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PubMed, Embase, and Cochrane Library. Additional studies were identified from reference lists. Only studies on in vivo biomechanical testing on both pregnant and non\u2010pregnant women were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Estimation of distensibility, compressibility, and biochemical composition of the uterine cervix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The distensibility methods evaluated a physiologic variable and might serve as a gold standard; however, they may never be clinically useful as they involve instrumentation of the cervical canal. The compression methods evaluated an unphysiological variable but despite that, they seemed to evaluate biologically relevant figures and were non\u2010invasive. Of the methods evaluating the biomechanical properties indirectly, those based on ultrasound may be clinically useful. Other indirect methods only measured variables within the most superficial layer of the distal uterine cervix, so further studies are needed to evaluate whether these measurements reflect the entire organ. Both compression methods and indirect methods were similar or superior to the Bishop score and to cervical length measurements regarding prediction of spontaneous preterm delivery and successful induction of labor in small studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The methods may have the potential to detect the biomechanical changes in the uterine cervix before the cervical length has shortened. The most promising methods need large\u2010scale clinical testing regarding induction of labor and preterm delivery before they can be used in the clinic.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12483","type":"journal-article","created":{"date-parts":[[2014,8,30]],"date-time":"2014-08-30T05:51:46Z","timestamp":1409377906000},"page":"1219-1237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Overview of the methods available for biomechanical testing of the uterine cervix in vivo"],"prefix":"10.1111","volume":"93","author":[{"given":"Lene","family":"Hee","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,17]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"266","article-title":"Pelvic scoring for elective induction","volume":"24","author":"Bishop EH","year":"1964","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e3280895dd3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90225-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(66)90661-2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(67)90292-X"},{"key":"e_1_2_8_8_1","first-page":"1261","article-title":"The distribution and functional activity of the cervical musculature","volume":"68","author":"Danforth DN","year":"1954","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.06.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-198303000-00005"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(83)90446-5"},{"key":"e_1_2_8_12_1","first-page":"563","article-title":"Connective tissue changes in the cervix during normal pregnancy and pregnancy complicated by cervical incompetence","volume":"71","author":"Rechberger T","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.02.008"},{"key":"e_1_2_8_14_1","first-page":"772","article-title":"In vitro analysis of muscular contractile ability and passive biomechanical properties of uterine cervical samples from nonpregnant women","volume":"77","author":"Petersen LK","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.01.076"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4260"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.015"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.3381184"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-012-0541-4"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/016173461003200302"},{"key":"e_1_2_8_21_1","unstructured":"ReuschL AndersonJ CarlsonL SimmonsH PehlkeC EliceiriK et\u00a0al.Detecting cervical microstructure via ultrasound and optical microscopy. 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