Comparison of cervical characteristics assessed by TVUS (with and without saline) with digital method in prediction of labor induction outcome: a prospective study

Authors

  • Sabita Sai Chandran Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
  • Harsha Shivan Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India; Freelance Laparoscopic Gynecologist in Private Hospitals, Bangalore, Karnataka, India
  • Deepak Bharathi Department of Radiodiagnosis, Mahatma Gandhi Medical College & Research Institute, Puducherry, India; Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Dhanvantari Nagar, Puducherry, India
  • Sunita Samal Department of Obstetrics & Gynecology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20150065

Keywords:

TVUS, Saline, Cervical length width, Digital method, Labor outcome

Abstract

Background: Objective: To compare digital and transvaginal sonographic cervical assessment (pre & post vaginal saline) in predicting the outcome of induction of labor.

Methods: Study design was prospective study, setting at medical college and research institute. Hundred pregnant women with singleton pregnancies admitted for induction of labor between 37-42 weeks of gestation. Digital and TVUS (Transvaginal ultrasonography) assessment of cervix was made with and without saline instillation and the statistical comparative data was derived. The primary outcome was initiation of active labor and the secondary outcomes were mode of delivery, active labor within 12 hours, induction to delivery interval, and the duration of active labor

Results: No ultrasound or digital cervical characteristics predicted the initiation of active labor (P>f; >0.05), mode of delivery and the duration of active labor; however, TVUS assessment of cervical length but not cervical width is significantly better than digital assessment of cervical length (P <0.001); it independently discriminates and predicts active labor within 12 hours.  

Conclusions: TVUS measurement of cervical length is a better predictor of active labor within 12 hours than digital assessment. Visualization of cervix by TVUS was enhanced with saline administration but the difference between the measurements with and without saline was not statistically significant.  

References

Jackson GM, Ludmir J, Badir TJ. Accuracy of digital examination and ultrasound in the evaluation of cervical length. J Obstet Gynecol. 1992;79:214-8.

Paterson-Brown S, Fisk NM, Edmonds DK, Rodeck CH. Pre-induction cervical assessment by Bishop’s score and transvaginal ultrasound. Eur J Obstet Gynecol Reprod Biol. 1991;40:17-23.

Boozarjomehri F, Timor-Tritsch I, Chao CR, Fox HE. Transvaginal Ultrasonographic evaluation of cervix before labor: presence of cervical wedging is associated with shorter duration of induced labor. Am J Obstet Gynecol. 1994;171:1081-7.

Ware, Raynor. Transvaginal ultrasonographic cervical measurement as a predictor of successful labor induction. Am J Obstet Gynecol. 2000 May;182(5):1030-2.

Chandra S, Crane JM, Hutchens D, Young DC. Transvaginal Ultrasound and digital examination in predicting successful labor induction. Obstet Gynecol. 2001;98:2-6.

Pandis GK, Papageorghiou AT, Ramanathan VG, Thompson MO, Nicolaides KH. Pre-induction sonographic measurement of cervical length in the prediction of successful induction of labour. Ultrasound Obstet Gynecol. 2001;18:623-8.

Gabriel R, Darnaud T, Chalot F, Gonzalez N, Leymarie F, Quereux C. Transvaginal sonography of the uterine cervix prior to labor induction. Ultrasound Obstet Gynecol. 2002 Mar;19(3):254-7.

Watson WJ, Stevens D, Welter S, Day D. Factors predicting successful induction of labor. Obstet Gynecol. 1996;88:990-2.

Gonen R, Degani S, Ron A. Prediction of successful induction of labor: comparison of Transvaginal Ultrasound and Bishop score. Eur J Ultrasound. 1998;7:183-7.

Elghorori MRM, Hassan I, Morris E, Frazer D. Intravaginal hydrosonography and cervical length assessment in pregnant women before induction of labor: a modified technique. J Obstet Gynecol. 2005 Jul;25(5):435-9.

Crane JMG, Van den Hof M, Armson BA, Liston R. Transvaginal ultrasound in the prediction of preterm delivery: singleton and twin gestations. Obstet Gynecol. 1997;90(3):357-63.

Yang SH, Roh CR, Kim JH. Transvaginal ultrasonography for cervical assessment before induction of labor. J Ultrasound Med. 2004 Mar;23(3):375-82.

Harrison RF, Flynn M, Craft I. Assessment of factors constituting an ‘inducibility profile’. Obstet Gynecol. 1977;49(3):270-1.

Downloads

Published

2017-02-08

Issue

Section

Original Research Articles