Misplaced Pages

Talk:Cervix

Article snapshot taken from Wikipedia with creative commons attribution-sharealike license. Give it a read and then ask your questions in the chat. We can research this topic together.

This is an old revision of this page, as edited by Snowmanradio (talk | contribs) at 13:55, 7 November 2014 (→Development: new section). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Revision as of 13:55, 7 November 2014 by Snowmanradio (talk | contribs) (→Development: new section)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)
Cervix received a peer review by Misplaced Pages editors, which is now archived. It may contain ideas you can use to improve this article.
This is the talk page for discussing improvements to the Cervix article.
This is not a forum for general discussion of the article's subject.
Article policies
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL
Archives: 1, 2
Good articleCervix has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Article milestones
DateProcessResult
April 28, 2014Good article nomineeNot listed
June 9, 2014Good article nomineeListed
Did You KnowA fact from this article appeared on Misplaced Pages's Main Page in the "Did you know?" column on June 23, 2014.The text of the entry was: Did you know ... that the cervix, which in adult women is much smaller than the rest of the uterus, is twice as large during childhood as the body of the uterus?
Current status: Good article
This article has not yet been rated on Misplaced Pages's content assessment scale.
It is of interest to the following WikiProjects:
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
WikiProject iconAnatomy: Organs High‑importance
WikiProject iconThis article is within the scope of WikiProject Anatomy, a collaborative effort to improve the coverage of Anatomy on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.AnatomyWikipedia:WikiProject AnatomyTemplate:WikiProject AnatomyAnatomy
HighThis article has been rated as High-importance on the project's importance scale.
Taskforce icon
This article has been classified as relating to organs.
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
WikiProject iconWomen's History High‑importance
WikiProject iconThis article is within the scope of WikiProject Women's History, a collaborative effort to improve the coverage of Women's history and related articles on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.Women's HistoryWikipedia:WikiProject Women's HistoryTemplate:WikiProject Women's HistoryWomen's History
HighThis article has been rated as High-importance on the project's importance scale.
Please add the quality rating to the {{WikiProject banner shell}} template instead of this project banner. See WP:PIQA for details.
WikiProject iconMedicine High‑importance
WikiProject iconThis article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Misplaced Pages talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine
HighThis article has been rated as High-importance on the project's importance scale.

Template:Find sources notice

GA Review

GA toolbox
Reviewing
This review is transcluded from Talk:Cervix/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: TonyTheTiger (talk · contribs) 17:44, 27 April 2014 (UTC)

WP:LEAD
Structure
Cervical mucus
Cervix as reservoir
Clinical significance
Thanks for your review. I will continue to work on the article and make many of the changes you suggest. I hope that you are able to re-review the article when changes have been made and the article renominated. --LT910001 (talk) 07:17, 28 April 2014 (UTC)

Addressing GA1

Thanks to Tony the Tiger for his thorough review. I've made the following changes and renominated:--LT910001 (talk) 00:03, 12 May 2014 (UTC)

  • Clarified and copy-edited numerous sections of the article
  • Removed or cited statements
  • Replaced several citations with a secondary source per WP:MEDRS
  • Added information about cervical contraception
  • Concatenated anatomical information about blood supply (...) into the 'structure' section.
  • Directly stated the cervix is a pathway for sperm.
  • Updated the cervical cancer information.
  • Made some copyedits per suggestions in the first GA
  • Updated the lead section

GA Review

GA toolbox
Reviewing
This review is transcluded from Talk:Cervix/GA2. The edit link for this section can be used to add comments to the review.

Reviewer: 97198 (talk · contribs) 10:30, 25 May 2014 (UTC)

Hi there! I'll be reviewing this article. I've had a look at the previous review and it looks like most of those issues have been resolved, so hopefully it'll pass this time. I've just done a copyedit f the article to fix minor issues but here are some other issues I've found:

Comments from 97198

Issues resolved from 97198
  • "Because of this change, known as metaplasia, this part of the cervix is at increased risk of cancer." — need to clarify what "this part of the cervix" is referring to, as it is unclear (I assume it's the transformation zone).
  • Under "Structure", you describe the lymphatic drainage routes for the "lateral cervix", then the "posterior and lateral cervix", and then the "posterior section of the cervix" — which is correct? What about the anterior cervix?
  • "The size of the cervix decreases over time relative to the uterus" — I get what you mean, but it kind of sounds like the cervix is literally shrinking, so do you think you could word it more clearly?
  • "when the endocervix is exposed to the harsh acidic environment of the vagina it undergoes metaplasia to squamous epithelium" — should briefly explain why/when the endocervix would be exposed as such, since it's not intuitive.
  • The "Mucus plug" image should have a more descriptive caption, since there's a lot more than the plug pictured.
  • "During the proliferative phase, the mucus is thin and serous to allow sperm to enter the uterus while during the secretory phase, the mucus is thick to prevent sperm from interfering with the already fertilized egg" — the average reader probably won't know what the proliferative and secretory phases are, so these should be explained.
  • "This counters a weakly founded theory put forward that the convulsing cervix, during orgasm, draws semen into the uterus. This upsuck theory has been generally accepted for some years, although there does not appear to be any evidence." — this is a pretty big claim, and it would be great if you could source it to a medical textbook, which would be more reliable than a single journal article.
  • Under "Clinical significance" there are a number of diseases involving the cervix apart from cancer that could be discussed — these include cervical stenosis, cervicitis and cervical agenesis. It may also be worth commenting on pre-cancerous lesions like cervical polyps and cervical intraepithelial neoplasia.
  • "An alternate approach, a LEEP procedure using a heated loop of platinum to excise a patch of cervical tissue" — an alternate approach to what? Visualising the cervix? Examining? Biopsying?
  • A minor point, but some of the books used as references don't have capitalised titles, which they should.
    •  Question: This is a result of the automatic template-filler. I have always found this somewhat confusing, as books in real life are not always written in title case. Is there a relevant policy or guideline I will be able to use for future reference? --LT910001 (talk) 23:57, 27 May 2014 (UTC)
I'd be very grateful if you could consider the footnote here: WP:GACR 2a, which states "Using consistent formatting or including every element of the bibliographic material is not required", as capitalising these is troublesome and quite effort-intensive. --LT910001 (talk) 23:15, 30 May 2014 (UTC)
  • Is there a reason for including the "Menstrual cycle" template at the bottom of the page? It doesn't seem particularly relevant to me.
  • "The number of past vaginal deliveries is a strong factor in influencing how rapidly the cervix is able to dilate in labour" — should mention that dilation/labour is typically faster in multips.
    •  Not done Not so. According to the sources it is the number of vaginal deliveries, rather than the number of viable pregnancies at term, that affect this. --LT910001 (talk) 23:51, 27 May 2014 (UTC)
I think that the question raised is that how multiple vaginal deliveries affects the rate of dilation. ie the more vag deliveries the faster the labour. Could mention precipitate delivery. Snowman (talk) 22:50, 29 May 2014 (UTC)

I'll put the review on hold for now because I don't think it'll be too hard to fix up these issues. Feel free to contact me for any help or questions! 97198 (talk) 10:30, 25 May 2014 (UTC)

Thanks for your comments and taking up the review. I will address these in coming days, and look forward to working with you to get this promoted. --LT910001 (talk) 21:29, 25 May 2014 (UTC)
Thanks 97198, for your thoughtful review. I believe I've addressed all your concerns. --LT910001 (talk) 23:15, 30 May 2014 (UTC)
97198 to keep track of this review, I've boxed issues I see as resolved. If you feel I've placed the wrong issues there, please take them out and we can continue discussion. --LT910001 (talk) 01:40, 6 June 2014 (UTC)

Comments from Snowmanradio

  • Actually the GA1 was a clear fail. I have partly re-written the introduction because is was badly written, amateurish, and factually wrong in parts. The very basic anatomy has not even been extracted correctly from Gray's Anatomy for Students, which is the book given as the relevant in-line reference. Of course, my version is not perfect, but my edits have helped to iron out some serious problems. In my opinion this article has not been prepared adequately to be a GA candidate, and I would support a quick fail. Alternatively, I think that it needs a lot of work to get to GA standard. Snowman (talk) 21:08, 29 May 2014 (UTC)
Snowmanradio this is the third article I have written or reviewed that you have been involved in in recent days, prior or subsequent to GA (Anatomy, Esophagus). Please stop following me. Over the next few days you will make a huge amount of mostly stylistic edits, with little to no discussion, that do not respect the sources I have used. I will take this to AN/I if this situation persists. --LT910001 (talk) 21:21, 29 May 2014 (UTC)
The guidelines say that anyone can contribute to a GA nomination discussion. I am interested in anatomy, so it is only natural that I have had a look at some of the anatomy articles. You do not own this article. The cervix is part of the uterus and this is explained in the the book that is used as the in-line citation in the article. How did a basic error about the anatomy of the uterus get into this article and not be corrected until after GA nomination? Snowman (talk) 21:29, 29 May 2014 (UTC)
Issues resolved from Snowmanradio
  • I would think that explaining dysplasia seen on smear slides and explaining cervical intraepithelial neoplasia (CIN) of the stratified squamous epithelium would be helpful. Snowman (talk) 21:59, 29 May 2014 (UTC)
 Done per 97198. --LT910001 (talk) 22:13, 30 May 2014 (UTC)
  • There are two HPV vaccines in the UK (and I presume the rest of the world); Gardasil and Cervarix (names used in the UK). I think that it would be reasonable to mention both or neither in a section about HPV vaccines. I do not know why you have only included Gardasil. Snowman (talk) 22:32, 29 May 2014 (UTC)
 Done included both. --LT910001 (talk) 22:13, 30 May 2014 (UTC)
 Done --LT910001 (talk) 23:01, 31 May 2014 (UTC)
 Done thank you. I have changed metaplasia --> dysplasia in the appropriate section. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • "Cervical intraepithelial neoplasia is a possible result, ...". The language is important here. CIN is not reported in a smear test result, however dysplaia and HPV changes are. Abnormalities from cervical cytology would be reported as mild, moderate, or severe dysplasia, without mentioning CIN. Note that mild and sometimes moderate dysplasia seen by cervical cytology can resolve spontaneously. CIN may be subsequently diagnosed with some sort of biopsy of the cervix. Snowman (talk) 14:16, 31 May 2014 (UTC)
 Done Clarified. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • "Conversely, methods of thinning the mucus may help to achieve pregnancy; one suggested method is to take guaifenesin in the few days before ovulation.". This looks out of context to me, because this drug in not licensed for this purpose, at least not in the UK. I would advise extreme caution in writing about drugs that may be used in women, who wish to get pregnant. Snowman (talk) 15:37, 1 June 2014 (UTC)
 Done It has been a balance to maintain the edits of other users prior to expansion,which is why there are some very odd sentences like this. I've removed it. --LT910001 (talk) 21:30, 2 June 2014 (UTC)
  • The stages of labour need some work. The first stage of labour includes the early uterine contractions, the effacement of the cx and dilation of the cx to about 3-5 cm dilation (classification slightly different in different countries - 4 cm in the UK). Then the second stage of labour begins and the cx dilates to its maximum as the baby moves along the birth canal. The second phase ends when the baby is born. The third stage is the delivery of the placenta and remaining membranes. Snowman (talk) 21:59, 29 May 2014 (UTC)
Yes. Please clarify what your concern is. --LT910001 (talk) 22:13, 30 May 2014 (UTC)
Please give a clearer description of the stages of labour. Snowman (talk) 14:24, 31 May 2014 (UTC)
I have given the stages of labour relevant to the cervix. Any more is out of this article's scope, contained within Childbirth and can be viewed there. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • In the UK a cervical smear is simply called a cervical smear or smear test. As far as I am aware, Pap test is mainly a USA or North American term. Snowman (talk) 21:59, 29 May 2014 (UTC)
 Not done See here: . --LT910001 (talk) 22:13, 30 May 2014 (UTC)
The ngram is somewhat tangential to the issue. In the UK conventional pap tests, are just called smear tests (or cervical smear tests) in the UK and the ngram would not show this. In the UK they have been replaced with Liquid-based cytology (LBC); see About cervical screening on one of the NHS webpages. LBC produces better slides. I do not know what sort of preparations are made in North America, but I would be surprised if they are all using the old style Pap tests over there. For LBC the cervical cells are brushed off the cervix rather than being scraped off with a spatula. Snowman (talk) 13:53, 31 May 2014 (UTC)
This is cutting-edge and I can only write about what is in the sources I have available. It may be sensible to wait 4-5 years and then, as this is used more widely and reported about in tertiary sources, to include it then. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
Actually, all routine NHS smears in the UK were changed from the old cervical smear method to LBC using the brush method about 5 years ago. Snowman (talk) 15:42, 1 June 2014 (UTC)
@LT910001: as Snowmanradio notes, "pap smear" is not a term I've ever heard used in when addressing laypeople in the UK, and if you had chosen the British English corpus in the Google ngram, since this is the issue here, you would see that the most common term is "cervical smear". This alternative terminology should be included in the article. Peter coxhead (talk) 07:28, 6 June 2014 (UTC)
 Done Thanks, I wasn't aware of that, and have included it. I had not changed this earlier because I didn't have any hard evidence to the contrary. --LT910001 (talk) 08:52, 6 June 2014 (UTC)
  • The existence of reserve cells could be included. What is interesting and speculative is the role of the reserve cells in the cervical transition zone in the pathogenesis of neoplastia, but this might not be within the scope of this GA. Snowman (talk) 15:15, 31 May 2014 (UTC)
Yep. There is no requirement for complete comprehensiveness, only that the 'main' issues have been covered. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • "In 2008, cervical cancer was the third most common cancer in women worldwide, ...". This is interesting, but this is six years ago, so presumably this is out-of-date. Is there anything more recent? Snowman (talk) 16:51, 31 May 2014 (UTC)
I can't find a review of this size using more recent data. Please note WP:MEDRS asks for reviews published in the last 5 years and this was published in 2011.--LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • The association between diethylstilbestrol, and clear cell adenocarcinomas is interesting, but I think that this is outside the scope of the page on cervix. The "double cervix" (see Uterus didelphys) would be relevant in the abnormalities section. Snowman (talk) 16:56, 31 May 2014 (UTC)
Thank you! I have been looking everywhere for this and I will include it. I won't be removing DSB as I think it's quite relevant. --LT910001 (talk) 23:01, 31 May 2014 (UTC)
  • "Most methods of hormonal contraception, such as the oral contraceptive pill, work primarily by preventing ovulation, ...". Wrong. POP pills do not necessarily prevent ovulation and mainly work by enhancing the cervical mucus plug. COC pills prevent ovulation. Snowman (talk) 15:47, 1 June 2014 (UTC)
Please provide a reliable source to back up this claim. --LT910001 (talk) 21:30, 2 June 2014 (UTC)
I thought is was common knowledge rather than a claim. It is really basic stuff in the field of contraception. See Progestogen-only pill, for an account of very-low-dose progestogen-only contraceptives, which do not rely on preventing ovulation. Snowman (talk) 08:47, 3 June 2014 (UTC)
  • "It is visible as a blood-tinged mucous discharge.". This implies that a "show", as it is called in the UK, is inevitable at the about the time of labour. Snowman (talk) 16:14, 1 June 2014 (UTC)
Thank you. Please clarify your concern. --LT910001 (talk) 21:30, 2 June 2014 (UTC)
Although this is not necessarily a RS for the Wiki this webpage is written by midwifes. It says; "Before labour starts, you might see a blob of mucus ...". Hence it says that a show does not always appear. Another webpage said that a show could occur 2 weeks before labour. Also, I think that it would be worth including the word "show" as an alternative common name for this phenomenon. Snowman (talk) 08:38, 3 June 2014 (UTC)
  • A number of the sources are older than five years. Do these need to be replaced to be consistent with WP:MEDMOS? Snowman (talk) 15:47, 2 June 2014 (UTC)
    This applies to medical claims, please clarify by stating the section or statement at hand. --LT910001 (talk) 21:30, 2 June 2014 (UTC)
    The "Contraception section" is supported with four different sources. Three of these are older than five years and hence incompatibly with WP:MEDMOS. Note that the "Weschler, Toni (2006)." reference is older than five years and is used five times in the article. Please check the rest of the sources for consistency with WP:MEDMOS. Snowman (talk) 13:01, 3 June 2014 (UTC)
    WP:MEDMOS is part of the Manual of Style. MEDMOS is not listed in the WP:GA criteria as a Manual of Style page that may be considered when reviewing GAs.
    On the assumption that this is actually about WP:MEDDATE, then notice how gently that section is positioned: "Here are some rules of thumb for keeping an article up-to-date, while maintaining the more-important goal of reliability. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published." There is no hard-and-fast rule against using sources that are more than 5 years old. In practice, sources up to 10 years old are routinely accepted unless there is a good reason to believe that information has changed since then. None of the things sourced to this book are likely to have changed in the last several decades. WhatamIdoing (talk) 15:11, 5 June 2014 (UTC)
  • Re; "This provides a protective seal for the uterus against the entry of pathogens and against leakage of uterine fluids.". I have never heard the expression "uterine fluids" before. What does it mean? Snowman (talk) 07:53, 3 June 2014 (UTC)
  • Omission: isthmus of the cervix, the upper third. It forms the lower segment of the uterus in pregnancy. Snowman (talk) 22:48, 3 June 2014 (UTC)

