Successful induction of labor: prediction by preinduction cervical length, angle of progression and cervical elastography

Abstract

Objective: To examine the potential value of preinduction cervical length, cervical elastography and angle of progression (AOP) in prediction of successful vaginal delivery and induction-to-delivery interval.

Methods: This was a prospective study in 99 women with singleton pregnancy undergoing preinduction ultrasound assessment at 35-42 weeks' gestation. Cervical length, elastographic score at the internal os and AOP were determined. Regression analysis was used to assess the relationship between cervical length and both AOP and elastographic score. Logistic regression analysis was used to determine which of the maternal characteristics (cervical length, AOP, elastographic score) were significant predictors of vaginal delivery and induction-to-delivery interval.

Results: Vaginal delivery occurred in 66 (66.7%) cases and Cesarean delivery was performed in 33 (33.3%) cases. There were significant correlations between cervical length and both AOP (r = - 0.319) and elastographic score (r = 0.368). Significant independent prediction of vaginal delivery and induction-to-delivery interval was provided by nulliparity and cervical length, with no additional significant contribution from electrographic score or AOP.

Conclusions: In women undergoing induction of labor, AOP and elastographic score at the internal os are unlikely to be useful in prediction of vaginal delivery and induction-to-delivery interval.

Keywords: angle of progression; cervical length; elastography; induction of labor.