- Soghra Khazardoost 1
- Fahimeh Ghotbizadeh 2
- Sahar Latifi 3
- Maryam Tahani 4
- Mohammad Ali Ali Rezaei 5
- Masoomeh Shafaat 3
1 Associate Professor, Department of Obstetrics and Gynecology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
2 Assistant Professor, Department of Obstetrics and Gynecology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
3 Tehran University of Medical Sciences, Tehran, IR Iran
4 Department of Obstetrics and Gynecology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
5 Pediatrician, Tehran University of Medical Sciences, Tehran, IR Iran
Objectives: Determining the necessity of cesarean section (C/S) due to failure of induction of labor (IOL) is essential to avoid fetus distress. In this study, the performance of the Bishop score and trans-vaginal ultrasound measurements were compared to predict successful IOL, and the most useful cut-oﬀ points were estimated.
Methods: Nulliparous women with gestation age of > 37 weeks with a live fetus in cephalic presentation were invited to participate in this study. Bishop score was assessed by digital examination, and trans-vaginal ultrasound was used to measure cervical length. Trans-abdominal ultrasound was utilized to determine the fetal head position.
Results: One hundred women entered the study. Multiple regression analysis revealed that the Bishop score and cervical length had a reliable predictive value in determining successful IOL. The cut-oﬀ points for predicting successful induction were 16 mm for cervical length and 5 for the Bishop score, using receiver operating characteristic curves (ROC). Both cervical length and Bishop score were good predictors for vaginal delivery (sensitivity and speciﬁcity of 85% and 67%, respectively for cervical length; and 84% and 70%, respectively for Bishop score).
Conclusions: Cervical length is a good predictor of successful IOL. Considering the painful process of digital exam, implementing trans-vaginal ultrasound is preferred.
- Rayburn WF, Zhang J. Rising rates of labor induction: present concerns and future strategies. Obstet Gynecol. 2002;100(1):164-7. https://doi.org/10.1097/00006250-200207000-00024 [DOI:10.1016/S0029-7844(02)02047-1]
- Molina FS, Nicolaides KH. Ultrasound in labor and delivery. Fetal Diagn Ther. 2010;27(2):61-7. [DOI:10.1159/000287588]
- Crane JM. Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol. 2006;49(3):573-84. [DOI:10.1097/00003081-200609000-00017]
- Fitzpatrick M, McQuillan K, O'Herlihy C. Inﬂuence of persistent occiput posterior position on delivery outcome. Obstet Gynecol. 2001;98(6):1027-31. https://doi.org/10.1097/00006250-200112000-00007 [DOI:10.1016/S0029-7844(01)01600-3]
- Sizer AR, Nirmal DM. Occipitoposterior position: associated factors and obstetric outcome in nulliparas. Obstet Gynecol. 2000;96(5 Pt 1):749-52. [DOI:10.1097/00006250-200011000-00019]
- Jackson GM, Ludmir J, Bader TJ. The accuracy of digital examination and ultrasound in the evaluation of cervical length. Obstet Gynecol. 1992;79(2):214-8.
- Holcomb WJ, Smeltzer JS. Cervical eﬀacement: variation in belief among clinicians. Obstet Gynecol. 1991;78(1):43-5.
- Buchmann E, Libhaber E. Interobserver agreement in intrapartum estimation of fetal head station. Int J Gynaecol Obstet. 2008;101(3):285-9. [DOI:10.1016/j.ijgo.2007.11.020]
- Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P, Cucherat M, et al. Birth simulator: reliability of transvaginal assessment of fetal head station as deﬁned by the American College of Obstetricians and Gynecologists classiﬁcation. Am J Obstet Gynecol. 2005;192(3):868-74. [DOI:10.1016/j.ajog.2004.09.028]
- Rozenberg P, Chevret S, Chastang C, Ville Y. Comparison of digital and ultrasonographic examination of the cervix in predicting time interval from induction to delivery in women with a low Bishop score. BJOG. 2005;112(2):192-6. [DOI:10.1111/j.1471-0528.2004.00549.x]
- Rozenberg P, Chevret S, Ville Y. [Comparison of pre-induction ultrasonographic cervical length and Bishop score in predicting riskof cesarean section after labor induction with prostaglandins]. Gynecol Obstet Fertil. 2005;33(1-2):17-22.
- Chou MR, Kreiser D, Taslimi MM, Druzin ML, El-Sayed YY. Vaginal versus ultrasound examination of fetal occiput position during the second stage of labor. Am J Obstet Gynecol. 2004;191(2):521-4. [DOI:10.1016/j.ajog.2004.01.029]
- Dupuis O, Ruimark S, Corinne D, Simone T, Andre D, Rene-Charles R. Fetal head position during the second stage of labor: comparison of digital vaginal examination and transabdominal ultrasonographic examination. Eur J Obstet Gynecol Reprod Biol. 2005;123(2):193-7. [DOI:10.1016/j.ejogrb.2005.04.009]
- Sherer DM, Miodovnik M, Bradley KS, Langer O. Intrapartum fetal head position I: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the active stage of labor. Ultrasound Obstet Gynecol. 2002;19(3):258-63. https://doi.org/10.1046/j.1469-0705.2002.00641.x [DOI:10.1046/j.1469-0705.2002.00656.x]
- Kawabata I, Nagase A, Oya A, Hayashi M, Miyake H, Nakai A, et al. Factors inﬂuencing the accuracy of digital examination for determining fetal head position during the ﬁrst stage of labor. J Nippon Med Sch. 2010;77(6):290-5. [DOI:10.1272/jnms.77.290]
- Tenore JL. Methods for cervical ripening and induction of labor. Am Fam Physician. 2003;67(10):2123-8.
