title: Body mass index, Bishop score, and sonographic measurement of the cervical length as predictors of successful labor induction in twin gestations.
abstract: OBJECTIVE
  To evaluate the predictive value of body mass index (BMI), Bishop score, and sonographic measurement of cervical length for predicting successful labor induction (defined as an ability to achieve the active phase of labor corresponding to a cervical dilatation of > or =4 cm within 12 h of initiating oxytocin) in near-term twin gestations.
  
  
  METHODS
  This prospective, observational study enrolled 72 consecutive women with twin gestations at >36.0 weeks' gestation who were scheduled for induction of labor. Transvaginal ultrasound for measurement of the cervical length was performed and the Bishop score was determined by digital examination. The BMI was calculated based on the weight and height at the time of induction.
  
  
  RESULTS
  Labor induction was successful in 63% (45/72) of women. The mean BMI was significantly lower in women who had successfully induced labor, but no significant differences existed with respect to the mean cervical length, median Bishop score, proportion of parous and nulliparous women, and the mean total birth weight of the twin pairs between the two patient groups. Multiple logistic regression demonstrated that only BMI provided a significant contribution in predicting successful labor induction.
  
  
  CONCLUSIONS
  BMI independently predicted the success of labor induction in twin gestations but the sonographic measurement of the cervical length and Bishop score had poor predictive values for successful induction.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Bundang-Gu, Seongnamsi, Korea. pkh0419@snubh.org
authors.forename: Kyo-Hoon
authors.initials: KH
authors.lastname: Park
authors.forename: Joon-Seok
authors.initials: JS
authors.lastname: Hong
authors.forename: Woong-Sun
authors.initials: WS
authors.lastname: Kang
authors.forename: Dong-Myung
authors.initials: DM
authors.lastname: Shin
authors.forename: Shi-Nae
authors.initials: SN
authors.lastname: Kim
mesh_terms: D000328:Adult; D015992:Body Mass Index; D054791:Cervical Length Measurement; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011273:Pregnancy, Prolonged / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D014427:Twins