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Diagnostic accuracy of pre-induction cervical elastography, volume, length, and uterocervical angle for the prediction of successful induction of labor with dinoprostone

  • Maternal-Fetal Medicine
  • Published:
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Abstract

Purpose

The study’s aim is to define among a group of ultrasonographic cervical measurements a candidate parameter predictive of successful of induction of labor in term pregnancies with unfavorable cervix.

Methods

This prospective observational study included 141 pregnant women at term with an unfavorable cervix (Bishop score ≤ 6). All patients underwent clinical and ultrasonographic cervical evaluation before dinoprostone induction. Pre-induction cervical assessments included the Bishop score, cervical length, cervical volume, uterocervical angle, and cervical elastographic parameters. Vaginal delivery (VD) was accepted as successful dinoprostone induction. Multivariate logistic regression was conducted to identify the potential risk factors significantly associated with CS while controlling for possible confounding variables.

Results

The vaginal delivery rate was 74% (n = 93) and the cesarean section (CS) rate was 26% (n = 32). Sixteen patients who had a cesarean section due to fetal distress before the active phase of labor were excluded from the study. The mean induction-to-delivery interval was 1176.1 ± 352 (540–2150) for VD and 1359.4 ± 318.4 (780–2020) for CS (p = 0.01). Bishop score was lower in women with cesarean section (p = 0.002). When both groups were compared in terms of delivery type, no difference was found between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements. Multivariable logistic regression model failed to show significant differences between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements.

Conclusion

Cervical length, cervical elastography, cervical volume, and uterocervical angle measurements did not provide a clinically useful prediction of outcomes following labor induction in our study group with unfavorable cervix. Cervical length measurements significantly predicted the time interval from induction to delivery.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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Funding

The authors declare that no funds, grants, or other supports were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Health Sciences University Tepecik Education and Research Hospital, İzmir, Turkey

    Alper İleri, Suna Yıldırım Karaca, Mehmet Adıyeke & Adnan Budak

  2. Department of Perinatology, Health Sciences University Tepecik Education and Research Hospital, İzmir, Turkey

    Hakan Gölbaşı & Mehmet Özer

  3. Department of Family Medicine, Health Sciences University Tepecik Education and Research Hospital, İzmir, Turkey

    Hande İleri

  4. Private Clinic, Obstetrics and Gynecology, İzmir, Turkey

    Merve Biçer

  5. Çiğli Education and Research Hospital, Department of Obstetrics and Gynaecology, İzmir Bakircay University, İzmir, Turkey

    Ayse Rabia Şenkaya, Sabahattin Anıl Arı & İbrahim Karaca

  6. Department of Physical Therapy and Rehabilitation, Dokuz Eylul University, İzmir, Turkey

    Özge Çeliker Tosun

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  1. Alper İleri
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Contributions

AI: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. SYK: protocol/project development, data collection or management, and manuscript writing/editing. HG: data collection or management, and manuscript writing. MA: data collection or management, manuscript writing. AB: data collection or management, and manuscript writing. MÖ: data collection or management, and manuscript writing. HI: data analysis and manuscript writing/editing. MB: data collection or management. ARŞ: data collection or management. SAA: data collection or management. OÇT: data analysis. IK: data analysis, manuscript writing/editing, and review.

Corresponding author

Correspondence to Alper İleri.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tepecik Training and Research Hospital (Date: 19/01/2021, No: 2021/01/02).

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İleri, A., Yıldırım Karaca, S., Gölbaşı, H. et al. Diagnostic accuracy of pre-induction cervical elastography, volume, length, and uterocervical angle for the prediction of successful induction of labor with dinoprostone. Arch Gynecol Obstet 308, 1301–1311 (2023). https://doi.org/10.1007/s00404-023-07076-8

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