title: Quantitative elastography of the cervix for predicting labor induction success.
abstract: OBJECTIVE
  To evaluate the role of quantitative elastography of the cervix in the prediction of successful labor induction compared to the Bishop score (BS) and ultrasound cervical length (CL).
  
  
  METHODS
  A prospective pilot study was conducted between July 2010 and June 2011 in patients without preterm membrane rupture undergoing labor induction with vaginal prostaglandins. Before starting induction, the BS, functional CL and cervical tissue strain (TS) were assessed. TS assessment was performed twice using the Tissue Doppler Imaging (TDI) software. Diagnostic accuracy was evaluated for the prediction of the following endpoints: active labor achievement (success vs. failure, time interval < 24 h and < 48 h), vaginal delivery (success vs. failure, time interval < 36 h and < 72 h) and total amount of prostaglandins used for labor induction (< 6 mg and < 12 mg).
  
  
  RESULTS
  We analyzed 77 patients with a mean gestational age of 39.7 ± 1.5 weeks of gestation and a mean strain of 0.75 ± 0.17. The TS significantly predicted a failure of labor induction, which occurred in 4 cases, both in mono- and multivariate analysis, independently of the functional cervical length (TS 0.6 ± 0.1). No correlation was found between the TS and other outcomes. The Bishop score and functional cervical length were found to predict only an early response to labor induction (time to active labor < 24 h, time to vaginal delivery < 36 h and PG usage < 6 mg). The diagnostic accuracy was slightly but not significantly improved if both TS and CL were considered.
  
  
  CONCLUSIONS
  Preliminary data show the possible usefulness of quantitative cervical elastography in the prediction of labor induction failure.
authors.affiliation: Obstetrics and Gynaecology, Mathias-Spital Rheine.
authors.forename: A
authors.initials: A
authors.lastname: Fruscalzo
authors.affiliation: Clinic of Obstetrics and Gynecology, Uiversity Hospital of Udine.
authors.forename: A P
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Obstetrics and Gynaecology, Mathias-Spital Rheine.
authors.forename: C
authors.initials: C
authors.lastname: Fröhlich
authors.affiliation: Center for Prenatal Medicine and Ultrasound, Mathias-Spital Rheine.
authors.forename: M
authors.initials: M
authors.lastname: Meyer-Wittkopf
authors.affiliation: Clinic of Obstetrics and Gynecology, University of Münster.
authors.forename: R
authors.initials: R
authors.lastname: Schmitz
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000000981:diagnostic imaging; D015331:Cohort Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007751:Labor, Induced; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D011453:Prostaglandins / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D012984:Software; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D011453:Prostaglandins