Abstract
The objective of this study was to determine the value of uterocervical angle (UCA) in predicting successful induction of labor (IOL) in singleton pregnant women compared to the Bishop score and cervical length (CL). A total of 205 normal term, singleton labor-induction cases were analyzed. Successful IOL was defined as the onset of active labor of induction. A comparative analysis was performed to evaluate the effectiveness of UCA, Bishop score, and CL in predicting IOL. Compared to the non-successful IOL group, the women in the successful IOL group had significantly wider UCA (p = 0.012) and higher Bishop score (p = 0.001); however, the CL was not significantly different (p = 0.130). UCA alone did not perform better than the Bishop score when predicting successful IOL. However, UCA combined with the Bishop score showed higher performance in predicting IOL (combined UCA > 108.4° and favorable Bishop score as sensitivity of 44.6%, specificity of 96.0%, PPV of 96.2%, and NPV of 43.6; combined UCA > 108.4° or favorable Bishop score as sensitivity of 85.7%, specificity of 50.0%, PPV of 78.7%, and NPV of 61.9). In conclusion, UCA combined with Bishop score may be an effective sonographic method for predicting successful IOL.
Highlights
Induction of labor (IOL) is a common practice in obstetrics and is followed in many countries with rates ranging from 1.4–35% [1,2]
Because IOL is a significant issue in obstetrics, evaluation of pre-delivery cervix status is an important consideration
This study investigated the value of uterocervical angle (UCA), cervical length (CL), and the traditionally used Bishop score for predicting
Summary
Induction of labor (IOL) is a common practice in obstetrics and is followed in many countries with rates ranging from 1.4–35% [1,2]. A recent publication revealed that the rate of IOL was 23.4% in the United States, 22.1% in the United Kingdom, 4.4% in African regions, 11.4% in Latin America, and 12.1% in Asian countries [2]. Various studies have defined failed IOL differently, i.e., both as no vaginal delivery and inability to achieve the active phase of labor [6]. It is crucial to evaluate predelivery cervical status. The proper selection of labor induction method, such as ripening or oxytocin, depends on cervical status, and the evaluation of a favorable cervix is a key issue in clinical obstetrics [8,9]
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