Transvaginal sonographic assessment of the cervix for prediction of successful induction of labor in nulliparous women

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Abd-Elhameed Abd-Elhafeez ◽  
Alaa Eldin Elguindy ◽  
Mohamed Abu El Fetoh Mohamed Hamed ◽  
Maii Nawara
Keyword(s):  
Cohort Study ◽  
Significant Positive Correlation ◽  
Transvaginal Ultrasound ◽  
Significant Negative Correlation ◽  
Cervical Length ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cutoff Value ◽  
Nulliparous Women ◽  
Successful Induction

Abstract Background Induction of labor is commonly performed in obstetric practice. Many methods have been suggested as good predictors of the outcome of labor induction, yet none of them is satisfactory enough. Objective To assess cervical length and uterocervical angle measured by transvaginal ultrasound as predictors of successful induction of labor. Methodology Prospective cohort study was conducted in a university-affiliated hospital over 150 nulliparous women undergoing induction of labor, in the period between May 2018 and August 2019. Transvaginal sonographic measurement of cervical length and uterocervical angle was done before induction of labor by prostaglandins. The patients were followed up till delivery and the outcome was recorded. Results The best cut-off value of cervical length for prediction of success of labor induction was 32.3 mm with 60% sensitivity and 56% specificity and the best cutoff value of uterocervical angle was 110.2 degrees with 87% sensitivity and 93% specificity. The cervical length showed a significant negative correlation while the uterocervical angle showed a significant positive correlation with the success of labor induction. Conclusion Cervical length and uterocervical angle are good predictors of successful labor induction.

Transvaginal Ultrasound Cervical Length as an Indicator for Successful Induction of Labor

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Ahmed El-Sheikh ◽  
Mohammed Mahdy, ◽  
Anwar Esmail ◽  
Mohammed El Husseny Radwan
Keyword(s):  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Induction Of Labor ◽  
Successful Induction

scholarly journals Study of pre induction transvaginal ultra-sonographic cervical length and its comparison with bishop score in predicting successful labor induction

2021 ◽  
Vol 10 (6) ◽  
pp. 2335
Author(s):  
Santosh Khajotia ◽  
Madhuri Sharma ◽  
Mool Chand Khichar ◽  
Manoj Gupta ◽  
Kavita Choudhary
Keyword(s):  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Cervical Length ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Bishop Score ◽  
Receiver Operating Characteristic Curves ◽  
Medical College ◽  
Successful Induction

Background: Induction of labor means initiation of uterine contraction, after period of viability by any method (medical, surgical or combined) before spontaneous onset of labor for the purpose of vaginal delivery. The condition of cervix or favorability is important for successful labor induction. Assessment of cervix has been used as a predictor of successful vaginal delivery. Induction of labor carried out in approximately 20% of all pregnancies. Aim and objectives of the current study were to compare the predictive value of trans-vaginal ultra-sonographic measurement of cervical length versus Bishop score prior to induction of labor in predicting the mode of delivery and maternal and fetal outcome.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology, Sardar Patel medical college and associated group of hospitals, Bikaner between February to November 2020. Study group included 100 pregnant women in which induction of labor was performed at 37-42 weeks of gestation.Results: Bishop Score appears to be a better predictor than the cervical length with sensitivity of 1.00 and a specificity of 0.12 compared to 0.52 and 1.00 respectively. In the receiver operating characteristic curves, the cut-off point for the prediction of successful induction taken was 2.6 cm cervical length and >4 for the bishop score.Conclusions: TVS cervical length could be used as alternative to Bishop score for prediction of successful labor induction in the sitting where the appropriate equipment and expertise are available. Bishop score and TVS cervical length both are good predictors of successful induction of labor. 

scholarly journals Role of transvaginal ultrasonographic cervical assessment in predicting the outcome of induction of labor

