Body mass index, Bishop score, and sonographic measurement of the cervical length as predictors of successful labor induction in twin gestations.
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.
Park
Kyo-Hoon
KH
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Bundang-Gu, Seongnamsi, Korea. pkh0419@snubh.org
Hong
Joon-Seok
JS
Kang
Woong-Sun
WS
Shin
Dong-Myung
DM
Kim
Shi-Nae
SN
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