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\begin{document}

\title{The Isthmus of the Cervix: Its Anatomical, and Functional Existence
Should be Reconsidered: A Hypothesis I}



\author[1]{Ali Hegazy}%
\affil[1]{Portiuncula University Hospital}%


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  \date{May 29, 2024}


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\begin{abstract}
Objective Failures in understanding uterine functions during pregnancy
are a major shortcoming of healthcare and can be attributed to many
possible causes. Importantly, there might be flaws in the current
concept of human parturition, which creates a genuine barrier to a
greater understanding of the process. The objective of the study is to
challenge the existence of the isthmus in view of the current
evidence-based studies. Design: Research Study Setting: Portiuncula
University Hospital, Ireland Population: N/A Methods: This study
investigated the current evidence-based literature that may support our
proposed hypothesis. Main Outcome Measures: N/A Results The isthmus of
the cervix, both anatomically and functionally, does not seem to exist.
There has been no convincing evidence to support its existence since
Aschoff first proposed it in 1905. In fact, the embryological,
anatomical, and histological characteristics of the cervix and the
radiological evidence for cervical changes during pregnancy challenge
its existence. The study makes it clear that there are two opposing and
contradicting views about the isthmus. In the first view, the isthmus
and its nebulous character must be accepted, and no evidence
contradicting this concept in the human being could be found. The other
view is that the isthmus, geographically and functionally, does not
exist, and we have provided abundant evidence to support this view.
Conclusion The anatomical and functional division of the cervix into
isthmus and non-isthmus portions may be the main obstacle to
understanding cervical function and parturition and they should be
revised in light of this hypothesis.%
\end{abstract}%



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