DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193026

A study of preinduction transvaginal ultrasonographic cervical length and its comparison with bishop score in predicting successful labour

Tajinder Kaur, Shaveta Garg, Geetanjali Kaur, Harsharan Kaur

Abstract


Background: Significant number of induced pregnancies land in caesarean delivery. Cervical assessment is integral to successful outcome of induction of labour. Objective of this study was to study preinduction transvaginal ultrasonographic cervical length and to compare it with Bishop Score in predicting successful labour.

Methods: This prospective study was conducted at the department of obstetrics and gynaecology, MMIMSR, Mullana, Ambala on 150 patients. A total of 150 women were studied from January 2015 to June 2016 after taking an informed consent. The sociodemographic particulars were recorded, detailed history was taken and examination performed. Transvaginal ultrasound was done to assess cervical length after evacuation of bladder. Bishop score was then determined by separate observer. The occurrence of vaginal delivery was considered as primary outcome. All statistics collected were entered in statistical software SPSS-15. ROC curves were constructed for both Bishop Score and TVS.

Results: The mean gestational age was 38 week 6 days, majority 134 (89.3%) being less than 40 weeks of gestation. The ROC curve for Bishop Score demonstrated better predictability compared to cervical length by TVS. Optimized cut off for Bishop score in addition to TVS was determined by ROC curve to predict successful vaginal delivery, it was ≥ 6 for Bishop score (sensitivity 90.7%, specificity 68.6%, positive predictive value 91.5% and negative predictive value 66.7%) and ≤ 3.0 cm for cervical length on TVS (sensitivity 74.6%, specificity 51.6%, positive predictive value 74.5% and negative predictive value 51.6%). The relation of both cervical length and Bishop score with successful vaginal delivery was found to be statistically significant with p value of 0.0001.

Conclusions: The present study indicates that Bishop Score is a better predictor for successful vaginal delivery as compared to cervical length by transvaginal ultrasonography.


Keywords


Bishop Score, Cervical length, Induction of labour, Transvaginal sonography

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References


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

Khandelwal R, Patel P, Pitre D. Comparison of cervical length measured by Transvaginal Ultrasonography and Bishop Score in predicting response to labor induction. J Obs Gynae India. 2018;68(1):51-7.

Tan PC, Vallikkannu N, Sugunuta 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.

Strobel E, Sladkevicius P, Rotvas L. Bishop score and ultrasound assessment of the cervix for prediction of time to onset of labor and time to delivery in prolonged pregnancy. Ultrasound Obstet Gynecol. 2006;28(3):298-305.

Gomes F, Ramalho C, Machado AP. Transvaginal ultrasound assessment of the cervix and digital examination before labor induction. Acta Med Port. 2006;19(2):109-14.

Anish K, Vanita S, Rashmi B. Pre-induction sonographic assessment of the cervix in the prediction of successful induction of labour in nulliparous women. Australian New Zealand J Obstet Gynaecol. 2007;47:389-93.

Yang SH, Roh CR, Kim JH. Transvaginal ultrasonography for cervical assessment before induction of labour. J Ultrasound Med. 2004;23(3):375-82.

Gabriel R, Darnaud T, Chalot F. Transvaginal sonography of the uterine cervix prior to labor induction. Ultrasound Obstet Gynecol. 2002;19(3):254-7.

Groeneveld YJB, Bohnen AM, Van Heusen AM. Cervical length measured by transvaginal ultrasonography versus Bishop score to predict successful labor induction in term pregnancies. FVV ObGyn. 2010;2(3):187-93.

Rane SM, Pandis GK, Guirgis RR. Preinduction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in prediction of induction-to-delivery interval. Ultrasound Obstet Gynecol. 2003;22:40-4.

Ezebialu IU, Eke AC, Eleje GU. Methods for assessing pre induction cervical ripening. Cochrane Database Syst Rev. 2015;(6):1-31.