J Korean Med Sci.  2007 Aug;22(4):722-727. 10.3346/jkms.2007.22.4.722.

Transvaginal Ultrasonographic Cervical Measurement in Predicting Failed Labor Induction and Cesarean Delivery for Failure to Progress in Nulliparous Women

• Park KH

• KMID: 1127094
• DOI: http://doi.org/10.3346/jkms.2007.22.4.722

Abstract

The aim of this study was to evaluate the value of transvaginal sonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. One hundred and sixty-one women scheduled for labor induction underwent transvaginal ultrasonography and digital cervical examinations. Logistic regression demonstrated that cervical length and gestational age at induction, but not the Bishop score, significantly and independently predicted failed labor induction. According to the receiver operating characteristic curves analysis, the best cut-off value of cervical length for predicting failed labor induction was 28 mm, with a sensitivity of 62% and a specificity of 60%. In terms of the likelihood of a cesarean delivery for failure to progress as the outcome variable, logistic regression indicated that maternal height and birth weight, but not cervical length or Bishop score, were significantly and independently associated with an increased risk of cesarean delivery for failure to progress. Transvaginal sonographic measurements of cervical length thus independently predicted failed labor induction in nulliparous women. However, the relatively poor predictive performance of this test undermines its clinical usefulness as a predictor of failed labor induction. Moreover, cervical length appears to have a poor predictive value for the likelihood of a cesarean delivery for failure to progress.

Keyword

Cervical Length; Bishop Score; Labor Induction; Cesarean Delivery for Failure to Progress

MeSH Terms

Adult
Analysis of Variance
Cervix Uteri/*ultrasonography
*Cesarean Section
Female
Humans
*Labor, Induced
Labor, Obstetric
Logistic Models
Parity
Pregnancy
Prospective Studies
ROC Curve
Risk Factors
Treatment Failure
Ultrasonography/*methods
Vagina/ultrasonography

Figure

• 

  Fig. 1 Receiver operating characteristic curves analysis for sonographically measured cervical length (mm) in predicting failed labor induction.

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