Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

AbstractObjectivesThe aim of this study was to introduce cervical strain elastography to objectively assess the cervical tissue transformation process during induction of labour (IOL) and to evaluate the potential of cervical elastography as a predictor of successful IOL.MethodsA total of 41 patients with full-term pregnancies elected for an IOL were included. Vaginal ultrasound with measurement of cervical length and elastography and assessment of the Bishop Score were performed before and 3 h after IOL. The measured parameters were correlated to the outcome of IOL and the time until delivery.ResultsWe observed an association between the strain pattern and the value of the strain ratio 3 h after IOL and a successful IOL (p=0.0343 and p=0.0342, respectively) which can be well demonstrated by the results after 48 h. In our study population the cervical length and the Bishop Score did not prove to be relevant parameters for the prediction of a successful IOL.ConclusionsWe demonstrated for the first time that the cervical elastography pattern after the first prostaglandine application can help predict the outcome of IOL.

Download Full-text

VP45.01: Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.24651 ◽

2021 ◽

Vol 58 (S1) ◽

pp. 285-285

Author(s):

J. Braun ◽

M.K. Strobel ◽

M. Eveslage ◽

H. Köster ◽

M. Möllers ◽

...

Keyword(s):

Strain Ratio ◽

Induction Of Labour ◽

Strain Pattern ◽

Successful Induction

Download Full-text

P17.08: Prediction of successful induction of labour using sonographic myometrial thickness

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.14341 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 288-288

Author(s):

E. Spiegel ◽

A.Y. Weintraub ◽

B. Aricha-Tamir ◽

Y. Ben Harush ◽

R. Hershkovitz

Keyword(s):

Induction Of Labour ◽

Successful Induction ◽

Myometrial Thickness

Download Full-text

Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172903 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2900

Author(s):

Kala K. ◽

Anupama V. Rani ◽

Dharmavijaya M. N. ◽

Umashankar K. M.

Keyword(s):

Prostaglandin E1 ◽

Post Partum ◽

Induction Of Labour ◽

Delivery Time ◽

Foetal Death ◽

Tertiary Institution ◽

Oral Misoprostol ◽

Significant Difference ◽

Successful Induction ◽

Vaginal Misoprostol

Background: Misoprostol is a prostaglandin E1 analogue, a methyl-ester of prostaglandin E1 additionally methylated at C-16. Misoprostol is an effective myometrial stimulant of pregnant uterus, selectively binding to prostanoid receptors. The objective of the study was to compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD).Methods: A prospective randomised clinical trial, comparing 50µg oral and 50µg vaginal misoprostol, six hourlies for a maximum of four doses for the induction of labour in women with IUFD. All patients with IUFD after 28 weeks without previous uterine surgeries, without contraindications for prostaglandins are included in the study. The study was conducted in the Department of Obstetrics and Gynecology MVJ Medical College and Research Hospital, Hoskote. Bangalore from June 2012 to June 2015. It is a tertiary institution serving predominantly rural population. The primary outcome measure was the induction to delivery time, secondary all complications were noted.Results: Twenty-five women were randomised to the vaginal route and twenty-five to the oral route. The induction to delivery time was longer with vaginal misoprostol 10.5±4.03 compared to oral misoprostol (9.58±4.9). There was no significant difference in the amount of misoprostol needed to achieve successful induction in the two groups. 3 patients needed oxytocin augmentation to complete the induction of labour. There were no cases of failed induction. The systemic side effects (shivering, diarrhoea, vomiting and pyrexia) were more common with oral misoprostol (44.5%) compared to vaginal misoprostol (20%).Conclusions: Oral misoprostol achieved successful induction of labour in women with IUFD in a shorter time than vaginal misoprostol. Both routes are equally effective in termination of pregnancy. Sublingual route is easy to administer, patient compliant, no need for internal examination, less chance of labour dysfunction, less chance of post-partum sepsis.

Download Full-text

Evaluation of pre induction scoring by clinical examination vs transvaginal sonography

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164664 ◽

2016 ◽

Vol 6 (1) ◽

pp. 228

Author(s):

Sonali Kaur Sharma ◽

Madhu Nagpal ◽

CL Thukral

Keyword(s):

Vaginal Delivery ◽

Transvaginal Ultrasound ◽

Cervical Length ◽

Induction Of Labour ◽

Labour Induction ◽

Transvaginal Sonography ◽

Bishop Score ◽

Unfavourable Cervix ◽

Successful Induction ◽

Singleton Pregnancies

Background: The aim of the study was to find out pre-induction cervical length by TV Sonography, determine Bishops score and to co-relate the obstetric outcome with these two variables.Methods: A study was done on 100 women with singleton pregnancies at 37-42 weeks of gestation, admitted for induction of labour in the Department of Obstetrics and Gynaecology at SGRDIMSR, Vallah, Amritsar, Punjab, India. All women underwent cervical assessment by both transvaginal ultrasound and Bishop Score and the outcome of labour induction was determined.Results: Of the 100 women, 53 women had vaginal delivery and 47 landed into LSCS. Bishop score < 6 and cervical length > 3 cm are cut off values of cervical unfavourablity. Successful induction was achieved among 87.5% and 78% women with favorable cervix according to Bishop Score and Cervical length respectively .Among the 92 and 50 women with unfavourable cervix according to Bishop score and cervical length, 48 (52.17%) and 14 (28%) had vaginal delivery respectively.Conclusions: Hence, cervical length by transvaginal ultrasound is a better predictor for the success of induction of labour as compared with assessment by Bishop Score alone.

Download Full-text

A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203836 ◽

2020 ◽

Vol 9 (9) ◽

pp. 3660

Author(s):

Priyanka . ◽

Shashi Bala Arya ◽

Mirdu Sinha ◽

J. K. Goel

Keyword(s):

Pregnant Women ◽

Induction Of Labour ◽

Labour Induction ◽

Bishop Score ◽

Misoprostol Group ◽

Successful Induction ◽

Group A ◽

Vaginal Misoprostol ◽

Foley’S Catheter ◽

Group B

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.

Download Full-text