Comparison of transvaginal sonographic cervical length measurement and Bishop score for predicting labour induction outcomes

Katja Vince; Tamara Poljičanin; Ratko Matijević

doi:10.1515/jpm-2022-0140

Article

Comparison of transvaginal sonographic cervical length measurement and Bishop score for predicting labour induction outcomes

Katja Vince , Tamara Poljičanin and Ratko Matijević

Published/Copyright: June 3, 2022

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal Journal of Perinatal Medicine Volume 50 Issue 9

Abstract

Objectives

Induction of labour (IOL) is of increasing prevalence worldwide and reliable prediction of its successful outcome is important. Traditional clinical methods for predicting successful IOL outcomes have been supplemented with newer technologies. The aim of this study was to compare transvaginal sonographic (TVS) cervical length measurement with Bishop score in predicting labour induction outcomes.

Methods

This study included pregnant women with term pregnancy, indication for IOL and unfavourable cervix (Bishop score >6) who had TVS performed prior to IOL. Exclusion critetia were regular contractions, ruptured membranes, non-cephalic presentation, uterine scar and pregnancy complications potentially influencing study outcomes. Outcomes measured were successful IOL defined as achievement of active phase of labour and vaginal delivery. Receiver operating characteristic (ROC) curves were used to determine diagnostic accuracy and sensitivity, specificity, positive and negative predictive values. Statistical significance was defined as p<0.05.

Results

Among 112 studied participants, IOL was successful in 101 (90.2%) pregnant women. AUC for Bishop score >2 was 0.831 (95% CI, 0.744–0.917, p<0.001) and for cervical length <30 mm 0.679 (95% CI 0.514–0.844, p<0.052). A total of 81 (72.3%) pregnant women delivered vaginally; AUC for Bishop score >2 was 0.754 (95% CI 0.648–0.861, p<0.001) and for cervical length <30 mm 0.602 (95% CI 0.484–0.720, p=0.092) which was the only insignificant predictor.

Conclusions

Bishop score >2 is a better predictor for both successful IOL and vaginal delivery among induced women with term pregnancy and unfavourable cervix compared to cervical length <30 mm.

Keywords: Bishop score; labour induction; prediction; transvaginal sonography; unfavourable cervix

Corresponding author: Katja Vince, Department of Gynecology and Obstetrics, University Hospital Merkur, Zajčeva 19, 10000 Zagreb, Croatia, Phone: +385 91 7621 900, E-mail: katjavince@gmail.com

Acknowledgments

The authors would like to thank fellow colleagues at Department of Gynecology and Obstetrics, University Hospital Merkur for assistance in data collection.

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013). Ethical approval for the study was obtained from School of Medicine University of Zagreb Ethical Committee and University Hospital Merkur Ethical Committee, grant number 0311-11089.

References

1. WHO. WHO recommendations for induction of labour. WHO; 2018. 6–7. Available from: https://apps.who.int/iris/bitstream/handle/10665/277233/9789241550413-eng.pdf [Accessed 7 Apr 2022].Search in Google Scholar

2. Alfirevic, Z, Keeney, E, Dowswell, T, Welton, NJ, Medley, N, Dias, S, et al.. Which method is best for the induction of labour? A systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Assess 2016;20:1–584. https://doi.org/10.3310/hta20650.Search in Google Scholar PubMed PubMed Central

3. Abisowo, OY, Oyinyechi, AJ, Olusegun, FA, Oyedokun, OY, Motunrayo, AF, Abimbola, OT. Feto-maternal outcome of induced versus spontaneous labour in a Nigerian tertiary maternity unit. Trop J Obstet Gynaecol 2017;34:21–7.10.4103/TJOG.TJOG_59_16Search in Google Scholar

4. Lindegren, L, Stuart, A, Fagerberg, MC, Källén, K. Retrospective study of maternal and neonatal outcomes after induction compared to spontaneous start of labour in women with one previous birth in uncomplicated pregnancies ≥41+3. J Perinat Med 2020;49:23–9. https://doi.org/10.1515/jpm-2020-0312.Search in Google Scholar PubMed

5. Obeidat, RA, Almaaitah, M, Ben-Sadon, A, Istaiti, D, Rawashdeh, H, Hamadneh, S, et al.. Clinical predictive factors for vaginal delivery following induction of labour among pregnant women in Jordan. BMC Pregnancy Childbirth 2021;21:685. https://doi.org/10.1186/s12884-021-04151-3.Search in Google Scholar PubMed PubMed Central