2019 ◽  
Vol 8 (2) ◽  
pp. 628
Author(s):  
Kiran Aggarwal ◽  
Anita Yadav
Keyword(s):  
Predictive Value ◽  
Cervical Length ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Labour Induction ◽  
Transvaginal Sonography ◽  
Bishop Score ◽  
Digital Examination ◽  
Significant Difference ◽  
Successful Induction

Background: Induction of labor is the most common intervention in modern obstetrics. The pre-induction ‘favourability’ of the cervix as assessed by the bishop score is very subjective. Transvaginal sonography appears to be a feasible alternative to the traditional bishop’s score. Aim of this study, was to compare cervical assessment by transvaginal sonography and digital examination in prediction of outcome of labor induction.Methods: Three hundred women at term with maternal and foetal indications for labor induction were included in the study. Modified Bishop score was assessed by digital examination and the cervical length was measured by Transvaginal sonography (TVS). Successful labor induction was taken as a vaginal delivery within 24 hours from the start of induction. Data were analyzed using SPSS for Windows 15.0.Results: Labour induction was successful in 81.33% of patients. Mean cervical length by digital examination was 2.6 cm, whereas the mean sonographic cervical length was 3.4cm. There was a significant difference of 0.8cm in mean cervical length measured by two methods (P=0.01). The best cut off point for predicting successful induction of labor was ≤3.4cm for sonographic cervical length (sensitivity 0.82, specificity 0.87, positive predictive value 0.77 and negative predictive value 0.25). The best cut off point for Modified Bishop score was 2 (sensitivity 0.95, specificity 0.93). The ROC curve showed that compared to TVS cervical length, Modified Bishop score was the best parameter for predicting successful induction of labor.Conclusions: Transvaginal sonographic cervical length measurement can be used as an adjunct tool to the traditional Bishop score for predicting successful labor induction in high risk pregnancies.

scholarly journals Prediction of labor induction outcome using different clinical parameters

2013 ◽  
Vol 141 (11-12) ◽  
pp. 770-774 ◽  
Author(s):  
Zaklina Tatic-Stupar ◽  
Aleksandra Novakov-Mikic ◽  
Mirjana Bogavac ◽  
Stevan Milatovic ◽  
Slobodan Sekulic
Keyword(s):  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Obstetrics And Gynecology ◽  
Clinical Parameters ◽  
Bishop Score ◽  
Test Results ◽  
Clinical Centre

Introduction. Induction of labor is one of the most common obstetric interventions in contemporary obstetrics. Objective. The aim of the study was to evaluate the clinical and sonographic parameters in prediction of success of labor induction. Methods. The prospective study included 422 women in whom induction of labor was carried out at the Department of Obstetrics and Gynecology of Clinical Centre of Vojvodina. The role of body mass index and age of women, parity Bishop score, cervical length measured by transvaginal ultrasound was evaluated in regard of the success of induction, which was considered successful if a vaginal delivery occurred within 24 hours after the onset of induction. Data were statistically analyzed by univariate statistical analysis and Pearson?s ?2 test. Results. Out of 422 women, induction of labor was successful in 356 (84.4%), and it failed in 66 (15.6%) cases. The values of Bishop score and cervical length had positive correlation with the success of induction. Conclusion. Bishop score and transvaginal cervical length were both reliable predictors in determining the success of labor induction, as well as parity and BMI. These parameters are mostly complementary, not competitive in prediction of labor induction success.

scholarly journals Uterine Cervical Change at Term Examined Using Ultrasound Elastography: A Longitudinal Study

2020 ◽  
Vol 10 (1) ◽  
pp. 75
Author(s):  
Hyun Soo Park ◽  
Hayan Kwon ◽  
Ja-Young Kwon ◽  
Yun Ji Jung ◽  
Hyun-Joo Seol ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cervical Length ◽  
Labor Induction ◽  
Ultrasound Elastography ◽  
Antenatal Visit ◽  
Mean Values ◽  
Nulliparous Women ◽  
Hardness Ratio ◽  
Cesarean Delivery Rate ◽  
Time Of Admission

