title: Usefulness of elastography in predicting the outcome of Foley catheter labour induction.
abstract: BACKGROUND
  Incorrect selection of women for labour induction may increase the risk of caesarean section and other postpartum and neonatal complications. It has been recently shown that elastography of the uterine cervix holds the potential to predict the outcome of pharmacological labour induction. There are no data on the usefulness of elastography in predicting the outcome of mechanical induction of labour.
  
  
  OBJECTIVE
  To assess the usefulness of elastographic cervical assessment in predicting the success of Foley catheter labour induction.
  
  
  METHODS
  This prospective observational study included 39 pregnant women at term with an unfavourable cervix (Bishop score ≤ 6) suitable for Foley catheter labour induction. Before labour induction the following data were recorded: Bishop score, cervical length (measured by ultrasound) and the stiffness of cervical internal os, canal and external os assessed by elastography (elastography index - EI). Statistical relationships between pre-interventional assessment of the cervix and outcome of Foley catheter labour induction (successful induction, time to delivery and route of delivery) were analysed.
  
  
  RESULTS
  EI's of internal cervical os and cervical canal were significantly lower (softer) in women with successful labour induction and vaginal delivery, while EI's of the external cervical os, Bishop score and cervix length were not significantly different. Time to vaginal delivery was significantly correlated with the EI's of internal cervical os, cervical canal and Bishop score, but not with EI's of the external cervical os and cervix length.
  
  
  CONCLUSIONS
  Elastography has the potential to predict the outcome of Foley catheter labour induction.
authors.affiliation: 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Wozniak
authors.affiliation: 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czuczwar
authors.affiliation: 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Szkodziak
authors.affiliation: 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Paszkowski
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D036861:Delivery, Obstetric; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D055815:Young Adult
keywords: cervix; elastography; foley catheter; labour induction; ultrasound