Successful Induction Of Labor Research Articles

Comparative study of 25 mg oral and 25 mg vaginal misoprostol administration for induction of labour at term

A successful induction of labour includes adequate uterine contraction after the addition of the inducing agent, and progressive dilatation of the cervix, thereby resulting in the successful vaginal delivery. Misoprostol has been found to be more superior than other conventional methods and resulting in shorter induction to delivery time. 100 patients with 36 or more gestation period, requiring induction, were divided into 2 groups of 50 each. Group I were given 25 µg misoprostol orally and Group II were given vaginally. Dosage was repeated every 4 hourly and monitored. The major indications of labour were severe pre- eclampsia, post dated pregnancy, mild pre-eclampsia, and PROM. Majority of the women who had undergone induction of labour were primigravida. 90% of patients in the vaginal group delivered vaginally as compared to 80% of the patients in the oral group. Caesarian section was planned in the cases of fetal distress, failure to progress or failed induction of labour. : Women who received vaginal misoprostol experiences shorter induction delivery times, required fewer doses of misoprostol amd required oxytocin augmentation less frequently than those who received oral misoprostol.

Induction of labor at second delivery subsequent to a primary cesarean: is stage of labor at previous cesarean a factor?

Parturients with a history of a cesarean delivery (CD) in the first delivery (P1), undergoing induction of labor (IOL) in the subsequent delivery (P2) are at increased risk for obstetric complications. The primary aim was to study if "the stage of labor" at previous cesarean (elective/latent/first/second) is associated with a successful IOL. The secondary aim was to search for other obstetric characteristics associated with a successful IOL. A retrospective longitudinal follow-up study in a large tertiary medical center. All parturients at term who underwent IOL at P2 with a singleton fetus in cephalic presentation, with a prior CD, between the years 2006 and 2014 were included. A univariate analysis was performed including the stage of labor at previous cesarean, birth weight of newborn at P1 and P2, gestational week of delivery at P2, time of interpregnancy interval, indication and mode of IOL, epidural analgesia and augmentation of labor at P2. Significant factors were incorporated in a multivariate logistic regression model. During the study period, 150 parturients underwent IOL (P2) subsequent to a previous CD (P1). VBAC was achieved in 78 (52%). We found no association between the stages of labor in which the previous CD was performed to a successful IOL. Applying the multivariate logistic regression revealed that augmentation of labor with oxytocin, OR 4.17, [1.73-10.05], epidural analgesia OR 3.30 [1.12-9.73] and birth weight (P2) < 4000g, OR 5.88, [1.11-33.33] were associated with a successful IOL. The stage of labor at previous CD should not be incorporated among the variables found to be associated with a successful IOL. As a result of our findings, clinician's will be able to adjust a personalized consult prior to initiating IOL.

Using dinoprostone vaginal insert for induction of labor: A single institute experience

ObjectiveTo evaluate the factors associated with the successful induction of labor (IOL) in women treated with dinoprostone slow-released vaginal insert. Material and methodsA retrospective study was conducted between June 2017 and December 2017, enrolling 65 patients who underwent dinoprostone slow-released vaginal insert-induced labor. The correlation between the characteristics of the pregnant women and its success, as well as perinatal complications and adverse outcomes were analyzed. ResultsFifty-three of 65 (81.5%) achieved a successful vaginal delivery. Only multi-parous pregnant women were an independent predictor factor for successful induction after dinoprostone slow-released vaginal insert, since all of them succeeded after this strategy treatment (100%, n = 18), compared to 74.5% (35/47) of successful rate in the nulliparous pregnant women with a statistically significant difference (p = 0.018). There were no adverse events occurred in both mothers and their offspring. ConclusionDinoprostone slow-released vaginal insert is a good choice for multiparous pregnant women who need IOL, regardless of which reasons are indicated. For nulliparous women, more studies might be needed to evaluate the effectiveness of PGE2 for IOL.

