title: Degree of cervical shortening after initial induction of labor as a predictor of subsequent successful induction.
abstract: OBJECTIVE
  To evaluate whether the degree of cervical length shortening is valuable in predicting the success of serial induction of labor on the second day in women in whom it failed on the first day, and to compare its performance with that of cervical length.
  
  
  METHODS
  This was a prospective observational study. We enrolled 92 consecutive women with singleton gestations at > 34.0 weeks' gestation who failed labor induction on the first day of serial induction. Transvaginal sonographic measurement of cervical length and determination of the Bishop score were undertaken before performing each labor induction on the first and second days.
  
  
  RESULTS
  The overall success rate of labor induction performed on the second day was 65% (60/92). Multiple logistic regression analysis demonstrated that the degree of cervical length shortening and cervical length were significantly associated with the successful induction of labor after adjustment for body mass index, parity, use of prostaglandin and Bishop score. There were no significant differences between areas under the ROC curves for degree of cervical length shortening and cervical length.
  
  
  CONCLUSIONS
  The degree of cervical length shortening is valuable in predicting the success of induction of labor on the second day in women in whom induction failed on the first day. However, compared with sonographic cervical length it is no better at predicting the success of subsequent induction of labor.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnamsi, Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Kang
authors.forename: K H
authors.initials: KH
authors.lastname: Park
authors.forename: S N
authors.initials: SN
authors.lastname: Kim
authors.forename: D M
authors.initials: DM
authors.lastname: Shin
authors.forename: J-S
authors.initials: JS
authors.lastname: Hong
authors.forename: H J
authors.initials: HJ
authors.lastname: Jung
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement / Q000379:methods; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve