Abstract
BackgroundAssessing the likelihood of success of induction of labour using ultrasonically measured cervical volume is an important research question.MethodA prospective observational study was carried out at North Colombo Teaching Hospital, Ragama, Sri Lanka. Pre-induction digital cervical assessment, transvaginal cervical length, and cervical volume measurements were performed. Inductions with singleton pregnancies at term were included. Basic demographic and clinical details, independent variables (Bishop score, cervical length and cervical volume), and dependent variables (frequency of delivery within 24 h and induction to delivery interval) were recorded. Vaginal delivery within 24 h was the primary outcome.ResultsWe studied 100 pregnant women who had induction of labour. Median (IQR) Bishop score was 5 (3–6), mean (SD) cervical length was 3.6 (0.7) cm, and mean (SD) cervical volume was 27.5 (10.4) cm3. Cervical length was the best predictor for predicting the likelihood of vaginal delivery within 24 h [aOR – 12.12 (3.44, 42.71); < 0.001], and cervical volume also appeared to be a significant potential predictor [aOR-1.10 (1.01, 1.17); 0.01]. Cervical length was found to have the highest AUC (0.83) followed by the cervical volume (0.74). The best cut-off value for cervical volume in predicting the likelihood of vaginal delivery within 24 h was less than 28.5 cm3 with a sensitivity of 72% and specificity of 74%.ConclusionsTransvaginal sonographic measurement of cervical volume appears to be a potential novel predictor for the likelihood of vaginal delivery within 24 h of induction of labour. Cervical length is still more superior to cervical volume in predicting the likelihood of vaginal delivery. Bishop score was not a significant predictor in this context.
Highlights
Induction of labour is one of the most frequently performed obstetric interventions in current obstetric practice [1]
Cervical length was the best predictor for predicting the likelihood of vaginal delivery within 24 h [aOR – 12.12 (3.44, 42.71); < 0.001], and cervical volume appeared to be a significant potential predictor [aOR-1.10 (1.01, 1.17); 0.01]
The best cut-off value for cervical volume in predicting the likelihood of vaginal delivery within 24 h was less than 28.5 c m3 with a sensitivity of 72% and specificity of 74%
Summary
Induction of labour is one of the most frequently performed obstetric interventions in current obstetric practice [1]. The digital cervical assessment with Bishop score is subjective and several studies have shown a poor. The likelihood of impact from measuring the cervical volume to assess cervical favourability is an important area to be studied. There is a dearth of literature with regards to the cervical volume to assess pre-induction cervical ripening. The primary aim was to evaluate the association between ultrasonically measured cervical volume and the frequency of delivery within 24 h. The secondary aim was to compare the frequency of delivery within 24 h with ultrasonically measured cervical length and Bishop score. Assessing the likelihood of success of induction of labour using ultrasonically measured cervical volume is an important research question
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