The aim of the study was to investigate if there are changes in elastographic parameters in the cervix at term around the time of delivery and if there are differences in the parameters between women with spontaneous labor and those without labor (labor induction). Nulliparous women at 36 weeks of gestation eligible for vaginal delivery were enrolled. Cervical elastography was performed and cervical length were measured using the E-CervixTM system (WS80A Ultrasound System, Samsung Medison, Seoul, Korea) at each weekly antenatal visit until admission for spontaneous labor or labor induction. E-Cervix parameters of interest included elasticity contrast index (ECI), internal os strain mean level (IOS), external os strain mean level (EOS), IOS/EOS strain mean ratio, strain mean level, and hardness ratio. Regression analysis was performed using days from elastographic measurement at each visit to admission for delivery and the presence or absence of labor against cervical length, and each E-Cervix parameter fitted to a linear model for longitudinal data measured repeatedly. A total of 96 women were included in the analysis, (spontaneous labor, n = 39; labor induction, n = 57). Baseline characteristics were not different between the two groups except for cesarean delivery rate. Cervical length decreased with advancing gestation and was different between the two groups. Most elastographic parameters including ECI, IOS, EOS, strain mean, and hardness ratio were significantly different between the two groups. In addition, ECI, IOS, and strain mean values significantly increased with advancing gestation. Our longitudinal study using ultrasound elastography indicated that E-cervix parameters tended to change linearly at term near the time of admission for delivery and that there were differences in E-Cervix parameters according to the presence or absence of labor.

Midtrimester Cervical Length in Low-Risk Nulliparous Women for the Prediction of Spontaneous Preterm Birth: Should We Consider a New Definition of Short Cervix?

2021 ◽  
Author(s):  
Paul Guerby ◽  
Mario Girard ◽  
Geneviève Marcoux ◽  
Annie Beaudoin ◽  
Jean-Charles Pasquier ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Health Care Providers ◽  
Gestational Age ◽  
Roc Curve ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Care Providers ◽  
Operating Characteristics ◽  
Spontaneous Preterm Birth ◽  
Nulliparous Women

Objective The study aimed to estimate the predictive value of midtrimester cervical length (CL) and the optimal cut-off of CL that should be applied with asymptomatic nulliparous women for the prediction of spontaneous preterm birth (sPTB). Study Design This is a prospective cohort study of asymptomatic nulliparous women with a singleton gestation. Participants underwent CL measurement by transvaginal ultrasound between 20 and 24 weeks of gestation. The participants and their health care providers remained blinded to the results of CL measurement. The primary outcomes were sPTB before 35 weeks and sPTB before 37 weeks. Receiver operating characteristics (ROC) curve analyses were performed. Analyses were repeated by using multiples of median (MoM) of CL adjusted for gestational age. Results Of 796 participants, the mean midtrimester CL was 40 ± 6 mm with a 1st, 5th, and 10th percentile of 25, 29, and 32 mm, respectively. ROC curve analyses suggest that a cut-off of 30 mm was the optimal CL to predict sPTB before 35 weeks (area under the ROC curve [AUC]: 0.70, 95% confidence interval [CI]: 0.56–0.85) and before 37 weeks (AUC: 0.70, 95% CI: 0.59–0.80). Midtrimester CL <30 mm could detect 35% of all sPTB before 35 weeks at a false-positive rate of 5% (relative risk: 9.1, 95% CI: 3.5–23.5, p < 0.001). We observed similar results using a cut-off of CL <0.75 MoM adjusted for gestational age. Conclusion A midtrimester CL cut-off of 30 mm (instead of 25 mm), or CL less than 0.75 MoM, should be used to identify nulliparous women at high risk of sPTB. Key Points

scholarly journals Evaluation of pre induction scoring by clinical examination vs transvaginal sonography

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.

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