Snowmanradio, to help organise this review and my responses I've boxed what I believe to be your comments which I have addressed. If I have done this incorrectly please take out the relevant issue and we can continue discussion.--LT910001 (talk) 01:40, 6 June 2014 (UTC)

Comments from GA1 reviewer

Thanks for your comments. I feel this article is more suitable for GA promotion so will respond to your comments in full this time. --LT910001 (talk) 06:04, 31 May 2014 (UTC)

Issues resolved from GA1 reviewer
The following are unresolved from GA1.--TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 04:59, 31 May 2014 (UTC)
 Not done. Sorry, I don't know what you mean. Please let me know and I'll see what I can do. --LT910001 (talk) 21:56, 31 May 2014 (UTC)
The link in the toolbox in the upper right of this page shows that the page has links that lead to disambiguation pages. Find them and fix them.--TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 15:50, 1 June 2014 (UTC)
I see that this has now been resolved.--TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 15:52, 1 June 2014 (UTC)
 Done Removed the summary, and provided source for said information in text. I've reordered so that 'Fertility' comes before 'Childbirth'. --LT910001 (talk) 21:56, 31 May 2014 (UTC)
 Done both. --LT910001 (talk) 21:56, 31 May 2014 (UTC)
  • Cervix as reservoir: This topic also seems misleading. It suggests that the sperm end their travel at the cervix. However, Human fertilization suggests otherwise. See "The sperm plasma then fuses with the egg's plasma membrane, the sperm head disconnects from its flagellum and the egg travels down the Fallopian tube to reach the uterus." which suggest the sperm travel up the fallopian tubes.--TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 04:59, 31 May 2014 (UTC)
 Done I'm sorry for the confusion. I hope my edits have cleared this up. --LT910001 (talk) 21:56, 31 May 2014 (UTC)

TonyTheTiger, I've boxed issues I believe are resolved. If this is not the case, please take them out and we can continue discussion. --LT910001 (talk) 01:40, 6 June 2014 (UTC)

It would be logical to expand this line with an account of cervical cerclage. Snowman (talk) 09:32, 2 June 2014 (UTC)
 Not done Making sure you notice this one.--TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 14:31, 3 June 2014 (UTC)

Further comments from 97198

This is my second sweep of the article, and I'll be re-identifying the issues from above that haven't been addressed, or new issues that have arisen:

