Prediction of an effective cervical ripenning in the induction of labour using vaginal dinoprostone.

Autor: López Jiménez N; Department of Obstetrics and Gynecology, Hospital Universitario de Torrevieja, 03186, Torrevieja, Spain., García Sánchez F; Department of Obstetrics and Gynecology, Hospital General Universitario Nuestra Señora del Prado, 45600, Talavera de la Reina, Toledo, Spain., Pailos RH; Department of Gynecology, Hospital Universitario Ramón y Cajal, 28034, Madrid, Spain., Rodrigo Álvaro V; Department of Obstetrics and Gynecology, Hospital La Mancha Centro, 13600, Alcázar de San Juan, Ciudad Real, Spain., Pascual Pedreño A; Department of Obstetrics and Gynecology, Hospital La Mancha Centro, 13600, Alcázar de San Juan, Ciudad Real, Spain., Moreno Cid M; Department of Obstetrics and Gynecology, Hospital La Mancha Centro, 13600, Alcázar de San Juan, Ciudad Real, Spain., Hernández Martínez A; Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla La Mancha IDINE, 13071, Ciudad Real, Spain. antonio.hmartinez@uclm.es., Molina Alarcón M; Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha IDINE, 02001, Albacete, Spain.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Apr 26; Vol. 13 (1), pp. 6855. Date of Electronic Publication: 2023 Apr 26.
DOI: 10.1038/s41598-023-33974-7
Abstrakt: To develop a predictive model for successful cervical ripening in women that undergo induction of labour by means of a vaginal prostaglandin slow-release delivery system (Propess®).  Prospective observational study on 204 women that required induction of labour between February 2019 and May 2020 at "La Mancha Centro" hospital in Alcázar de San Juan, Spain. The main variable studied was effective cervical ripening (Bishop score > 6). Using multivariate analysis and binary logistic regression, we created three initial predictive models (model A: Bishop Score + Ultrasound cervical length + clinical variables (estimated fetal weight, premature rupture of membranes and body mass index)); model B: Ultrasound cervical lenght + clinical variables; and model C: Bishop score + clinical variables) to predict effective cervical ripening. All three predictive models obtained (A, B and C) presented good predictive capabilities, with an area under the ROC curve ≥ 0.76. Predictive model C, composed of the variables: gestational age (OR 1.55, 95% CI 1.18-2.03, p = 0.002), premature rupture of membranes (OR 3.21 95% CI 1.34-7.70, p = 0.09) body mass index (OR 0.93, 95% CI 0.87-0.98, p = 0.012), estimated fetal weight (OR 0.99, 95% CI 0.99-1.00, p = 0.068) and Bishop score (OR 1.49 95% CI 1.18-1.81, p = 0.001), is presented as the model of choice with an area under the ROC curve of 0.76 (95% CI 0.70-0.83, p < 0.001). A predictive model composed of the variables: gestational age, premature rupture of membranes, body mass index, estimated fetal weight and Bishop score upon admission presents good capabilities in predicting successful cervical ripening following administration of prostaglandins. This tool could be useful in making clinical decisions with regard to induction of labour.
(© 2023. The Author(s).)
Databáze: MEDLINE
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