Fire Safety Related Challenges Faced by Existing Hospitals: A Review

Introduction: All through the world, induction of labour fails in 20% of cases and thus cesarean section is performed. Obesity is a risk factor for undesired results of pregnancies. Although the Bishop score is simple and easy to apply, it is a subjective evaluation method and results may vary according to the clinical experience of the person applying it. Transvaginal cervical measurement can be more objective criterion in assessing the success of labor induction. We aimed to identify the proper characteristics of the pregnant women, which can go for successful induction of labour. Method: Induction of labor for 100 women using vaginal misoprostol was done following identification of their BMI, modified bishop score and transvaginal cervical length. All women were pregnant ?38 weeks, singleton, cephalic presentation, intact fetal membranes. Results: About 92 women had successful induction of labour (group 1) while the remaining eight women had failed induction (group 2). BMI did not show statistical significance however, the modified Bishop score and the transvaginal cervical length showed high statistical significance. Using the modified bishop score 2 as a cutoff value showed sensitivity 89.1%, and specificity 62.5% while using the transvaginal cervical length 2.65 as a cutoff value showed sensitivity 72.8% and specificity 100%. Conclusion: Induction of labour by vaginal misoprostol is very promising in term women providing identification of their modified Bishop score and their transvaginal cervical length.

UMBILICAL ARTERY DOPPLER VERSUS NON-STRESS TEST IN HIGH RISK PREGNANCIES

Background: Maternal monitoring of fetal movement is a mean of screening fetal status. The rationale is based on the assumption that early recognition of decreased fetal movement (DFM) makes it possible for the clinician to intervene at a stage when the fetus is still compensated, and thus prevent progression to fetal or neonatal injury or death. Objective: To evaluate the role of non-stress test and umbilical artery Doppler measurements as an antenatal screening test for assessment of fetal well-being in high risk pregnancies affected by decreased fetal movements. Patients and methods: The current study enrolled 200 patients complaining of decreased fetal movements came for ante natal care in ante natal care clinic of Al Azhar Assiut University Hospital. Enrolled women were randomly allocated in two equal groups, the study continued for 1 year (from January 2019 – December 2019). Results: This study shows that the use of umbilical artery Doppler ultrasound assessment as an antenatal screening test was associated with a reduction in the incidence of cesarean delivery for fetal distress, more successful induction of labor, less admissions to NICU and better APGAR score in high risk pregnant population complaining of decreased fetal movement compared to non-stress test. Conclusion: Umbilical artery Doppler ultrasound assessment of the fetus in conjunction with a policy of directed intervention resulted in a decrease in the rate of cesarean delivery for fetal distress in a high-risk pregnancy, when compared with the NST.

UMBILICAL ARTERY DOPPLER VERSUS NON-STRESS TEST IN HIGH RISK PREGNANCIES

Background: Maternal monitoring of fetal movement is a mean of screening fetal status. The rationale is based on the assumption that early recognition of decreased fetal movement (DFM) makes it possible for the clinician to intervene at a stage when the fetus is still compensated, and thus prevent progression to fetal or neonatal injury or death. Objective: To evaluate the role of non-stress test and umbilical artery Doppler measurements as an antenatal screening test for assessment of fetal well-being in high risk pregnancies affected by decreased fetal movements. Patients and methods: The current study enrolled 200 patients complaining of decreased fetal movements came for ante natal care in ante natal care clinic of Al Azhar Assiut University Hospital. Enrolled women were randomly allocated in two equal groups, the study continued for 1 year (from January 2019 – December 2019). Results: This study shows that the use of umbilical artery Doppler ultrasound assessment as an antenatal screening test was associated with a reduction in the incidence of cesarean delivery for fetal distress, more successful induction of labor, less admissions to NICU and better APGAR score in high risk pregnant population complaining of decreased fetal movement compared to non-stress test. Conclusion: Umbilical artery Doppler ultrasound assessment of the fetus in conjunction with a policy of directed intervention resulted in a decrease in the rate of cesarean delivery for fetal distress in a high-risk pregnancy, when compared with the NST.

