[Transvaginal ultrasonography of the uterine cervix before induction of labor].
OBJECTIVE
To compare the Bishop score and transvaginal ultrasonographic measurement of cervical length for predicting the mode of delivery following medically indicated induction of labor in term patients.


METHODS
The study was conducted prospectively among 134 women who required medically indicated induction of labor. Inclusion criteria were singleton pregnancy, gestational age > or = 37 weeks of amenorrhea, cephalic presentation, and intact fetal membranes. Transvaginal ultrasonography was performed for measurement of the cervical length but the patients were managed without considering this parameter. A receiver-operating characteristic curve was constructed to determine the best cut-of value of cervical length for predicting the risk of cesarean section following induction of labor.


RESULTS
Thirty six patients (26.9%) underwent cesarean section and cervical dilatation at time of the cesarean section was < 8 cm in 25 cases. The Bishop score was not predictive for the mode of delivery in this study. In contrast, the cesarean section rate was significantly lower in women with a uterine cervix < 26 mm (18.9 vs 36.6%, p = 0.02). Moreover, the difference has concerned only the cesarean sections performed before 8 cm dilatation (9.5 vs 30.0%, p = 0.002).


CONCLUSIONS
Cervical length measured with transvaginal ultrasonography is a better predictor than the Bishop score for predicting the risk of cesarean section following medically indicated induction of labor.
Gabriel
R
R
Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire, 51092 Reims, France. rgabriel@chu-reims.fr
Darnaud
T
T
Gonzalez
N
N
Leymarie
F
F
Quéreux
C
C
D002584:Cervix Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D014463:Ultrasonography; D014621:Vagina