Transvaginal sonographic measurement of cervical length vs. Bishop score in labor induction at term: tolerability and prediction of Cesarean delivery
| Autor: | S Suguna, K. F. Quek, Jamiyah Hassan, Peng Chiong Tan, Narayanan Vallikkannu |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty Visual analogue scale Term Birth medicine.medical_treatment Bishop score Pain Gestational Age Cervix Uteri Ultrasonography Prenatal Predictive Value of Tests Pregnancy Medicine Humans Radiology Nuclear Medicine and imaging Labor Induced Prospective Studies Prospective cohort study Pain Measurement Gynecology Palpation Radiological and Ultrasound Technology business.industry Cesarean Section Obstetrics and Gynecology Gestational age General Medicine Cervical Length Measurement Exact test Parity Reproductive Medicine ROC Curve Predictive value of tests Labor induction Female business |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 29(5) |
| ISSN: | 0960-7692 |
| Popis: | To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term, to assess their tolerability (in terms of pain) and ability to predict need for Cesarean delivery.A prospective study was performed on 249 women admitted for labor induction. Cervical length was measured using transvaginal ultrasound examination. A 10-point visual analog scale (VAS) for procedure-related pain was obtained. Bishop score was determined just before labor induction and another pain score was obtained. Delivery outcome was recorded. Analyses were by t-test, Fisher's exact test, receiver-operating characteristics (ROC) curves and multivariate logistic regression.Transvaginal sonography was significantly less painful than digital examination for Bishop score assessment (mean difference in VAS score 3.46; P0.001). Analyses of the ROC curves for cervical length and Bishop score indicated that both were predictors of Cesarean delivery (area under the curve 0.611 vs. 0.607; P=0.012 vs. P=0.015, respectively) with optimal cut-offs for predicting Cesarean delivery of20 mm for cervical length and Bishop scoreor=5. Cervical length had superior sensitivity (80% vs. 64%) and marginally better positive (30% vs. 27%) and negative (89% vs. 83%) predictive values. Multivariate logistic regression analysis revealed that only nulliparity (adjusted odds ratio (AOR) 4.1; 95% CI, 2.1-8.1; P0.001) and transvaginal sonographic cervical length20 mm (AOR 3.4; 95% CI, 1.4-8.1; P=0.006) were independent predictors of Cesarean delivery.Transvaginal sonography for cervical length measurement is better tolerated than digital examination for Bishop score assessment. Both cervical length and Bishop score are useful predictors of the need for Cesarean delivery following labor induction. A cervical length20 mm at labor induction at term is an independent predictor of Cesarean delivery. |
| Databáze: | OpenAIRE |
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