Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Branislava Ćosića 37, 21000 Novi Sad, Serbia.
Medicina (Kaunas). 2024 Jul 12;60(7):1127. doi: 10.3390/medicina60071127.
: The incidence of labor induction is steadily increasing worldwide. The main aim of this study was to evaluate the ultrasound parameters and their mutual correlation and to analyze the parameters' predictive capability in assessing the success of labor induction. The secondary goal was to assess patients' tolerability and acceptance of transvaginal ultrasound and digital gynecological examination. : This prospective observational follow-up study included 252 women selected for labor induction. The transvaginal ultrasound examination measured the posterior cervical angle, cervical length, the length and width funneling of the cervix, the distance between the head of the fetus and the external uterine os, and the position of the fetal occiput. After the ultrasound, a digital vaginal examination was performed (according to the Bishop score), and the women were asked to rate their perception of pain for each procedure. : The most common indication for labor induction was post-term pregnancy (57.59%), and the most common method of labor induction was oxytocin with amniotomy (70%). The results showed that a significant independent prediction of vaginal delivery could be provided based on the Bishop score and cervical length. Other investigated ultrasound parameters, the length and width of the funneling of the cervix ( < 0.001), the fetal head stage ( < 0.001), and the size of the posterior cervical angle ( < 0.05), showed statistical significance in relation to the success of labor induction. Patients reported lower discomfort and pain during transvaginal ultrasound examination (mean score 2, IQR 3) compared to digital examination (mean score 5, IQR 4), with < 0.001. : The results imply that the assessment of ultrasound parameters before induction of labor is necessary to predict the outcome and reduce the possibility of complications. In terms of tolerability and choice by the patients, the transvaginal ultrasound examination was better rated than the vaginal gynecological examination.
: 全球范围内,分娩诱导的发生率正在稳步上升。本研究的主要目的是评估超声参数及其相互关系,并分析这些参数在评估分娩诱导成功方面的预测能力。次要目标是评估患者对经阴道超声和数字妇科检查的耐受性和接受程度。
: 这项前瞻性观察性随访研究纳入了 252 名选择分娩诱导的女性。经阴道超声检查测量了后宫颈角、宫颈长度、宫颈管的长度和宽度漏斗形、胎儿头部与子宫外口之间的距离以及胎儿枕骨的位置。超声检查后进行了数字阴道检查(根据 Bishop 评分),并要求女性对每个步骤的疼痛感知进行评分。
: 分娩诱导的最常见指征是过期妊娠(57.59%),最常见的分娩诱导方法是催产素联合羊膜切开术(70%)。结果表明,Bishop 评分和宫颈长度可提供阴道分娩的独立预测。其他研究的超声参数,宫颈管的长度和宽度漏斗形(<0.001)、胎儿头部阶段(<0.001)和后宫颈角的大小(<0.05)与分娩诱导的成功也具有统计学意义。与数字检查(平均评分 5,IQR 4)相比,患者报告经阴道超声检查的不适感和疼痛程度较低(平均评分 2,IQR 3),差异具有统计学意义(<0.001)。
: 结果表明,在分娩诱导前评估超声参数对于预测结果和降低并发症的可能性是必要的。在耐受性和患者选择方面,经阴道超声检查的评分优于阴道妇科检查。