title: Predicting success of labor induction in singleton term pregnancies by combining maternal and ultrasound variables.
abstract: OBJECTIVE
  To assess pre-induction maternal and ultrasonographic factors in the prediction of the onset of labor within 12 h, and vaginal delivery (VD) irrespective of the induction-to-delivery interval in term pregnancies.
  
  
  METHODS
  We performed a prospective cohort study with 204 singleton pregnant women between 37 and 42 weeks of gestation. The following maternal and ultrasonographic variables were assessed: parity, marital status, height, body mass index (BMI), previous cesarean section (Cs), Bishop score, variety of fetal position, single deepest pocket (SDP), fetal middle cerebral and umbilical artery resistance indices, cervical length (CL) measurement, posterior cervical angle (PCA), head circumference (HC) and estimated fetal weight (EFW). χ(2) test and logistic regression analysis were applied to compare the groups. Receiver operating characteristics (ROC) curves were determined.
  
  
  RESULTS
  VD occurred in 116 (56.9%) women. Prediction of the onset of labor within 12 h was provided by the BMI and resistance index of the fetal middle cerebral artery. Prediction of the VD irrespective of the induction-to-delivery interval was provided by height, BMI, parity, number of prenatal visits, consistency, effacement and dilation of uterine cervix, PCA, oligohydramnios, HC and EFW. Area under ROC curve for PCA and EFW were 63.5 (sensibility: 66.4%, specificity: 59.1%) and 60.2 (sensibility: 54.3%, specificity: 70.4%), respectively.
  
  
  CONCLUSIONS
  Several pre-induction maternal and ultrasonographic factors can increase the chance of achieving a successful VD. PCA and EFW were the best ultrasonographic predictors for the success of induction of labor; however, with limited potential to be used in the clinical practice.
authors.affiliation: a Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto , SP , Brazil .
authors.forename: Caio Antonio de Campos
authors.initials: CA
authors.lastname: Prado
authors.affiliation: b Department of Obstetrics , Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP) , São Paulo , SP , Brazil , and.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: a Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto , SP , Brazil .
authors.forename: Geraldo
authors.initials: G
authors.lastname: Duarte
authors.affiliation: a Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto , SP , Brazil .
authors.forename: Silvana Maria
authors.initials: SM
authors.lastname: Quintana
authors.affiliation: c Department of Obstetrics and Gynecology , Guastalla Civil Hospital , AUSL Reggio Emilia , Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Tonni
authors.affiliation: a Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto , SP , Brazil .
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Cavalli
authors.affiliation: a Department of Obstetrics and Gynecology , Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto , SP , Brazil .
authors.forename: Alessandra Cristina
authors.initials: AC
authors.lastname: Marcolin
mesh_terms: D020070:Cervical Ripening / Q000502:physiology; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007745:Labor Onset / Q000502:physiology*; D007746:Labor Presentation; D007751:Labor, Induced; D016015:Logistic Models; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D018709:Statistics, Nonparametric; D047929:Term Birth; D013997:Time Factors; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Induction of labor; maternal characteristic; perinatal outcome; ultrasound; vaginal delivery