Effect of pre-induction transperineal ultrasonographic cervical lengt measurements and Bishop score on induction-to-delivery time

Abstract

Objective: We aimed to evaluate the effect of preinduction cervical length and Bishop score for induction-to-delivery interval in nulliparae and multiparae. Materials and Methods: A total of 97 pregnant women (55 nulliparae, 42 multiparae) between 35 and 44 weeks of gestation were included in the study. Misoprostol 50 g tablet was used as labour induction agent intravaginally. Cervical length measurement was obtained by transperineal ultrasonographic approach and Bishop score was determined with digital examination. While Mann-Whitney U test, Pearson correlation, spearman correlation and multiple linear regressions were used for continuous variables, chi-square test was used for categorical variables. Receiver Operating Characteristics Curve was used for bishop score and cervical length. Results: All vaginal deliveries were occurred within 24 hours. Eighth patients (8.2%) had nausea, 1 had (1%) vomiting, 9 had (9.3%) tachysystoly and 5 had (5.1%) hiperstimulation. Eight pregnant women (8.2%) were delivered with caesarean section. In nulliparous and multiparous women, Bishop score and cervical length showed correlation (r=0.752, p=0.000; r=0.691, p=0.000; respectively). Cervical length (r=0.490, p=0.000) and Bishop score (r=0.455, p=0.01) were correlated in nulliparae whereas only Bishop score (r=0.441, p=0.04) were correlated in multiparae. To determine the induction-to-delivery time using multiple linear regression, the cervical length for multiparae (t=3.850, p=0.000) and the Bishop Score for multiparae (t=11.222, p=0.000) were the only independent variables. Receiver operating characteristics for induction-to-delivery time curve showed that cervix length was better than Bishop score in nulliparae whereas the Bishop Score was better than cervical length in multiparae. Conclusion: Fifty g misoprostol intravaginally was found successful in induction of delivery. To determine induction-to-delivery time in pregnancies, cervical length in nulliparae and Bishop score in multiparae was found more suitable.

Keywords

• Ultrasonography,Delivery, Obstetric,Cervix Uteri,Misoprostol,Parity

İndüksiyon öncesi transperineal ultrasonografik servikal uzunluk ve Biskop skorunun indüksiyon-doğum süresine etkisi

Abstract

Amaç: Nullipar ve multipar gebelerde indüksiyon öncesi ultrasonografik servikal uzunluk ve Bishop skorunun indüksiyon-doğum süresine etkisini araştırdık. Gereç ve Yöntem: Çalışmaya 35-44 gebelik haftaları arasında değişen 97 gebe (55 nullipar, 42 multipar) alındı; indüksiyon amacıyla intravaginal yoldan misoprostol 50 g tablet kullanıldı; Bishop skoru dijital muayene ile belirlendi; servikal uzunluk transperineal ultrasonografi ile ölçüldü. Sürekli değişkenler için Mann-Whitney U testi, Pearson korelasyon, Spearman korelasyon ve çoklu doğrusal regresyon kullanıldı. Kategorik değişkenler için ÷2 testi kullanıldı. Bishop skoru ve servikal uzunluk için Receiver Operating Characteristic (ROC) eğrisi çizildi. Bulgular: Bütün vaginal doğumlar 24 saat içerisinde gerçekleşti. Bulantı 8 (%8.2), kusma 1 (%1) taşisistoli 9 (%9.3), hiperstimülasyon 5 (%5.1) gebede görüldü. Sekiz olgu (%8.2) sezaryen ile doğurtuldu. Nullipar ve multipar gebelerde Bishop skoru ve servikal uzunluk (sırasıyla r=0.752, p=0.000; r=0.691, p=0.000) korelasyon gösterdi. Nullipar gebelerde indüksiyon-doğum süresi ile servikal uzunluk (r=0.490, p=0.000) ve Bishop skoru (r=0.455, p=0.01) korelasyon gösterdi, multiparlarda ise sadece Bishop skorunda (r=0.441, p=0.004) korelasyon bulundu. Çoklu doğrusal regresyon modeline göre nullipar gebelerde servikal uzunluk (t=3.850, p=0.000), multipar gebelerde ise Bishop skorunun (t=11.222, p=0.000) tek bağımsız değişken olduğu görüldü. ROC eğrisine göre nulliparlarda indüksiyon-doğum süresini belirlemede servikal uzunluğun, multiparlarda ise Bishop skorunun daha iyi olduğu bulundu. Sonuç: İntravaginal yoldan misoprostol 50 g uygulaması doğum indüksiyonunda başarılı bulundu. İndüksiyon-doğum süresini belirlemede nullipar gebelerde servikal uzunluğun, multipar gebelerde ise Bishop skorunun kullanılmasının daha uygun olduğu sonucuna varıldı.

Keywords

• Ultrasonografi,Doğum, obstetrik,Serviks uteri,Misoprostol,Parite

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