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Sonoelastography as method for preliminary evaluation of uterine cervix to predict success of induction of labor
A Muscatello1, M Di Nicola, V Accurti
1Department of Obstetrics and Gynecology, University of L'Aquila, S. Salvatore Hospital, Coppito, Italy.
Introduction:
Induction of labor is a useful practice to solve many obstetric situations but has a large impact on the health of women and their babies and therefore needs to be clearly justified clinically.
Aim:
To determine the sensitivity of sonoelastography in the evaluation of the cervix to predict the success of induction.
Materials And Methods:
We enrolled 53 subjects preparing for induction of labor. Transvaginal evaluation of cervical length and a sonoelastogram were performed. We preliminarily classified the sonoelastograms into five elastography index (EI) categories and examined the different distribution of cesarean or spontaneous deliveries in various subgroups of EI by χ(2) test and multivariate analysis by logistic regression.
Results:
Statistical analysis revealed a significant difference of prevalence of spontaneous delivery (EI1-3 82.75%, EI4-5 45.8%) versus cesarean section (EI1-3 17.25%, EI4-5 54.16%) (p = 0.0072). The diagnostic validity of EI was evaluated using the receiver operating characteristic curve and cut-off of the predictive value was EI3.
Discussion:
The results of our study indicate that sonoelastography is an innovative technique that could allow a more objective preliminary evaluation of the cervix before inducing labor, however further studies with a larger number of subjects and a standardization of image acquisition are necessary.