Resolved issues from 97198's second round of comments
  • I'm still not happy with the description of the lymphatic drainage, as I mentioned above. It sounds as if there may have been an error in the source(s); are you able to find another source that describes the cervical lymphatics to clear it up?
 Done The original source said "The cervix drains in three directions: laterally, in the broad ligament, to the external iliac nodes; posterolaterally along the uterine vessels to the internal iliac nodes; and posteriorly along the recto-uterine fold to the sacral lymph nodes," but having consulted the source I've added, the meaning was the anterior and lateral cervix rather than just the lateral cervix; I've corrected this. --LT910001 (talk) 23:06, 8 June 2014 (UTC)
  • I agree with Snowman's suggestion to mention liquid-based cytology along with Pap tests — unfortunately its wiki article is pretty shoddy, but it from what I can gather it's fairly widely used and there's plenty of tertiary and secondary (try Google Books if you don't have access to other textbooks) sources that discuss it as an alternative to Paps.
As far as I'm aware it isn't commonly used. Maybe mentioning it would be okay, but I don't really see the need. CFCF (talk · contribs · email) 13:44, 2 June 2014 (UTC)
http://www.ncbi.nlm.nih.gov/pubmed/24021666 seems to mention the use in endometrial cancers, so maybe it should be mentioned in uterus?
As for cervical cancers I can only say that there are 23 review articles on LBC + cervix , none of which are really relevant except Technologic advances for evaluation of cervical cytology: is newer better?, which is from 2001. I suggest we skip it. CFCF (talk · contribs · email) 13:49, 2 June 2014 (UTC)
LBC is primarily for screening for ca of cervix. However, as with conventional smears, occasionally cells from the endometrial cancers are also seen and would be reported as such. LBC could be mentioned on the uterus article, but it is more relevant in the cervix article. LBC has been routine practice in the UK for several years, so just mentioning Pap smears here would be inappropriate. This NICE review should be adequate, published in 2003 and last updated in 2014. Snowman (talk) 14:27, 2 June 2014 (UTC)
Okay, that may very well be true. In that case it would be good to add a UK guideline/review and add a sentence, but I don't agree it is necessary for a GA-review. If you'd give me a source I will gladly add it.Sorry, somehow missed your link CFCF (talk · contribs · email) 14:58, 2 June 2014 (UTC)
LBC has superseded Pap smears (at least in the UK), so I think that the article would not be up-to-date if it excluded LBC. The article includes cytology and Pap smears, but do you think Pap smears should be excluded as well? Do you know type of test is done in Sweden? (I understand this is where you live).Snowman (talk) 15:10, 2 June 2014 (UTC)
Update; I have included LBC briefly using a 2010 book ref. I am from the UK, where LBC is now routine, so excluding LBC seemed odd to me. Snowman (talk) 15:44, 2 June 2014 (UTC)
In Sweden the common practice is a Pap, and in certain cases biopsy. -- CFCF (talk · contribs · email) 07:14, 3 June 2014 (UTC)
  • The "Clinical significance" section is looking a whole lot better now; well done.
  • The "toolbox dablink" issue referred to by Tony is about the tool on the top right of the page that lists the disambiguation links in the article, but I've fixed these myself.
Thank you --LT910001 (talk) 21:34, 2 June 2014 (UTC)
  • "These abnormalities are found in both the mothers and daughters of the mothers exposed, and diethylstilbestrol is no longer used" — needs a citation.
 Done I've removed this uncited sentence and clarified the above statements as relating to the daughters. --LT910001 (talk) 23:19, 8 June 2014 (UTC)
  • Regarding Snowman's comments above about the stages of labour, I agree with LT91 that further detail is unlikely to be significantly relevant to the cervix.
Perhaps, I did not make myself clear. To me this is the problem area; "Along with other factors, cervical dilation is used to divide childbirth into stages. Generally, the active first stage of labour is defined by a cervical dilation of more than 3–5 centimetres (1.2–2.0 in), with the second phase of labor defined when the cervix is dilated to more than 10 centimetres (3.9 in), which is regarded as its fullest dilation.". I would tend to agree that there is no need for more detail here, but there is a need for the description about the stages of labour to be accurate. The beginning of the first stage of labour has two main definitions, depending on whether the early part is included or not. The dilation of the cervix is used in both definitions to mark the end of the first stage of labour and hence also the start of the second phase. The first stage ends when the cervix is dilated to about 3-4 cm dilated (international variation in this definition - ie 3 cm in some nations and 4 cm in others, and so on). The second phase begins immediately after the first stage and during the second phase the cervix dilates beyond 3-4 cm, the cervix reaches max dilation, and then the baby pushed along the birth canal, gradually at first and then the baby is born (all part of the second phase). The second stage ends when the baby is delivered and note that this is not defined by the dilation of the cervix. The cervix will have been fully dilated for the last minutes of the second stage, the exact period of time varying. Of course the full dilation of the cervix is significant, but it does not define the end of the second stage. The third stage begins when the baby is born (again not defined by the dilation of the cervix) and ends when the placenta and membranes have been delivered (of course the placenta has to pass through the cervix). The is basic stuff, and mistakes or ambiguities would be an embarrassment to the Wiki. See "Intrapartum care: Care of healthy women and their babies during childbirth". NICE. 2007. {{cite web}}: Unknown parameter |month= ignored (help), which is an authoritative statement on childbirth in the UK and it gives clear accounts of the stages of labour. Perhaps, the most relevant thing to say is that midwifes and doctors use the degree of dilation of the cervix together with other factors to assess the progress of labour. Snowman (talk) 14:37, 1 June 2014 (UTC)
Is this really necessary? I feel it is more relevant in an article like childbirth, and here we should probably stick to mentioning it and then linking to childbirth, somewhat like the bottom suggestion from SMR. CFCF (talk · contribs · email) 13:44, 2 June 2014 (UTC)
Of course, dramatically shortening the section on childbirth could provide an alternative solution and it think that this would work. Snowman (talk) 14:20, 2 June 2014 (UTC)
 Not done This does not relate to the GA criteria, and both the primary reviewer and I do not see this as necessary. I will not be shortening childbirth nor will I be including this information. We have wikilinks that do a stellar job at linking users to relevant articles. --LT910001 (talk) 21:34, 2 June 2014 (UTC)
Correcting the definitions of the stages of labour is well within GA criteria. Snowman (talk) 08:39, 3 June 2014 (UTC)
  • "The number of past vaginal deliveries is a strong factor in influencing how rapidly the cervix is able to dilate in labour" — I perhaps wasn't clear about this above, but you should clarify that more past vaginal deliveries lead to quicker dilation (basically, you've said that there's a correlation but not how they're correlated).
 Not done It is surprisingly difficult to find any reliable sources that state that this is proportional. All the books and sources I have consulted differentiate between the times taken in multiparous women and primiparous women, but do not say that there is a direct correlation between parity and speed of dilation. Thus the strange wording currently. --LT910001 (talk) 23:19, 8 June 2014 (UTC)

As I see it, there are only a few minor issues remaining which can hopefully be resolved fairly easily. In the meantime, I'll keep the review on hold. 97198 (talk) 13:22, 1 June 2014 (UTC)

Personally speaking, I would like to know what some members of WP Medicine about think parts of the article to make sure that the article is not going-off the rails anywhere. May I ask user 97198, if there are any aspects of cytology, clinical medicine, pharmacology, or anything else that you would like assistance with in your review of this article. This GA covers a broad topic. It would be appropriate for GA reviewers to ask at Wiki Project talk pages for a relatively expert opinion about something, even for small sections of the article. By way of an example, see the GA nomination on the Salt article, where a section on the health aspects of salt were reviewed and amended following a request to WP Medicine and the final outcome was satisfactory to all interested participants. Snowman (talk) 16:12, 1 June 2014 (UTC)
I'd be willing to offer assistance concerning this if you need any help, just ping me and I'll come running! CFCF (talk · contribs · email) 13:38, 2 June 2014 (UTC)
That would be fine by me. I have also notified WP medicine to see if anyone else is interesting in contributing. Snowman (talk) 14:37, 2 June 2014 (UTC)
Thanks, CFCF. If you're happy to do it, it would be great if you could read over the article and highlight anything you find that you think is problematic. @Snowmanradio: I do feel pretty comfortable with medical topics, and especially gynaecology, otherwise I wouldn't have taken on the review, although if anyone from WP:MED has any additional comments to offer, that would be helpful. 97198 (talk) 04:00, 3 June 2014 (UTC)
I've looked over the article and found some small things which I corrected myself. On the whole I would say the article is of high quality and your comments have helped it further. I don't really have anything further to add. CFCF (talk · contribs · email) 07:14, 4 June 2014 (UTC)
Apart from this red link Vaginal adenosis CFCF (talk · contribs · email) 07:16, 4 June 2014 (UTC)
Thank you CFCF. --LT910001 (talk) 21:34, 2 June 2014 (UTC)
I would ask user User:CFCF to comment on my queries above including what is the meaning of "uterine fluids" and the relevance of the isthmus of the cervix. I would ask user User:LT910001 to bring the citations in the clinical sections up to WP:MEDMOS standards. I think that the readability is not yet good enough is parts. I have not finished checking factual content. I will correct the text on the stages of labour myself. Snowman (talk) 08:30, 4 June 2014 (UTC)

I overlooked that comment because to me uterine fluids simply refers to any fluid excreted by the uterine glands. I understand this might not be entirely clear for a lay reader though. Possibly needs clarification. CFCF (talk · contribs · email) 14:57, 4 June 2014 (UTC)

Again, I have marked addressed issues as 'resolved', if I have wrongly identified any please unbox it and we can continue discussion. --LT910001 (talk) 23:06, 8 June 2014 (UTC)

Stop

Snowmanradio, please stop

This process is insane. Snowmanradio, I am extremely unhappy with your conduct during this review. I have noted this on your talk page. With regards to your review:

  • Please do not simultaneously review and edit
  • You do not WP:OWN the article. Your edits are often completely unrelated to discussion and even at times at odds with it () and they are unrelenting in nature. You have made 27 edits since the review started.
  • Please do not make a huge amount of edits while this article is under review. This is completely insane, the article will not be able to be reviewed and I will not be able to respond if the article is constantly changing in front of our eyes.
  • Please stop following me from review to review (Met at Anatomy, 20 May Esophagus , 30 May Cervix , 5 June Parathyroid gland )
  • Please list your comments once, in a single location, and wait for a reply.
  • Please do not make ambiguous demands (" I think that the readability is not yet good enough..." "In my opinion this article has not been prepared adequately ..." )
  • Please do not insult me ("amateurish", again () and again ("It is really basic stuff in the field of contraception", and again )
  • Please do not modify my signatures or indentation is the midst of a discussion as you have just done. ()
  • Please show understanding of the GARC, which do not demand complete comprehensiveness, and MEDRS, which does not require sources be less than 5 years old. ()
  • If you want to review the article yourself, (cfr. Esophagus and comments about the primary reviewer here), please take up the responsibility and do it, rather than reviewing an article pre-GA or acting as a secondary reviewer.

