Cervical Length Assessment by Ultrasound in Prolonged Pregnancy as a Predictor of Spontaneous Onset of Labor and Successful Vaginal Delivery in Comparison with Bishop Score
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- Category: Vol. 85, June 2017
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Cervical Length Assessment by Ultrasound in Prolonged Pregnancy as a Predictor of Spontaneous Onset of Labor and Successful Vaginal Delivery in Comparison with Bishop Score, HADEER MESHAL and EMAD SALAH
Abstract
Objective: To examine the value of cervical length meas-urement with Bishop score in a prolonged pregnancy to predict spontaneous onset of labor within the subsequent 7 days and the rate of successful vaginal delivery.
Patients and Methods: It is a prospective cohort study done at Kasr El-Aini Hospital over a period from February 2012 to October 2014. This study included 200 pregnant patients from 41 weeks to 42 weeks of gestation. These patients are not in labor, with single vertex fetal presentation, without previous uterine scar; without previous operations on the cervix (e.g. cervical amputation); and with absence of any obstetric or medical complications with pregnancy (e.g. Diabetes). All patients were subjected to history taking, abdominal and vaginal examination including Bishop Score. The cervical length measurement by Trans-vaginal ultrasound was recorded in all patients. Spontaneous onset of labor pains is awaited for patients who have completed 41 weeks till 41 weeks + 6 days. The number of cases who delivered vaginally and the number of cases who delivered by Cesarean Section due to failure of progress or fetal distress were recorded. Labor induction was done for patients who completed 42 weeks of gestation according to standard Kasr El-Aini guide-lines of induction. The number of cases who were delivered vaginally and cases who delivered by Cesarean Section due to failure of progress or fetal distress were recorded.
Results: In our study, according to the Bishop score, it is inversely related to the number of cases showing spontaneous onset of labor pains and the number of cases that delivered vaginally among this group (mean=6.05). Also, according to the cervical length, it was found that it is conversely related to the number of cases who delivered vaginally in the spon-taneous onset of labor pains group with statistical difference with the number of cases that delivered by Cesarean Section in this group (mean=21.82mm).
Conclusion: Prediction of spontaneous onset of labor and successful vaginal delivery can be done when cervical length measurement by trans-vaginal ultrasound combined with Bishop score.