Transvaginal Ultrasonographic Cervical Assessment as a Predictor Of Successful Labor Induction | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 4, Volume 1, Issue 1, December 2000, Pages 48-59 PDF (571.82 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2000.11014 | ||
| Authors | ||
| Nahed H. Mohamed1; Naglaa H. Mohamed1; Mahmoud A. Mansour2 | ||
| 1Obstetrics and Gynecology Department, Faculty of Medicine for Girls | ||
| 2Biochemistry Department, Faculty of Pharmacy Al- Azhar University | ||
| Abstract | ||
| OBJECTIVE: To assess cervical maturation before labor induction with measurements obtained by transvaginal scans. Cervical length and detection rate of cervical gland area, were compared with Bishop score and serum Prostaglandin E2 levels at term for duration of labor, successful labor induction and mode of delivery. STUDY DESIGN: Transvaginal scans were performed for detection of cervical gland area and measurements of cervical length in 80 singleton pregnant women scheduled for induction of labor at >37 weeks of gestation. Cervical ripening was assessed simultaneously by Bishop score and preinduction serum prostaglandin E2 metabolite was detected by ELISA technique. Results were compared against parity, gestational age, and mode of delivery and induction-to-delivery interval. RESULTS: Seventy percent of the studied women were delivered vaginally (46.7% of nulliparous and 84 % of multiparous women). Women with cervical length <3.0 cm and also women with higher PGE2 levels had shorter labors (P< 0.01) and were more likely to be delivered vaginally (P< 0.05). Significant decrease in the detection rate of cervical gland area in women who had shorter labors and were delivery vaginally (P<0.05) and also in multiparous than nulliparous women (P < 0.01) . The mean serum PGE2 level was significantly higher in multiparous than nulliparous women (P < 0.01). Women with Bishop score > 4 also had shorter labors and were more likely to be delivered vaginally (P< 0.05). Whereas, there was no significant difference in the mode of delivery with Bishop score < 4 (P >0.05). Cervical length, detection rate of cervical gland area serum PGE2 levels, and Bishop score showed linear correlation with duration of labor (r =0.47 P< 0.05, r =0.58 P< 0.01, r = 0.67 P< 0.05 and r = 0.43, P <0.01 respectively). CONCLUSIONS: Ttransvaginal ultrasonographic cervical measurement is comparable to Bishop score in assessing cervical ripeness for labor induction. Cervical measurement parity and serum PGE2 were independent predictors of the mode of delivery. Whereas, the mode of delivery cold not be predicted in women with Bishop score < 4. | ||
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