SONOGRAPHIC CERVICAL CANAL LENGTH AND/ OR A BISHOP SCORE ASSESSMENT AS A PREDICTOR FOR SUCCESSFUL INDUCTION OF LABOR

Document Type : Original Article

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Department of Obstetrics and Gynecology, Alexandria University, Egypt

Abstract

Objectives: To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term. Patients and Methods: A prospective study involved 140 women subjected to induction of labor. Preinduction assessment of Modified Bishop score and transvaginal ultrasound measurement of cervical length was done. Results: One hundred and forty nulliparous women had CL <28 mm and modified Bishop score of ≥7; 84.8% (123/140) of them delivered vaginally and (17/140) delivered by cesarean section Analysis of the ROC curves for cervical length and Modified Bishop score indicated that both were predictors of Successful vaginal delivery (area under the curve 0.766 vs. 0.728; with optimal cutoffs for predicting Vaginal delivery of ≤ 18 mm for cervical length and Bishop score >7. Cervical length had superior sensitivity (83.74% vs. 65.4%) and marginally better positive (95.4% vs. 94.1%) and negative (37.5% vs. 21.8%) predictive values. Conclusions:Transvaginal sonography for cervical length measurement is better tolerated than digital examination for Modified Bishop score assessment.

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