Study of comparison of transvaginal cervical length and Bishop score in predicting successful labour induction- a prospective study from a tertiary care hospital of Rajasthan

Monika; Balveer  Jakhar; Neeraj Choudhary; Susheela Khoiwal

doi:10.18203/2320-1770.ijrcog20232294

Authors

Monika Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
Balveer Jakhar Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
Neeraj Choudhary Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India
Susheela Khoiwal Department of Obstetrics and Gynecology, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232294

Keywords:

Bishop score, Cervical length

Abstract

Background: Labor induction is one of the common interventions in obstetric practice. Assessment of cervix has been used as a predictor of the successful vaginal delivery. The traditional method of predicting whether an induced labour will result in successful vaginal delivery is based on the pre induction favourability of cervix as assessed by the Bishop score. Now we used transvaginal sonography (TVS) as an objective method of assessment of cervical length to evaluate the role of the pre-induction transvaginal ultrasonographic (TVS) cervical length in predicting labour outcome and comparing it to the Bishop score in patients undergoing induction of labour.

Methods: This observational prospective study included 100 pregnant women in which induction of labour was performed at 37-42 weeks of gestation. Cervical length on transvaginal ultrasound and bishop score by digital examination is assessed prior to induction in cases according to standard protocol.

Results: In our study though the sensitivity of the Bishop score in predicting the successful labour induction was higher (75.6%) compared with that of cervical length measured trans vaginally (69.35%). The specificity and positive predictive value for the cervical length (2.7 cm) was 77.78% and 91.49% compared with the Bishop score (4) 55.55% and 81.82% respectively.

Conclusions: Bishop score and transvaginal cervical length both are good predictors of successful induction of labour. Transvaginal cervical length provides a better prediction of the likelihood of vaginal delivery within 24 hours of induction.

Metrics

Metrics Loading ...

References

RCOG. Induction of labour. In: Evidence based Clinical Guideline Number 9. London: RCOG Clinical Support Unit; 2001.

Cole RA, Howie PW, Magnaughton MC. Elective induction of labour. A randomized prospective trial. Lancet. 1975;1:767-70

Sande HA, Tuveng J, Fontelien TA. Prospective randomized study of induction of labour. Int J Gynecol Obstet. 1983;21:333-6.

Sue-A-Quan AK, Hannah ME, Cohen MM , Foster GA. Effect of labour induction on rates of still birth and cesarean section in post term pregnancies. CMAJ. 1999;160:1145-9.

O’ Brien WF. Cervical ripening and labour induction. Clin Obstet and Gynecol. 1990;163:859-67.

Andersen HF, Nugent CE, Wanty SD, Hayashi RH. Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length. Am J Obstet Gynecol. 1990;163(3):859-67.

Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-8.

Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, et al. The length of the cervix and the risk of spontaneous premature delivery. N Engl J Med. 1996;334(9):567-73.

Ware V, Raynor BD. Transvaginal ultrasonographic cervical measurement as a predictor of successful labor induction. Am J Obstet Gynecol. 2000;182(5):1030-2.

Cunningham F, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. eds. Induction and Augmentation of Labor. In: Williams Obstetrics. 26th edn. McGraw Hill; 2022:469-481.

Yu SY, Leppert PC. The collagenous tissues of the cervix during labour and delivery. In: Leppert PC, Woessner JF Jr, eds. The extracellular matrix of the cervix, uterus and fetal membranes: Synthesis, Degradation and Hormonal Regulation. Ithaca, NY: Perinatology Press; 1991:68-76.

Naftolin F, Stubblefield P. Dilation of the uterine cervix. 1st edn. New York: Raven Press; 1980.

Kleissel HP, van der Rest M, Naftolin F, Glorieux FK, de Leon A. Collagen changes in the human uterine cervix at parturition. Am J Obstet Gynecol. 1978;130:213-21.

Aspden RM. The theory of fiber reinforced composition materials applied to the mechanical properties of the cervix during pregnancy. J Theol Biol. 1988;130:213-21.

Pandis, Danielsen CC. A study of the interaction in vitro between type 1 collagen and a small dermatan sulfate proteoglycan. Biochem J. 1988;251:643-8.

Cubal T, Woessner JF Jr. Collagenase, its inhibitors, and decorin in the lower uterine segment in pregnant women. Am J Obstet Gynecol. 1993;168:1598-603.

Gomez, Cerreta JM, Mandl I. Orientation of elastic fibers in the human cervix. Am J Obstet Gynecol. 1986;155:219-24.

Vallikkanu, Ito A, Matsuta K, Mori Y. hyluronic acid is an endogenous inducer of interleukin-1 production by human monocyte and rabbit macrophages. Biochem Biophys Res Commun. 1986;140:715-22.