (of 3 or 5 images, depending on the review) to complete the certification process.

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 Cervix
Normal Cervix
Image Criteria for Cervical Length Measurement
  • Exam is transvaginal
  • Maternal bladder is empty
  • Field of view is optimized
  • Anterior = Posterior width of cervix
  • Internal os is well seen
  • External os is well seen
  • Cervical canal is visible in its entirety
  • Calipers are correctly placed
  • Shortest, best of 3 measurements is reported
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