title: Sonoelastography as method for preliminary evaluation of uterine cervix to predict success of induction of labor.
abstract: BACKGROUND
  Induction of labor is a useful practice to solve many obstetric situations but has a large impact on the health of women and their babies and therefore needs to be clearly justified clinically.
  
  
  OBJECTIVE
  To determine the sensitivity of sonoelastography in the evaluation of the cervix to predict the success of induction.
  
  
  METHODS
  We enrolled 53 subjects preparing for induction of labor. Transvaginal evaluation of cervical length and a sonoelastogram were performed. We preliminarily classified the sonoelastograms into five elastography index (EI) categories and examined the different distribution of cesarean or spontaneous deliveries in various subgroups of EI by χ(2) test and multivariate analysis by logistic regression.
  
  
  RESULTS
  Statistical analysis revealed a significant difference of prevalence of spontaneous delivery (EI1-3 82.75%, EI4-5 45.8%) versus cesarean section (EI1-3 17.25%, EI4-5 54.16%) (p = 0.0072). The diagnostic validity of EI was evaluated using the receiver operating characteristic curve and cut-off of the predictive value was EI3.
  
  
  CONCLUSIONS
  The results of our study indicate that sonoelastography is an innovative technique that could allow a more objective preliminary evaluation of the cervix before inducing labor, however further studies with a larger number of subjects and a standardization of image acquisition are necessary.
authors.affiliation: Department of Obstetrics and Gynecology, University of L'Aquila, S. Salvatore Hospital, Coppito, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Muscatello
authors.forename: M
authors.initials: M
authors.lastname: Di Nicola
authors.forename: V
authors.initials: V
authors.lastname: Accurti
authors.forename: N
authors.initials: N
authors.lastname: Mastrocola
authors.forename: V
authors.initials: V
authors.lastname: Franchi
authors.forename: I
authors.initials: I
authors.lastname: Colagrande
authors.forename: F
authors.initials: F
authors.lastname: Patacchiola
authors.forename: G
authors.initials: G
authors.lastname: Carta
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016015:Logistic Models; D011247:Pregnancy; D016896:Treatment Outcome