COMPARISON OF PRE AND POST INDUCTION BISHOPS SCORE IMPROVEMENT IN INTRACERVICAL FOLEY’S CATHETER AND PGE2 GEL

Background: Aim-The success of labor induction depends on the cervical status at the time of induction. Objective- For effective cervical ripening both foley catheter and a dinoprostone gel are used. The aim of this study was to compare the efficacy and safety of the intracervical Foleys catheter and dinoprostone gel in cervical ripening for successful induction of labor.&#x0D; Methods: It was a randomized controlled study conducted in the obstetrics department at SMS Medical College, Jaipur. 100 Women were enrolled with a bishops score &lt;5with various indication for induction of labour. They intracervical Foleys catheter insertion and group B received Dinoprostone gel 0.5mg instilleted intracervical. Maximum of 2 doses dinoprostone gel could be administered 6 hours apart. Primary efficacy parameter was change in Bishops score as compared to baseline.&#x0D; Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score at 12 hr,8.02 ± 3.22 and 7.1 ± 4.48 in Foleys catheter and Dinoprostone gel, respectively, But p value was not statistically significant(0.242).&#x0D; Conclusion- This study shows that both Foleys catheter and Dinoprostone are equally effective in cervical ripening.&#x0D;

Do fertility treatments affect labor induction success rate? A retrospective cohort study

Purpose To evaluate labor induction success rate by Foley catheter (FC) on patients who conceived spontaneously, as compared to those who underwent fertility treatments. Materials and methods This retrospective cohort study included all pregnant women hospitalized at a single tertiary care center between January 2011 and May 2018 for induction of labor with FC. The study groups included patients with a singleton pregnancy who conceived after fertility treatments: controlled ovarian hyperstimulation (COH) or in vitro fertilization (IVF), while control group included patients who conceived spontaneously. Our primary outcome was the rate of cesarean deliveries. Regression analysis was conducted on the following parameters: age, gravidity, parity, the gestational week, and IVF. Results The study groups included 59, 321, and 3159 patients who conceived following COH, IVF, or spontaneously, respectively. While 72.1% of patients who conceived spontaneously had a vaginal delivery, only 62.7% and 58% of patients who conceived by COH and IVF had successful labor induction (respectively, p < .01). Similarly, significantly higher cesarean section (CS) rates were demonstrated by patients who conceived by COH and IVF (28.8% and 30%, respectively), compared to the control group (18.7%, p < .01). Regression analysis demonstrated that although age, parity, and the gestational week were significantly related to cesarean sections, no statistically significant association was found regarding fertility treatments (p = .050). Conclusions The possible association between fertility treatments and cesarean delivery remains an important dilemma for obstetricians and fertility experts. While unadjusted analysis demonstrated such association among patients who undergo labor induction by FC, adjusted analysis has not supported that finding. Further studies focusing on the causes of failed vaginal delivery are needed to further expand our knowledge and to improve patient consultation.

Relations between second-trimester aneuploidy screening results and prediction of labour induction success in term pregnancies

We aimed to assess whether the second-trimester maternal serum markers could be used for the prediction of labour induction success. This prospective study enrolled women planned labour induction at term. Women were assigned to one of two groups: vaginal prostaglandin or balloon dilatation. All patients were evaluated for Bishop score, maternal serum oestriol, human chorionic gonadotropin and progesterone at the time of second-aneuploidy screening. The total successful rate for induction of labour was 63.9% in both groups. Maternal serum oestriol multiple of median (MoM) values were significantly lower among the caesarean section group compared to the vaginal delivery group (p < .001). A MoM value of 0.74 for oestriol was associated with a sensitivity of 75.9%, specificity of 41.0%, a positive predictive value of 76.6% and a negative predictive value of 58.0% for a successful induction of labour. Oestriol had a good performance in the prediction of successful induction of labour at term. IMPACT STATEMENT What is already known on this subject? Induction of labour is a common procedure undertaken whenever the benefits of prompt delivery outweigh the risks of expectant management. Previous studies have reported that a decreased progesterone/oestradiol ratio and increased maternal plasma oestriol levels are associated with successful labour. What the results of this study add? The results of this study showed that second-trimester oestriol multiple of median (MoM) value provide a significant contribution to the efforts of the prediction of successful induction of labour in term pregnancy, having a sensitivity of 69.8%, specificity of 92.4%, positive predictive value of 83.3% and negative predictive value of 82.5%. What the implications are of these findings for clinical practice and/or further research? This finding can be used as an additional method for prediction of labour induction as well as multiparity and Bishop score. This adds new valuable data to the literature which could be used for systematic reviews and for implementing guidelines and protocols on labour induction.

Incidence of cesarean delivery after induction of labor with intravenous oxytocin drip among women undergoing induction of labor at Dessie referral hospital, Northeast Ethiopia, 2017

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The number of delivering women undergoing an induction of labor is greater than 20% and continues to rise. Simultaneously, the cesarean delivery rate continues to increase as well. This increase has resulted from evidence-based recommendations on how to handle certain conditions. Labor induction has been associated with increased likelihood of cesarean birth for some groups of women.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Institutional based retrospective cross sectional study was conducted on 319 women medical chard who undergone induction of labor with oxytocin infusion at Dessie referral hospital. Systematic sampling techniques was used to select the samples. The data was cleaned, edited, coded, and entered in to EPI INFO version 3.5 and exported and analyzed by SPSS with windows version 20.0. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 319 delivery records were reviewed. Out of this 256 (80.3%) was successful induction of labor. Incidence of cesarean section after induction of labor with oxytocin infusion among women at Dessie referral hospital was 136 (42.6%). The most frequent cause of induction of labor was due to hypertensive disorder 133 (41.7%) followed by pre labor rupture of membrane 111 (34.8%). Cesarean section was done due to failed induction of labor 63 (19.7%) followed by fetal distress 40 (12.5%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; In present study incidence of cesarean delivery after induction of labor was 42.6%. Most frequent cause of induction of labor was due to hypertensive disorder followed by pre-labor rupture of membrane. Cesarean section was done due to failed induction of labor followed by fetal distress.&lt;/p&gt;

Predicting labor induction success by cervical funneling in uncomplicated pregnancies.

AimPredictive accuracy of cervical funneling for successful vaginal delivery prior to labor induction was compared to that of conventional methods such as Bishop score and cervical length.MethodsProspective observational study was conducted on nulliparous women at 38 gestational weeks or more with intact membranes who delivered vaginally following labor induction. Transvaginal ultrasound was performed prior to labor induction to evaluate the cervix, to determine the cervical length and to check for the presence of funneling. Following pelvic examinations, the Bishop score was calculated. Predictive accuracy of the three different methods, namely cervical funneling, cervical length and Bishop, were compared.ResultsA total of 235 nulliparous women with intact membranes were recruited. Of these, 194 women (82.6%) had successful vaginal deliveries following induction. Cervical funneling was observed in 105 women (44.7%). The rate of successful vaginal delivery was significantly higher in women with cervical funneling than in those without funneling (90.5% vs 76.2%, P < 0.004). Multivariable analysis showed that cervical funneling, similar to traditional measures such as the Bishop score and cervical length, was an independent predictor of successful vaginal delivery following labor induction (odds ratio = 2.95; 95% confidence interval: 1.38–6.47; P = 0.007).ConclusionsSimilar to the conventional methods of cervical evaluation, such as the Bishop score and cervical length, cervical funneling may serve as a useful and valid predictor of successful vaginal deliveries prior to labor induction.

The Effect of Ultrasound-Measured Preinduction Cervical Length on Delivery Outcome in a Low-Resource Setting

Background Induction of labour is not without risk, and it calls for a method that will be sensitive enough to predict successful labour induction. Aim This study aims to evaluate the role of transvaginal ultrasonographic cervical length measurement at term in the prediction of successful induction of labour (IOL). Materials and Methods This prospective study was carried out in the Department of Obstetrics and Gynaecology of Federal Teaching Hospital Abakaliki between 1st of July and 30th of November 2015. Preinduction Bishop score and cervical length were assessed before induction of labour. Intracervical, cervical, extraamniotic Foley catheter was used to improve the Bishop score. The data were analyzed using the IBM SPSS Statistics 20. Results The mean maternal age of the study group was 30.68 ± 6.38 years with a range of 19–43 years. The mean gestational age and parity were 39.57 ± 1.49 and 1.85 ± 0.63, respectively. All the women studied had successful induction of labour with mean induction delivery time of 8.1 ± 3.0 hours and mean duration of labour of 7.4 ± 2.9 hours. Preinduction cervical length is a good predictor of a short duration of labour (P = 0.001). Parturient with a preinduction cervical length of less than 3 cm was likely to have labour lasting less than 6 hours (RR = 4.20 (95% CI 1.85–9.529). Conclusion Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of duration of labour following the induction of labour. It is recommended that IOL should be considered and success anticipated in a parturient with a cervical length less than 3 cm.

High dose and low dose oxytocin regimens as determinants of successful labor induction: a multicenter comparative study

BackgroundInduction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study was aimed at comparing the effects of high dose versus low dose oxytocin regimens on success of labor induction.MethodsHospital-based comparative cross-sectional study was conducted in four selected hospitals in Ethiopia prospectively from October 1, 2017 to May 30, 2018. A total of 216 pregnant women who undergo induction of labor at gestational age of 37 weeks and above were included. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to look for determinants of successful induction. The result was presented using 95% confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance.ResultThe mean “Induction to delivery time” was 5.9 h and 6.3 h for participants who received high dose Oxytocin and low dose Oxytocin respectively. Higher successful induction (72.2% versus 61.1%) and lower Cesarean Section rate (27.8% vs. 38.9) were observed among participants who received low dose Oxytocin compared to high dose. Favourable bishop score [AOR 4.0 95% CI 1.9, 8.5], elective induction [AOR 0.2 95% CI 0.1, 0.4], performing artificial rupture of membrane [AOR 10.1 95% CI 3.2, 32.2], neonatal birth weight of <4Kg [AOR 4.3, 95% CI 1.6, 11.6] and being parous [AOR 2.1 95% CI 1.1, 4.0] were significantly associated with success of induction.ConclusionsIn this study, Different oxytocin regimens didn’t show significant association with success of induction. But, high dose oxytocin regimen was significantly associated with slightly shorter induction to delivery time. Favourable bishop score, emergency induction, performing artificial rupture of membrane and delivery to non-macrosomic fetuses were positive determinants of successful induction. We recommend researchers to conduct multicenter research on a large number of patients that controls confounders to see the real effects of different oxytocin regimens on success of labor induction.

Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals

Novel coronavirus disease 2019 is rapidly spreading throughout the New York metropolitan area since its first reported case on March 1, 2020. The state is now the epicenter of coronavirus disease 2019 outbreak in the United States, with 84,735 cases reported as of April 2, 2020. We previously presented an early case series with 7 coronavirus disease 2019–positive pregnant patients, 2 of whom were diagnosed with coronavirus disease 2019 after an initial asymptomatic presentation. We now describe a series of 43 test-positive cases of coronavirus disease 2019 presenting to an affiliated pair of New York City hospitals for more than 2 weeks, from March 13, 2020, to March 27, 2020. A total of 14 patients (32.6%) presented without any coronavirus disease 2019–associated viral symptoms and were identified after they developed symptoms during admission or after the implementation of universal testing for all obstetric admissions on March 22. Among them, 10 patients (71.4%) developed symptoms of coronavirus disease 2019 over the course of their delivery admission or early after postpartum discharge. Of the other 29 patients (67.4%) who presented with symptomatic coronavirus disease 2019, 3 women ultimately required antenatal admission for viral symptoms, and another patient re-presented with worsening respiratory status requiring oxygen supplementation 6 days postpartum after a successful labor induction. There were no confirmed cases of coronavirus disease 2019 detected in neonates upon initial testing on the first day of life. Based on coronavirus disease 2019 disease severity characteristics by Wu and McGoogan, 37 women (86%) exhibited mild disease, 4 (9.3%) severe disease, and 2 (4.7%) critical disease; these percentages are similar to those described in nonpregnant adults with coronavirus disease 2019 (about 80% mild, 15% severe, and 5% critical disease).

Early versus delayed amniotomy after vaginal misoprostol for labor induction in nulliparous women

Objectives To compare between the effectiveness and safety of early versus delayed amniotomy after vaginal misoprostol for the induction of labor. Background The aim of successful induction of labor is to achieve vaginal delivery when continuation of pregnancy presents a threat to the life or well-being of the mother or fetus. The process of induction of labor should only be considered when vaginal delivery is felt to be the appropriate route of delivery. Patients and methods A randomized, clinical trial that included 80 nulliparous women with medical or obstetric indication for labor induction. They were randomly assigned into two equal groups, the first group for early amniotomy and the second group for late amniotomy after use of vaginal misoprostol. Data were collected and tabulated. Results There was significant difference in the duration of labor between the two groups of early and late amniotomy with aP value of 0.000.There was also no significant difference in the mode of delivery with aP value equal to 0.197. Conclusion In well-selected cases, vaginal misoprostol followed by early intervention with amniotomy for labor induction appears to be associated with higher successful vaginal delivery rate, shorter induction-delivery interval, and better neonatal outcome over standard care.

