Does Cervical Length Predict the Successful Labor Induction in Term Nulliparous Women Who Had Unfavorable Cervix

Abstract

The aim of this study was to determine the predictive value of cervical length (CL) measurement in the result of labor induction in term nulliparous women who had a strict cervix. A total of 78 pregnancies were evaluated prospectively. Dinoprostone ovule was used for the induction of labor in all cases. Low dose oxytocin was administered for augmentation of the labor. Statistical analyses were performed using SPSS Version 24. A p-value <0.05 was determined as to be statistically significant. Dinoprostone's indication for labor induction was seen in 57.7% of cases at post-term pregnancy and unsafe fetal wellbeing observed in the remaining 42.3% of the patients. 59% of patients delivered their babies vaginally, and we performed a cesarean section in 41% of patients. The most cesarean indication was fetal distress (40.6%). The arrest of labor was considered in 31.2% of the patients and failed labor induction was observed in 28.1% of the patients. A significant correlation was found between CL and successful labor induction. The Area Under the Curve (AUC) for CL was: 0.6975 (95% CI: 0.5816-0.8134). The sensitivity and specificity of CL≤ 20 mm were 94% and 45%, respectively, while the positive and negative predictive values associated with it were 57% and 90%. Sensitivity was 23%, and specificity was 84% at the CL≥ 30 mm cut-off point. There was no significant difference between umbilical cord pH and the route of delivery (p: 0.185). Our study indicates that CL measurement is a highly effective method to predict labor induced, particularly in nulliparous and having unfavorable cervix. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.