Transvaginal sonographic measurement of cervical length versus Bishop score in labor induction at term for prediction of caesarean delivery.

OBJECTIVE

The current study aims to compare between a transvaginal sonographic measurement of cervical length and Bishop score in the induction of labor (IOL) at term for prediction of cesarean delivery (CD).

MATERIALS AND

METHODS

A prospective cohort study included 320 full-term pregnant women attending Ain Shams Maternity Hospital in the period from August 2017 to February 2018 were enrolled. Seventy-three women were delivered by CD (positive group), and 247 women were delivered vaginally (negative group). All patients had a vaginal examination for assessing the Bishop Score before IOL then a transvaginal ultrasound for assessment of cervical length. IOL was initiated by using PGE1 analog. The primary outcome measure was the accuracy of the cervical length or the bishop score for prediction of the CD.

RESULTS

In our current study, CD was achieved in 22.8% of all participants while vaginal delivery was achieved in 77.8% after IOL by misoprostol 25 micrograms within 24 h from the beginning of induction. Both the cervical length and Bishop Score had poor predictive value for CD (AUC = 0.694 and 0.623, respectively).

CONCLUSIONS

Both transvaginal sonography for cervical length and Bishop score are useful predictors of the need for CD following labor induction.