Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial
Objective To evaluate the association between transvaginal ultrasound scan of cervix and Bishop’s score in predicting successful induction of labour, cut-off points and patients’ tolerability and acceptance for both procedures. Design A comparative clinical trial. Setting A tertiary hospita...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Published: |
Public Library of Science
2022
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| Online Access: | http://psasir.upm.edu.my/id/eprint/102848/ |
| _version_ | 1848863887400632320 |
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| author | Abang Abdullah, Zainab Hananah Chew, Kah Teik V. Velayudham, V. Ramesh Yahaya, Zainab Mohd Jamil, Amilia Afzan Abu, Muhammad Azrai Abdul Ghani, Nur Azurah Mohamed Ismail, Nor Azlin |
| author_facet | Abang Abdullah, Zainab Hananah Chew, Kah Teik V. Velayudham, V. Ramesh Yahaya, Zainab Mohd Jamil, Amilia Afzan Abu, Muhammad Azrai Abdul Ghani, Nur Azurah Mohamed Ismail, Nor Azlin |
| author_sort | Abang Abdullah, Zainab Hananah |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Objective
To evaluate the association between transvaginal ultrasound scan of cervix and Bishop’s score in predicting successful induction of labour, cut-off points and patients’ tolerability and acceptance for both procedures.
Design
A comparative clinical trial.
Setting
A tertiary hospital in Selangor, Malaysia.
Participants
294 women planned for elective induction of labour for various indications were included. All women had transvaginal ultrasound to assess the cervical length and digital vaginal examination to assess the Bishop cervical scoring by separate investigators before induction of labour.
Primary outcome measure
To evaluate the association of the cervical length by transvaginal ultrasound scan and Bishop score in predicting successful induction of labour.
Secondary outcome measure
Variables associated with successful induction of labour and patients’ tolerability and acceptance for transvaginal ultrasound scan of cervix.
Results
There was no statistically significant difference among the vaginal and Caesarean delivery groups in terms of mean maternal age, height, weight, body mass index, ethnicity and gestational age at induction. Vaginal delivery occurred in 207 women (70.4%) and 87 women (29.6%) delivered via Caesarean section. There was a high degree of correlation between the cervical length and Bishop score (r-value 0.745; p <0.001). Sonographic assessment of cervical length demonstrated a comparable accuracy in comparison to Bishop score. Analysis using ROC curves noted an optimal cut-off value of ≤27mm for cervical length and Bishop score of ≥ 4, with a sensitivity of 69.1% vs 67%, specificity 60.9% vs 55%, and area under the curves (AUCs) of 0.672 and 0.643 respectively (p <0.001). Multivariate logistic regression analysis demonstrated that parity (OR 2.70), cervical length (OR 0.925), Bishop score (OR 1.272) and presence of funnelling (OR 3.292) were highly significant as independent predictors of success labour induction. Women also expressed significantly less discomfort with transvaginal ultrasound compared with digital vaginal examination.
Conclusion
Sonographic assessment of cervical measurement predicts the success of induction of labour with similar diagnostic accuracy with conventional Bishop score. |
| first_indexed | 2025-11-15T13:40:03Z |
| format | Article |
| id | upm-102848 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T13:40:03Z |
| publishDate | 2022 |
| publisher | Public Library of Science |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1028482024-06-30T14:56:34Z http://psasir.upm.edu.my/id/eprint/102848/ Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial Abang Abdullah, Zainab Hananah Chew, Kah Teik V. Velayudham, V. Ramesh Yahaya, Zainab Mohd Jamil, Amilia Afzan Abu, Muhammad Azrai Abdul Ghani, Nur Azurah Mohamed Ismail, Nor Azlin Objective To evaluate the association between transvaginal ultrasound scan of cervix and Bishop’s score in predicting successful induction of labour, cut-off points and patients’ tolerability and acceptance for both procedures. Design A comparative clinical trial. Setting A tertiary hospital in Selangor, Malaysia. Participants 294 women planned for elective induction of labour for various indications were included. All women had transvaginal ultrasound to assess the cervical length and digital vaginal examination to assess the Bishop cervical scoring by separate investigators before induction of labour. Primary outcome measure To evaluate the association of the cervical length by transvaginal ultrasound scan and Bishop score in predicting successful induction of labour. Secondary outcome measure Variables associated with successful induction of labour and patients’ tolerability and acceptance for transvaginal ultrasound scan of cervix. Results There was no statistically significant difference among the vaginal and Caesarean delivery groups in terms of mean maternal age, height, weight, body mass index, ethnicity and gestational age at induction. Vaginal delivery occurred in 207 women (70.4%) and 87 women (29.6%) delivered via Caesarean section. There was a high degree of correlation between the cervical length and Bishop score (r-value 0.745; p <0.001). Sonographic assessment of cervical length demonstrated a comparable accuracy in comparison to Bishop score. Analysis using ROC curves noted an optimal cut-off value of ≤27mm for cervical length and Bishop score of ≥ 4, with a sensitivity of 69.1% vs 67%, specificity 60.9% vs 55%, and area under the curves (AUCs) of 0.672 and 0.643 respectively (p <0.001). Multivariate logistic regression analysis demonstrated that parity (OR 2.70), cervical length (OR 0.925), Bishop score (OR 1.272) and presence of funnelling (OR 3.292) were highly significant as independent predictors of success labour induction. Women also expressed significantly less discomfort with transvaginal ultrasound compared with digital vaginal examination. Conclusion Sonographic assessment of cervical measurement predicts the success of induction of labour with similar diagnostic accuracy with conventional Bishop score. Public Library of Science 2022 Article PeerReviewed Abang Abdullah, Zainab Hananah and Chew, Kah Teik and V. Velayudham, V. Ramesh and Yahaya, Zainab and Mohd Jamil, Amilia Afzan and Abu, Muhammad Azrai and Abdul Ghani, Nur Azurah and Mohamed Ismail, Nor Azlin (2022) Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial. PLoS ONE, 17 (1). art. no. e0262387. pp. 1-14. ISSN 1932-6203 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262387 10.1371/journal.pone.0262387 |
| spellingShingle | Abang Abdullah, Zainab Hananah Chew, Kah Teik V. Velayudham, V. Ramesh Yahaya, Zainab Mohd Jamil, Amilia Afzan Abu, Muhammad Azrai Abdul Ghani, Nur Azurah Mohamed Ismail, Nor Azlin Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title | Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title_full | Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title_fullStr | Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title_full_unstemmed | Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title_short | Pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| title_sort | pre-induction cervical assessment using transvaginal ultrasound versus bishops cervical scoring as predictors of successful induction of labour in term pregnancies: a hospital-based comparative clinical trial |
| url | http://psasir.upm.edu.my/id/eprint/102848/ http://psasir.upm.edu.my/id/eprint/102848/ http://psasir.upm.edu.my/id/eprint/102848/ |