To clarify, I am more thank happy to work with other contributors on a review, and I believe I have a track record of doing this both are reviewer and nominee, and in article space. I am not happy when dealing with a reviewer who follows me from article to article, significantly rewrites content I've put a lot of effort into making while it is actively or about to be reviewed, who is unable to compromise during discussion, and who personally insults me. --LT910001 (talk) 04:42, 5 June 2014 (UTC)

Update: raised at AN/I: Misplaced Pages:Administrators'_noticeboard/Incidents#User_stalking_and_harassment_by_Snowmanradio --LT910001 (talk) 05:37, 5 June 2014 (UTC)
For what it's worth, I'm inclined to agree with LT910001. I am more than happy to collaborate with other users in writing, improving and reviewing articles but many of your contributions to this review have been less than productive and unnecessarily nitpicky for a GAN. You've shown a complete unwillingness to compromise on any of the points you've raised and it seems as if, regardless of what changes were made, you would never support this article's passing. GA is not about making articles perfect; see WP:GVF. 97198 (talk) 11:37, 5 June 2014 (UTC)

Reply

You will reply, please do so below:

Hiatus

I am determined to get this article passed. To keep track of the review I've boxed the issues I think are resolved; if they are not please let me know. 97198, I'm really quite exhausted and will take a couple of days to catch my breath and recover. I would like to ask everyone here to slow down and restrain editing of the actual article for a while. When the article's stable again, the review can continue. 91798, I'd ask you, when the article is a bit more stable, to give this article a thorough re-read as it has changed quite a bit. I would like this article to be able to be read by laypeople, and so I'd be grateful if you could point out anything that has been included that hinders this or could be included to facilitate this.

Lastly, I have pretty strong feelings about including "Contraception" in "Clinical significance" section but I am not feeling up to editing and will, with consensus, make this change after I have come back. I feel it is, essentially, a form of implicit sexism to consider issues such as contraception as under the purview of clinical medicine. Contraception is a choice and should be viewed from the perspective of the woman (ie from a social / culture or incorporated into the 'function' section) rather than from the perspective of a practitioner. --LT910001 (talk) 01:40, 6 June 2014 (UTC)

 Done moved to 'function' section. --LT910001 (talk) 23:22, 8 June 2014 (UTC)

97198 I believe I have addressed your concerns. --LT910001 (talk) 23:22, 8 June 2014 (UTC)

Okay, looking good. There are just a few small things that I'd like to see fixed:
  • The first paragraph of the lead is somewhat awkwardly worded, with a lot of very short sentences beginning the same way. Could this be reworded slightly to improve the flow?
 Done--CFCF (talk · contribs · email) 11:31, 9 June 2014 (UTC)
  • Ref #6 ("SINGER2005") is broken.
 Done--CFCF (talk · contribs · email) 11:29, 9 June 2014 (UTC)
  • Inconsistencies between British and American English have been introduced in edits throughout the review (such as oestrogen/estrogen and foetus/fetus). Either is fine, but the article should be consistent.
 Done oestrogen estrogen Feel free to change.--CFCF (talk · contribs · email) 11:29, 9 June 2014 (UTC)
Other than that, in my opinion the article meets all of the GA criteria, so if you ping me after making those changes I think it'll be ready to pass (finally!). 97198 (talk) 08:48, 9 June 2014 (UTC)
I'm guessing it is okay that I made those minor changes. 97198 -- CFCF (talk · contribs · email) 11:32, 9 June 2014 (UTC)
Thanks! It all looks good to me so I'll go ahead and promote the article. 97198 (talk) 11:38, 9 June 2014 (UTC)

Post-GA gratuitous feedback

Some comments: Cas Liber (talk · contribs) 14:15, 9 June 2014 (UTC)

  • I changed the first section name to Structure and location as we need to slot in somewhere that the supravaginal part lies behind the bladder and is separated from it by cellular tissue known as parametrium. The uterine arteries run through this. Also, the upper part of the cervix is covered by peritoneum posteriorly - this segment of the peritoneal cavity is the recto-uterine pouch and hence the rectum lies behind this, though there may be some ileum in the way too (all this from Gray's Anatomy, p. 1574 of my old 1967 copy...but I doubt it will have changed). Was going to put it in but felt it'd be prudent to figure where the best spot to put it in'd be.....
I've changed back to "Structure", per WP:MEDMOS#Anatomy, which is a fairly standard layout for almost all our anatomy articles. --LT910001 (talk) 03:38, 10 June 2014 (UTC)
  • Also - the whole article is about the human cervix...I have no idea about other mammalian cervixes and how we cover it.....
Yep. Per WP:MEDMOS#Anatomy such a section would be placed in a subsection "Other animals" and, when necessary, with subsections relating either to the animals or to vertebrates/invertebrates. The reason that this is done in a separate section rather than throughout the entire article is because the vast majority of knowledge about cervix and sources relate to human anatomy. --LT910001 (talk) 03:38, 10 June 2014 (UTC)
  • The article also does not mention that the cervix has more connective and less muscle tissue than the rest of the uterus. This should be in the histology or structure section....
Thanks for mentioning this, please feel free to include it. My main aim in nominating for GA is that it represents a threshold I'd like to get popular anatomy articles above. For this reason I've been focused on broadness and accessibility rather than a completely comprehensive discussion. Anatomy articles are a very untended lot and there is a lot more basic work that I'd like to do on a whole swathe of articles to get them to a level other editors may wish to engage with. --LT910001 (talk) 03:38, 10 June 2014 (UTC)
I can see your rationale about buffing a wider range of articles to GA standard rather than spending a significant amount more time to buff fewer to FA. Often you get good GA reviewers, but at the end of the day there is often only one reviewer (this one got alot of feedback, which is a Good Thing). FA is good in that it applies an extra level of rigour and once you have a template you can apply some of the good advice to other articles. I am thinking this one could do with a Peer Review and then go off to FAC without too much bother, which'd be good in that it would give an improved template to work from to apply to other anatomy articles. Cas Liber (talk · contribs) 06:31, 10 June 2014 (UTC)

