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Comparison between sonographic cervical length and Bishop score in preinduction cervical assessment: a randomized
1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnamsi, Korea. pkh0419@snubh.org
Summary
Sonographic cervical length measurement can reduce prostaglandin use by 50% for cervical ripening in term nulliparae compared to the Bishop score, without impacting induction success.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Medicine
Background:
- Cervical ripening is crucial for labor induction.
- The Bishop score is a traditional method for assessing cervical readiness.
- Accurate assessment is needed to optimize prostaglandin use.
Purpose of the Study:
- To compare sonographic cervical length with the Bishop score.
- To determine the need for prostaglandin for preinduction cervical ripening.
- To evaluate outcomes in nulliparae at term.
Main Methods:
- 154 term nulliparae undergoing labor induction were randomized.
- Groups received prostaglandin based on Bishop score or sonographic cervical length.
- Unfavorable cervix defined as Bishop score ≤ 4 or cervical length ≥ 28 mm.
Main Results:
- Prostaglandin use was significantly lower in the sonographic cervical length group (36% vs. 75%).
- Induction success, Cesarean delivery rates, and time to delivery were similar between groups.
- Maternal demographics and gestational age were comparable.
Conclusions:
- Sonographic cervical length assessment can halve prostaglandin administration for cervical ripening.
- This method does not adversely affect induction outcomes in term nulliparae.
- Using a cervical length of ≥ 28 mm as a cut-off is effective.