- ACOG Committee on Practice Bulletins - Obstetrics . ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol. 2009;114(2 Pt1):386-97. [DOI:10.1097/AOG.0b013e3181b48ef5]
- Kenyon S, Ullman R, Mori R, Whittle M. Care of healthy women and their babies during childbirth: summary of NICE guidance. BMJ. 2007;335(7621):667-8. [DOI:10.1136/bmj.39322.703380.AD]
- Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the ﬁrst cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol. 2012;120(5):1181-93. [DOI:10.1097/AOG.0b013e3182704880]
- Rouse DJ, Owen J, Savage KG, Hauth JC. Active phase labor arrest: revisiting the 2-hour minimum. Obstet Gynecol. 2001;98(4):550-4. https://doi.org/10.1016/S0029-7844(01)01516-2 [DOI:10.1097/00006250-200110000-00005]
- Chandra S, Crane JM, Hutchens D, Young DC. Transvaginal ultrasound and digital examination in predicting successful labor induction. Obstet Gynecol. 2001;98(1):2-6. https://doi.org/10.1016/S0029-7844(01)01386-2 [DOI:10.1097/00006250-200107000-00002]
- Faltin-Traub EF, Boulvain M, Faltin DL, Extermann P, Irion O. Reliability of the Bishop score before labour induction at term. Eur J Obstet Gynecol Reprod Biol. 2004;112(2):178-81. [DOI:10.1016/S0301-2115(03)00336-1]
- Reis FM, Gervasi MT, Florio P, Bracalente G, Fadalti M, Severi FM, et al. Prediction of successful induction of labor at term: role of clinical history, digital examination, ultrasound assessment of the cervix, and fetal ﬁbronectin assay. Am J Obstet Gynecol. 2003;189(5):1361-7. [DOI:10.1067/S0002-9378(03)00725-7]
- Gabriel R, Darnaud T, Chalot F, Gonzalez N, Leymarie F, Quereux C. Transvaginal sonography of the uterine cervix prior to labor induction. Ultrasound Obstet Gynecol. 2002;19(3):254-7. [DOI:10.1046/j.1469-0705.2002.00643.x]
- Rane SM, Pandis GK, Guirgis RR, Higgins B, Nicolaides KH. Preinduction sonographic measurement of cervical length in prolonged pregnancy: the eﬀect of parity in the prediction of induction-to-delivery interval. Ultrasound Obstet Gynecol. 2003;22(1):40-4. https://doi.org/10.1002/uog.165 [DOI:10.1002/uog.166]
- Yang SH, Roh CR, Kim JH. Transvaginal ultrasonography for cervical assessment before induction of labor. J Ultrasound Med. 2004;23(3):375-82. [DOI:10.7863/jum.2004.23.3.375]
- Strobel E, Sladkevicius P, Rovas L, De Smet F, Karlsson ED, Valentin 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. [DOI:10.1002/uog.2746]
- Keepanasseril A, Suri V, Bagga R, Aggarwal N. Pre-induction sonographic assessment of the cervix in the prediction of success ful induction of labour in nulliparous women. Aust N Z J Obstet Gynaecol. 2007;47(5):389-93. [DOI:10.1111/j.1479-828X.2007.00762.x]
- 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. [DOI:10.1002/uog.4018]
- 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. [DOI:10.1046/j.0960-7692.2001.00580.x]
- Gonen R, Degani S, Ron A. Prediction of successful induction of labor: comparison of transvaginal ultrasonography and the Bishop score. Eur J Ultrasound. 1998;7(3):183-7. [DOI:10.1016/S0929-8266(98)00042-1]
- Ware V, Raynor BD. Transvaginal ultrasonographic cervical measurement as a predictor of successful labor induction. Am J Obstet Gynecol. 2000;182(5):1030-2. [DOI:10.1067/mob.2000.105399]
- Uyar Y, Erbay G, Demir BC, Baytur Y. Comparison of the Bishop score, body mass index and transvaginal cervical length in predicting the success of labor induction. Arch Gynecol Obstet. 2009;280(3):357-62. [DOI:10.1007/s00404-008-0915-x]
- 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 Pt 1):227-33. [DOI:10.1097/01.AOG.0000196508.11431.c0]
- Dietz HP, Lanzarone V, Simpson JM. Predicting operative delivery. Ultrasound Obstet Gynecol. 2006;27(4):409-15. [DOI:10.1002/uog.2731]
- Eggebo TM, Heien C, Okland I, Gjessing LK, Romundstad P, Salvesen KA. Ultrasound assessment of fetal head-perineum distance before induction of labor. Ultrasound Obstet Gynecol. 2008;32(2):199-204. [DOI:10.1002/uog.5360]
- Rane SM, Guirgis RR, Higgins B, Nicolaides KH. Models for the prediction of successful induction of labor based on pre-induction sonographic measurement of cervical length. J Matern Fetal Neonatal Med. 2005;17(5):315-22. doi: 10.1080/14767050500127690. [DOI:10.1080/14767050500127690]
- Niino Y. The increasing cesarean rate globally and what we can do about it. Biosci Trends. 2011;5(4):139-50. doi: 10.5582/bst.2011.v5.4.139. [DOI:10.5582/bst.2011.v5.4.139]
- Arrieta A. Health reform and cesarean sections in the private sector: The experience of Peru. Health Policy. 2011;99(2):124-30. [DOI:10.1016/j.healthpol.2010.07.016]
- Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2009. Natl Vital Stat Rep. 2010;59(3):1-19.
- Staﬀord RS. Cesarean section use and source of payment: an analysis of California hospital discharge abstracts. Am J Public Health. 1990;80(3):313-5. [DOI:10.2105/AJPH.80.3.313]