6. Freret, TS, Woods, GT, James, KE, Kaimal, AJ, Clapp, MA. Incidence of and risk factors for failed induction of labor using a contemporary definition. Obstet Gynecol 2021;137:497–504. https://doi.org/10.1097/AOG.0000000000004257.Search in Google Scholar PubMed

7. Vince, K, Matijević, R. Comparison of intracervical and intravaginal prostaglandin E2 for induction of labor in term pregnancies with unfavorable cervix: randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2022;270:100–4. https://doi.org/10.1016/j.ejogrb.2022.01.004.Search in Google Scholar PubMed

8. Wormer, KC, Bauer, A, Williford, AE. Bishop score. In: StatPearls. Treasure Island, FL: StatPearls Publishing 2022; 2021.Search in Google Scholar

9. Marconi, AM. Recent advances in the induction of labor. F1000Res 2019;8:F1000. Faculty Rev-1829. https://doi.org/10.12688/f1000research.17587.1.Search in Google Scholar PubMed PubMed Central

10. Garcia-Simon, R, Oros, D, Gracia-Cólera, D, Moreno, E, Paules, C, Cañizares, S, et al.. Cervix assessment for the management of labor induction: reliability of cervical length and Bishop score determined by residents. J Obstet Gynaecol Res 2015;41:377–82. https://doi.org/10.1111/jog.12553.Search in Google Scholar PubMed

11. Khazardoost, S, Vahdani, FG, Latifi, S, Borna, S, Tahani, M, Rezaei, MA, et al.. Pre-induction translabial ultrasound measurements in predicting mode of delivery compared to bishop score: a cross-sectional study. BMC Pregnancy Childbirth 2016;16:330. https://doi.org/10.1186/s12884-016-1090-x.Search in Google Scholar PubMed PubMed Central

12. Strobel, MK, Eveslage, M, Köster, HA, Möllers, M, Braun, J, de Santis, C, et al.. Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour. J Perinat Med 2020;49:195–202. https://doi.org/10.1515/jpm-2020-0189.Search in Google Scholar PubMed

13. Meier, K, Parrish, J, D’Souza, R. Prediction models for determining the success of labor induction: a systematic review. Acta Obstet Gynecol Scand 2019;98:1100–12. https://doi.org/10.1111/aogs.13589.Search in Google Scholar PubMed

14. Kolkman, DG, Verhoeven, CJ, Brinkhorst, SJ, van der Post, JA, Pajkrt, E, Opmeer, BC, et al.. The bishop score as a predictor of labor induction success: a systematic review. Am J Perinatol 2013;30:625–30. https://doi.org/10.1055/s-0032-1331024.Search in Google Scholar PubMed

15. Abdullah, ZHA, Chew, KT, Velayudham, VRV, Yahaya, Z, Jamil, AAM, Abu, MA, et al.. Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial. PLoS One 2022;17: e0262387. https://doi.org/10.1371/journal.pone.0262387.Search in Google Scholar PubMed PubMed Central

16. Hatfield, AS, Sanchez-Ramos, L, Kaunitz, AM. Sonographic cervical assessment to predict the success of labor induction: a systematic review with metaanalysis. Am J Obstet Gynecol 2007;197:186–92. https://doi.org/10.1016/j.ajog.2007.04.050.Search in Google Scholar PubMed

17. 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;280:357–62. https://doi.org/10.1007/s00404-008-0915-x.Search in Google Scholar PubMed

18. Athulathmudali, SR, Patabendige, M, Chandrasinghe, SK, De Silva, PHP. Transvaginal two-dimensional ultrasound measurement of cervical volume to predict the outcome of the induction of labour: a prospective observational study. BMC Pregnancy Childbirth 2021;21:433. https://doi.org/10.1186/s12884-021-03929-9.Search in Google Scholar PubMed PubMed Central

19. Londero, AP, Schmitz, R, Bertozzi, S, Driul, L, Fruscalzo, A. Diagnostic accuracy of cervical elastography in predicting labor induction success: a systematic review and meta-analysis. J Perinat Med 2016;44:167–78. https://doi.org/10.1515/jpm-2015-0035.Search in Google Scholar PubMed

20. Verhoeven, CJ, Opmeer, BC, Oei, SG, Latour, V, van der Post, JA, Mol, BW. Transvaginal sonographic assessment of cervical length and wedging for predicting outcome of labor induction at term: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 2013;42:500–8. https://doi.org/10.1002/uog.12467.Search in Google Scholar PubMed

Received: 2022-03-16

Accepted: 2022-05-12

Published Online: 2022-06-03

Published in Print: 2022-11-25

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0140

Keywords for this article

Bishop score; labour induction; prediction; transvaginal sonography; unfavourable cervix