Ultrasound assessment of foetal head-perineum distance prior to induction of labour as a predictor of successful vaginal delivery: a prospective study from a tertiary care hospital of Rajasthan

Authors

  • Neeraj Choudhary Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Savitri Verma Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Sudha Gandhi Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Anuradha Monga Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Vimla Charan Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
  • Asha Kumari Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231940

Keywords:

Bishop score, FHPD

Abstract

Background: Induction of labor (IOL) is one of the most frequent obstetric procedures require for various obstetrics indications in 13-20% of term. Traditionally success of induction has been determined by Bishop score, but this score is observer based and significant inter observer disagreements have been noted. Ultrasound can help obstetricians in counselling patients before induction of labour and explain the probability of successful induction. So in this study we did ultrasound assessment of foetal head-perineum distance prior to induction of labour as a predictor of successful vaginal delivery.

Methods: All eligible women who are planned for induction of labour will undergo ultrasound assessment of foetal head–perineum distance prior to induction of labour. Transvaginal ultrasound will also be performed using ultrasound probe to measure cervical length. After the scans, prevaginal examination will be performed to assess the various components of modified Bishop score (min 0, max 10). If cervix is found unfavourable, induction of labour will be done. If patient did not go into active labour, then induction will be considered unsuccessful) or else oxytocin drip in cases where cervix is found favourable. The patients will be followed up till delivery.

Results: Out of 125 patients enrolled for the study, 101 women delivered successfully vaginally and 24 had to undergo caesarean delivery. Of these 24 cases of caesarean delivery, 11 cases were excluded as the operative procedure was performed for indication not related to unsuccessful induction such as occurrence of foetal distress in labour, thick meconium-stained liquor with unfavourable cervix. The final analysis was performed from 114 subjects (101 vaginal births and 13 caesarean births).

Conclusions: Transperineal fetal head–perineum distance is less painful as less time consuming and less acceptable by patients compare to Transvaginal measurement of cervical length and painful digital examination for bishop score.

References

Dückelmann AM, Bamberg C, Michaelis SM, Lange J, Nonnenmacher A, Dudenhausen JW, et al. Measurement of fetal head descent using the ‘angle of progression’ on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise. Ultra Obstet Gynecol. 2010;35(2):216-22.

Maslow AS, Sweeny AL. Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol. 2000;95(6):917-22.

Seyb ST, Berka RJ, Socol ML, Dooley SL. Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol. 1999;94(4):600-7.

Heffner LJ, Elkin E, Fretts RC. Impact of labor induction, gestational age, and maternal age on cesarean delivery rates. Obstet Gynecol. 2003;102(2):287-93.

Molina FS, Nicolaides KH. Ultrasound in labor and delivery. Fetal Diagn Ther. 2010;27(2):61-7.

Hendrix NW, Chauhan SP, Morrison JC, Magann EF, Martin JN Jr, Devoe LD. Bishop score: a poor diagnostic test to predict failed induction versus vaginal delivery. South Med J. 1998;91(3):248-52.

Pandis GK, Papageorghiou AT, Ramanathan VG, Thompson MO, Nicolaides KH. Preinduction sonographic measurement of cervical length in the prediction of successful induction of labor. Ultrasound Obstet Gynecol. 2001;18(6):623-8.

Rane SM, Guirgis RR, Higgins B, Nicolaides KH. Models for the prediction of successful induction of labor based on preinduction sonographic measurement of cervical length. J Matern Fetal Neonatal Med. 2005;17(5):315-22.

Peregrine E, O’Brien P, Omar R, Jauniaux E. Clinical and ultrasound parameters to predict the risk of cesarean delivery after induction of labor. Obstet Gynecol. 2006;107(2 Part 1):227-33.

Rane SM, Guirgis RR, Higgins B, Nicolaides KH. The value of ultrasound in the prediction of successful induction of labor. Ultrasound Obstet Gynecol. 2004;24(5):538-49.

Rane SM, Guirgis RR, Higgins B, Nicolaides KH. Pre-induction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in the prediction of the need for Cesarean section. Ultrasound Obstet Gynecol. 2003;22(1):45-8.

Rane SM, Pandis GK, Guirgis RR, Higgins B, Nicolaides KH. Pre-induction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in the prediction of induction-to-delivery interval. Ultra Obstet Gynecol. 2003;22(1):40-4.

Eggeboø TM, Gjessing LK, Heien C, Smedvig E, Okland I, Romundstad P, et al. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultra Obstet Gynecol. 2006;27:387-91.

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Published

2023-06-28

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Original Research Articles