Mlodawski Jakub, Mlodawska Marta, Plusajska Justyna, Detka Karolina, Bialek Katarzyna, Swiercz Grzegorz
Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland.
Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland.
J Clin Med. 2023 Jul 5;12(13):4492. doi: 10.3390/jcm12134492.
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.
Bishop评分(BS)的测定是妇产科评估宫颈的传统方法。这项检查的特点是评估具有主观性且重复性低。在旨在基于初始评估来评估该程序结果的科学研究中,有必要找到一种基于超声检查的客观量表。我们选择了五个经阴道探头测量的超声参数,它们等同于各个BS轴(三维超声评估的扩张程度(DL)、进展角度(AoP)、阴道-宫颈角度(VCA)、使用E-宫颈模块的应变弹性成像以及宫颈长度(CL))。所有选定参数的重复性良好至极佳(组内相关系数(ICC)= 0.878 - 0.994),再现性也良好(ICC = 0.826 - 0.996)。每个选定参数与其相应的BS轴均显著相关。相关系数的最高值出现在CL(-0.75)和DL(0.71)上。其他参数的相关性为中等至高(AoP与胎先露位置 = 0.69,硬度比与一致性 = -0.33,位置与VCA = -0.38)。与BS评分总和相关性最佳的是AoP(0.52)和CL(-0.61)。选定的类似于BS轴的超声参数具有高重复性,且与原始临床BS轴显著相关。需要进一步研究基于这些参数的多变量模型的预测特性。