Bishop score versus transvaginal ultrasonographic measurement of cervical length in predicting successful labor induction in post-term pregnancy: prospective cohort study

Authors

  • Mansour A. Khalifa Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
  • Ahmed M. Abbas Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
  • Mohammed A. Gaber Department of Obstetrics and Gynecology, Kom Ombo Central Hospital, Aswan, Egypt
  • Maher Salah Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184523

Keywords:

Bishop score, Induction of labor, Prolonged pregnancy, Ultrasonography

Abstract

Background: The current study aims to compare the efficacy of Bishop score assessment and transvaginal ultrasonographic measurement of the cervical length in prediction of the outcome of labor induction in post-term pregnancy.

Methods: A comparative Prospective observational study conducted in Department of Obstetrics and Gynecology, Kom Ombo central hospital from January 2017 to October 2017. Pregnant women were classified into two groups of Bishop Score Group (1): ladies with (Bishop Score <5) = unfavorable cervix and Group (2): those with (Bishop Score >5) = favorable cervix. Also, they were classified into two groups of cervical lengths: Group (1): women with (cervical length <25mm, shorter cervix) and Group (2): those with (cervical length ≥25 mm, longer cervix). The Primary outcome was Bishop score by digital examination and Cervical length by TVS.

Results: The study group was 100 women. Regarding sonographic assessment, 44 patients had cervical length <25 mm and the mean cervical length for the whole study group was 25.19±8.16 mm. Successful induction was achieved in 78 patients (78%), while CS was done in 22 patients due to failed induction.  No difference between both groups regarding the parity (p=0.063). When comparing women with successful VD versus those delivered by CS, we found significantly higher Bishop score in the first group 5.12 ± 1.93  vs 3.89 ± 1.71 in the second group (p=0.002). Additionally, VD group had significantly shorter cervix than CS group (22.31 ±7.14 vs. 35.37± 5.80 mm, p=0.007). The Bishop score showed significant moderate negative correlation with the cervical length (r=-0.589, p=0.001).

Conclusions: Success of labor induction in women undergoing induction due to prolonged pregnancy can be highly predicted by cervical length as it is more objective and accurate than Bishop Score. The 25 mm cut-off point for cervical length was the best predictor of vaginal delivery.

References

Friedman E, Labor; clinical evaluation and management, 2nd ed New York: Appleton-Century-Crofts; 1978.

Park KH. Transvaginal ultrasonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. J Kor Med Sci. 2007;22(4):722-7.

Crowley P. Interventions for preventing or improving the outcome of delivery at or beyond term. Cochrane Database of Systematic Reviews. 1997(1).

Sims ME, Walther FJ. Neonatal morbidity and mortality and long-term outcome of postdate infants. Clinic Obstet, Gynecol. 1989;32(2):285-93.

Cunningham FG, MacDonald PC and Gant NF. Post term pregnancy. Williams Obstetrics, 20™ ed. Norwalk, CT: Appleton and Lange; 1997:828.

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

Fuentes A, Williams M. Cervical assessment. Clin Obstet Gynecol. 1995; 38(2):224-31.

Honest H, Bachmann LM, Coomarasamy A, Gupta JK, Kleijnen J, Khan KS. Accuracy of cervical transvaginal sonography in predicting preterm birth: a systematic review. Ultrasound Obstet Gynecol. 2000;22(3):305-22.

Mosbeh MH and Al-Sharkawy EAA: Comparison of the modified Bishop's score, sonographic cervical length and plasma matrix metalloproteinase-9 (MMP-9) in predicting the success of labor induction, Egypt Soc Obstet Gynecol.2001,27:719-32.

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):623-28.

Meijer‐Hoogeveen M, Van Holsbeke C, Van Der Tweel I, Stoutenbeek P, Visser GH. Sonographic longitudinal cervical length measurement in nulliparous women at term: Prediction of spontaneous onset of labor. Ultrasound Obstet Gynecol. 2008;32(5):652- 6.

Keepanasseril A, Suri V, Bagga R, Aggarwal N. Pre-induction sonographic assessment of the cervix in the prediction of successful induction of labor in nulliparous women. Aust NZJ Obstet Gynaecol.2007;47(5):389-93.

Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J. Transvaginal sonographic measurement of cervical length vs. Bishop Score in labor induction at term: tolerability and prediction of Cesarean delivery. Ultrasound Obstet Gynecol. 2007;29(5):568-73.

Uzun I, Sık A, Şevket O, Aygün M, Karahasanoglu A, Yazıcıoglu HF. Bishop score versus ultrasound of the cervix before induction of labor for prolonged pregnancy: which one is better for prediction of cesarean delivery. J Maternal-Fetal Neonat Med. 2013;26(14):1450-4.

Aragao JB, Fei tosa FE, Alencar Jr, Vasconcelos RP, de Amorim MM, Passini R Jr. Cervical ultrasonography versus Bishop score as a predictor of vaginal delivery. Rev Bras Gynecol Obstet. 2011;33(11):361-6.

Yanik A, Gulumser C, Tosun M. Ultrasonographic measurement of cervical length in predicting mode of delivery after oxytocin induction. Adv Ther.2007;24(4):748-56.

Chandra S, Crane JM, Hutchens D, Young DC. Transvaginal ultrasound and digital examination in predicting successful labor induction. American College of Obstet Gynaecol, 2001;98(1):2-6.

Downloads

Published

2018-10-25

Issue

Section

Original Research Articles