Cervical and Lower Uterine Parameter Ultrasound and Elastographic Parameters for the Prediction of a Successful Induction of Labor.

The prediction of successful induction of labor (IOL) has been the subject of a series of studies. The predictive role of cervical sonographic and elastographic parameters has been controversially discussed. Lower uterine segment (LUS) thickness and strain values have not been discussed yet in this regard. A prospective cohort study was performed to examine the predictive power of Bishop score parameters, sonographic cervical length (CL), cervical funneling, cervical strain values, LUS thickness and its strain values regarding successful IOL within 24 hours and intervals to onset of labor, ROM and delivery of the fetus. A p-value of < 0.05 was considered statistically significant. 135 patients were examined. A cervical length of 25 mm, the presence of cervical funneling and digital shorter cervix was significant for the prediction of successful induction of labor (IOL) within 24 hours. There was weak correlation between the functional CL and the onset of labor (r2 = 0.10) and ROM (r2 = 0.13). There was also a weak correlation between the cervical funnel width and the time interval to the onset of labor (r2 = 0.25), ROM (r2 = 0.23) and delivery of the fetus (r2 = 0.22). Cervical elastography, LUS thickness and strain values were not significant for the prediction of a successful IOL. We were able to show that cervical structural changes at the level of the internal os, i. e., shortening through funneling, may be the determining factor for successful IOL.

The effect of maternal obesity on the success of labor induction with a cervical ripening double-balloon catheter and on pain perception during catheter insertion

The effect of maternal obesity on the success of labor induction with a cervical ripening double-balloon catheter and on pain perception during catheter insertion

Titrated oral misoprostol solution versus vaginal misoprostol for labor induction in primi gravid ladies

Abstract Background It is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix; which is necessary for successful labor induction. Aim of the Work to test the safety and efficacy of titrated oral misoprostol compared to vaginal misoprostol for labor induction in term gravid ladies. Patients and Methods This prospective, single-blinded randomized controlled clinical trial was conducted at Ain-Shams University Maternity Hospital during the period between August 2017 and August 2018. 120 pregnant women planned for induction of labor were recruited in the study according to the inclusion / exclusion criteria. Subjects included in the study were randomized into two groups: patients who received oral 200 ug misoprostol in 200 ml water titrated over 24 hours and placebo tablets vaginally which resemble vagiprost tablets (25 microgram misoprostol) and the second group contained pients who received vaginal misoprostol 25microg maximum four doses, and placebo solution of 200 ml of tap water. Results titrated oral misoprostol is as effective in promoting cervical ripening and inducing labor as intravaginal misoprostol, oral Misoprostol has a similar maternal and perinatal safety profile to vaginal misoprostol. Conclusion This new approach to oral misoprostol administration was successful in minimizing the risk of uterine hyper-stimulation, which has been a feature of misoprostol use for induction of labor, at the expense of a somewhat slower response. Oral Misoprostol has a similar maternal and perinatal safety profile compared to vaginal misoprostol.

Posterior cervical angle and cervical length in predicting the successful induction of labour in nulliparous woman

Objective:To assess the value of pre-induction sonographic assessment of the posterior cervical angle (PCA) and cervical length in the prediction of successful induction of labor (IOL).Patients and Methods:The present prospective observational study included IOL candidates who had their PCA and cervical length assessed by transvaginal ultrasonography and the Bishop score at the Obstetrics and Gynecology Department, Ain-Shams Maternity Hospital, Cairo, Egypt, from 1st November 2018 to 31st May 2019. The accuracy of these tests in predicting successful IOL (defined as vaginal delivery) was compared.Results: The analysis included 41 women with successful IOL and 29 women with unsuccessful IOL. The suggested cutoffs for the prediction of successful IOL were a PCA of more than 100°, a cervical length of less than 31 mm, and a Bishop score of more than four. The areas under the receiver operating characteristics curves for these three measures were not significantly different. However, a PCA of more than 100° had the best sensitivity (87.80%), specificity (86.21), positive predictive value (90%), negative predictive value (83.3%) compared with the other two predictors.Conclusion: Posterior cervical angle had the best accuracy in predicting successful induction of labor compared with the cervical length and the Bishop score

The Success of Labor Induction Based on a Modified BISHOP Score.

The Success of Labor Induction Based on a Modified BISHOP Score.