الفهرس | Only 14 pages are availabe for public view |
Abstract Summary Traditionally preinduction cervical assessment is based on the digital examination of the cervix and evaluation of several variants, originally proposed by Bishop. The advantage of the Bishop score is that it can evaluate parameters such as consistency or station that may influence the outcome. A low Bishop score prior to labor induction has been associated with failure of induction, prolonged labor and a high rate of cesarean delivery. Also the Bishop score does not require any special equipment; however its evaluation remains a matter of controversy depending on the differences in the clinical senses of examinations. Transvaginal sonographic measurement of the cervical length has been reported as a method which can predict labor induction outcome. Transvaginal ultrasonography is likely more objective than the Bishop score and has been shown to have reduced intra- and inter observer variability. The current study was done in Beni-suef university Hospital and included 150 pregnant women admitted for induction of labor. The 150 women were tested for calculation of cervical condition according to the Bishop Score and measurement of cervical length by T. V. S before starting labor induction, which were done using prostaglandins E1 analogue (misoprostol) 25 mcg. The current study used the cut-off values of a Bishop score ≤ 7 and a cervical length > 33 mm to predict successful labor induction and By comparing both methods the best cut-off for cervical length above which CS can be predicted is 33.5 (sensitivity 86.7%, specificity 88%), while the best cut-off for Bishop Score below which CS can be predicted is 7.5 (sensitivity 98.7%, specificity 84%). Bishop score showed relatively higher area under the ROC curve, so can be considered better predictor for mode of delivery. . Conclusion Cervical length measured by transvaginal ultrasound can be considered a good predictor of successful induction of labour like Bishop score and it carries the advantage of being an objective test which does not depend on the clinician’s experience or skills and it is also less painful than digital examination and non-invasive but can’t detect cervical consistency, position and station of the head which are detected by Bishop score, however this test is more expensive and need special equipment. While Bishop Score is considered as a non-costly method for prediction of cervical status. By comparing both methods the best cut-off for cervical length above which CS can be predicted is 33.5 (sensitivity 86.7%, specificity 88%), while the best cut-off for Bishop Score below which CS can be predicted is 7.5 (sensitivity 98.7%, specificity 84%). Bishop score showed relatively higher area under the ROC curve, so can be considered better predictor for mode of delivery. |