Sonographic cervical assessment to predict the success of labor induction: a systematic review with metaanalysis.
OBJECTIVE
The purpose of this investigation was to review the literature that evaluates sonographic cervical assessment to predict successful induction of labor.


METHODS
Published prospective trials that measured sonographic cervical length before labor induction was initiated were evaluated. Trials were excluded if they contained data presented in later articles or did not contain extractable data. The total analysis included 20 trials with 3101 aggregate participants.


RESULTS
Cervical length predicted successful induction (likelihood ratio of positive test, 1.66; 95% confidence interval [CI], 1.20-2.31) and failed induction (likelihood ratio of negative test, 0.51; 95% CI, 0.39-0.67). Cervical length did not predict any specific outcome (eg, mode of delivery). The assessment of cervical wedging proved to be a useful diagnostic test, with a likelihood ratio of a positive test result of 2.64 and a likelihood ratio of a negative test result of 0.64.


CONCLUSIONS
Sonographic cervical length was not an effective predictor of successful labor induction. Further evaluation of cervical wedging in the prediction of labor induction appears warranted.
Hatfield
Ann S
AS
Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA. ann.hatfield@jax.ufl.edu
Sanchez-Ramos
Luis
L
Kaunitz
Andrew M
AM
D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007751:Labor, Induced; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal