VP57.03: Transvaginal ultrasound evaluation of cervix as a tool in predicting successful labour induction in term pregnancies: systematic review and meta‐analysis

Abstract

The study aims to determine diagnostic value of transvaginal ultrasound cervical evaluation in labour induction outcome in term pregnancies, review of published studies on pre-induction ultrasound cervix evaluation compared to Bishop score and to recognise factors in cervical evaluation that is sensitive and specific in predicting labour induction outcome. Published articles from Cochrane, PubMed/MEDLINE, Medscape, Herdin and Googlescholar were searched to find eligible studies from January 2000 up to present. Key words used are "transvaginal ultrasonography", "induction of labour", "cervical assessment" and "cervical length". Full articles obtained and studied for content, data extraction and analysis. Eligible studies are observational prospective studies that evaluated pre-induction transvaginal ultrasound cervical assessment to predict successful labour induction in term pregnancies and those comparing ultrasound cervical evaluation and Bishop score. Studies with patients already in labour were excluded, as well as narrative systematic reviews, retrospective design and case reports. A total of five published literatures were included. The analysis of pooled data demonstrated that there is no significant difference in transvaginal cervical length measurement and Bishop score in predicting successful labour induction in term pregnancies using the fixed effects (Z = 1.39; p = 0.16) models. Comparing Bishop score and cervical length, it can be seen that those data coming from Bishop score were highly favourable. However, when tested for significance at 0.05 level, it yielded a value of 1.39. This is lower than the z-value of 1.96 at 0.05 level. The review proved there is no significant difference in transvaginal cervical length measurement and Bishop score in predicting successful labour induction in term pregnancies. However, cervical length measurement as well as Bishop score yielded successful labour induction with mean cut-off values of <3cm & score of >/ = 4, respectively.