Bishop score and ultrasound assessment of the cervix for prediction of time to onset of labor and time to delivery in prolonged pregnancy.

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Abstract

Objectives
To determine the ability of Bishop score and sonographic cervical length to predict time to spontaneous onset of labor and time to delivery in prolonged pregnancy.

Methods
Ninety-seven women underwent transvaginal ultrasound examination and palpation of the cervix at 291-296 days' gestation according to ultrasound fetometry at 12-20 weeks' gestation. Sonographic cervical length and Bishop score were recorded. Multivariate logistic regression analysis was used to determine which variables were independent predictors of the onset of labor/delivery 24 h, 48 h, and 96 h. Receiver-operating characteristics (ROC) curves were drawn to assess diagnostic performance.

Results
In nulliparous women (n = 45), both Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h and 48 h (area under ROC curve for the onset of labor 24 h 0.79 vs. 0.80, P = 0.94; for delivery 24 h 0.81 vs. 0.85, P = 0.64; for the onset of labor 48 h 0.73 vs. 0.74, P = 0.90; for delivery 48 h 0.77 vs. 0.71, P = 0.50). Only Bishop score discriminated between nulliparous women who went into labor/delivered 96 h or > 96 h. A logistic regression model including Bishop score and cervical length was superior to Bishop score alone in predicting delivery 24 h (area under ROC curve 0.93 vs. 0.81, P = 0.03) and superior to Bishop score alone and cervical length alone in predicting the onset of labor 24 h (area under ROC curve 0.90 vs. 0.79, P = 0.06; and 0.90 vs. 0.80, P = 0.06). In parous women (n = 52), Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h (area under ROC curve for the onset of labor 0.75 vs. 0.69, P = 0.49; for delivery 0.74 vs. 0.70, P = 0.62), but only Bishop score discriminated between women who went into labor/delivered 48 h and > 48 h. Three parous women had not gone into labor and six had not given birth at 96 h. In parous women logistic regression models including both Bishop score and cervical length did not substantially improve prediction of the time to onset of labor/delivery.

Conclusions
In prolonged pregnancy Bishop score and sonographic cervical length have a similar ability to predict the time to the onset of labor and delivery. In nulliparous women the use of logistic regression models including Bishop score and cervical length is likely to offer better prediction of the onset of labor/delivery 24 h than the use of the Bishop score alone.

Detaljer

Författare
Enheter & grupper
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Radiologi och bildbehandling

Nyckelord

Originalspråkengelska
Sidor (från-till)298-305
TidskriftUltrasound in Obstetrics & Gynecology
Volym28
Utgivningsnummer3
StatusPublished - 2006
PublikationskategoriForskning
Peer review utfördJa

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