Repeatability and Reproducibility of Potential Ultrasonographic Bishop Score Parameters

Jakub Mlodawski; Marta Mlodawska; Justyna Plusajska; Karolina Detka; Katarzyna Bialek; Grzegorz Swiercz

doi:10.3390/jcm12134492

Repeatability and Reproducibility of Potential Ultrasonographic Bishop Score Parameters

J Clin Med. 2023 Jul 5;12(13):4492. doi: 10.3390/jcm12134492.

Authors

Jakub Mlodawski^{1

2}, Marta Mlodawska¹, Justyna Plusajska^{1

2}, Karolina Detka², Katarzyna Bialek^{1

2}, Grzegorz Swiercz^{1

2}

Affiliations

¹ Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland.
² Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland.

Abstract

Determination of the Bishop score (BS) is a traditional method of assessing the cervix in obstetrics and gynecology. This examination is characterized by subjectivity of assessment and low repeatability. In scientific studies intended to evaluate the results of the procedure based on the initial assessment, it is necessary to find an objective scale based on ultrasonography. We selected five ultrasound parameters, measured with a transvaginal transducer, that are equivalent to the individual BS axes (dilatation assessed in three-dimensional ultrasound (DL), angle of progression (AoP), vagino-cervical angle (VCA), strain elastography using the E-Cervix module, and cervical length (CL)). All selected parameters were characterized by good to excellent repeatability (intraclass correlation coefficient (ICC) = 0.878-0.994) and reproducibility (ICC = 0.826-0.996). Each of the selected parameters significantly correlated with its corresponding BS axis. The highest value of the correlation coefficient was achieved with CL (-0.75) and DL (0.71). Other parameters were characterized by an average to high correlation (AoP and station = 0.69, hardness ratio and consistency = -0.33, position and VCA = -0.38). The best correlation with the sum of the BS points was exhibited by AoP (0.52) and CL (-0.61). The selected ultrasound parameters analogous to the BS axes were characterized by high repeatability and significant correlation with the axes of the original clinical BS. Further research into the predictive properties of a multivariate model based on these parameters is needed.

Keywords: bishop score; elastography; induction of labor.

Grants and funding

Project financed under the program the Minister of Education and Science, entitled “Regional Initiative of Excellence”, in the years 2019–2023; project no. 024/RID/2018/19, amount of financing 11 999 000 PLN.