Peer Review

Look, I think the article is looking good and kudos to all who've gotten involved to date - I'm listing it at Peer Review - Misplaced Pages:Peer review/Cervix/archive1 - to try and help give it a shove to FAC. Cas Liber (talk · contribs) 02:14, 11 June 2014 (UTC)

Edits

I have closed this segment as a consensus was achieved in the interests of moving forward and focussing efforts on other areas. Cas Liber (talk · contribs) 15:31, 21 June 2014 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Have reverted these edits because

  1. Cancer is by definition invasive. Check out the definition by the NCI . CIN is not cervical intraepithelial cancer but cervical intraepithelial neoplasm. This is why it is an N and not a C
  2. If we read about what the Template:Main is we find that "This template is used after the heading of the summary, to link to the sub-article that has been (or will be) summarised" This section is about the role of the cervix in childbirth it is not a summary of childbirth. Thus main article for it would be "Childbirth and the cervix"
  3. Does the HPV vaccine "combat" which implies treats HPV infection once establish? As far as I am aware the answer is no. If you have a high quality ref that shows otherwise happy to look at it. The evidence we do have is that the CDC says prevents HPV and the NCI and FDA also say prevents HPV infections Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:33, 17 June 2014 (UTC)
Discussion is also taking place here What every we do we need to base our decisions on sources. If you can find high quality sources that support "combat" I would consider it. I have not been able to find any. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:12, 17 June 2014 (UTC)
"prevent" is the correct encyclopaedic medical term on technical grounds, and it's also perfectly understandable to the general reader. Technically, it is primary prevention. Imo, "combat" is journalistic in style and should be avoided here. (I find the dialogue on the so-called "peer review" page too depressing to participate in, and so am posting here.) 86.128.169.211 (talk) 09:32, 18 June 2014 (UTC)

Right, to clarify where we're at, we appear to have a consensus on "prevent HPV infection" in the intro and not using "invasive" to describe cancer. It appears as though folks agree on short sentences, a little longer than Jmh649's original versions but that he his willing to compromise a little here..? I am clarifying this as my impression is that maybe if we do have this then we close both this and the intro segment of the Peer Review at this point, and shift focus onto other areas. Cas Liber (talk · contribs) 21:04, 18 June 2014 (UTC)

Incidentally, I am ok with this - did wonder whether too off topic but on the balance important enough to be here I think. Cas Liber (talk · contribs) 21:04, 18 June 2014 (UTC)

Yes a little longer is okay. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:32, 18 June 2014 (UTC)
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

The current set of diagrams showing the four phases of dilation in the first stage of labour is nearly illegible/indecipherable

The image size is inadequate. Zooming the browser does not help. A new set of diagrams, or a larger version of the current set, is needed.

98.186.170.137 (talk) 09:31, 12 July 2014 (UTC)

(belatedly) yes I've just noticed this. Sadly, the original author is blocked, but will see what can be done about scaling it up later. Cas Liber (talk · contribs) 00:26, 21 July 2014 (UTC)
Those diagrams have still not been superseded by something better. Does anyone who reads this have a suitable replacement that is superior to the current lousy set of images? 98.186.170.137 (talk) 03:41, 26 October 2014 (UTC)
A couple of points: Fred the Oyster is still very active on Commons (profile), which is the relevant project. More importantly, the image is a well-made vector SVG file, and should be cleanly viewable at any size. Here is a 2,000 px wide PNG version. I don't think the problem is the file itself so much as the media viewer's stubbornness. I can open the file in Inkscape and it looks crisp and clear regardless of nominal size or zoom level. I'll mess with it and see if I can't figure out what's going on. Otherwise, asking Fred or posting at the Commons:Graphic Lab is the next step. Grayfell (talk) 04:45, 26 October 2014 (UTC)
I'm in over my head. I'v started a discussion here: Misplaced Pages:SVG help#Nominal size of vector-based SVG is too small. If anybody has any advice, or tips on good SVG tutorials, let me know. Grayfell (talk) 05:49, 26 October 2014 (UTC)

Development

One of the sub-sections is called "Development". Is this clear enough? Would it be better to call it "Embryology"? "Embryological development" is a bit longer, but perhaps clearer too? Snowman (talk) 13:55, 7 November 2014 (UTC)

Categories: