经阴道超声波测量宫颈长度与改良毕夏普评分用于临产前宫颈评估:随机对照试验。

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Chigozie G Okafor, George U Eleje, Joseph I Ikechebelu, Chisolum O Okafor, Betrand O Nwosu, Chidinma C Okafor, Gerald O Udigwe, Johnbosco E Mamah, Evaristus C Ezema, Chukwudi A Ogabido, Hillary I Obiagwu, Chukwuemeka C Okoro, Tobechi K Njoku, Chinedu L Olisa, Emmanuel I Okaforcha, Ifeanyi O Okonkwo, Lazarus U Okafor, Kelechi U Okoye, Obinna K Nnabuchi, Chiemezie M Agbanu, Ahizechukwu C Eke
{"title":"经阴道超声波测量宫颈长度与改良毕夏普评分用于临产前宫颈评估:随机对照试验。","authors":"Chigozie G Okafor, George U Eleje, Joseph I Ikechebelu, Chisolum O Okafor, Betrand O Nwosu, Chidinma C Okafor, Gerald O Udigwe, Johnbosco E Mamah, Evaristus C Ezema, Chukwudi A Ogabido, Hillary I Obiagwu, Chukwuemeka C Okoro, Tobechi K Njoku, Chinedu L Olisa, Emmanuel I Okaforcha, Ifeanyi O Okonkwo, Lazarus U Okafor, Kelechi U Okoye, Obinna K Nnabuchi, Chiemezie M Agbanu, Ahizechukwu C Eke","doi":"10.1177/1742271X241288156","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The inducibility of the cervix for labour induction is usually determined by cervical status evaluation. The Bishop score is historically used to forecast the success of induction of labour, although it is subjective, and not reproducible. However, transvaginal ultrasound measurements of cervical length are rarely used for preinduction cervical assessment. The study compared cervical length measured via transvaginal ultrasound and the modified Bishop score for preinduction cervical assessment at term.</p><p><strong>Methods: </strong>The study involved 72 pregnant, nulliparous women for induction of labour at term. They were randomised into the transvaginal ultrasound group and the modified Bishop score group. The cervix was said to be 'ripe' when the transvaginal ultrasound cervical length (CL) was < 28 mm or the modified Bishop score was ⩾ 6. The cervix was considered 'unripe' when the Bishop score was < 6 or the transvaginal ultrasound was ⩾ 28 mm. Participants with ripe cervices had induction of labour with an oxytocin infusion, while those with unripe cervices had preinduction cervical ripening with misoprostol. The primary outcome measures were the mode of delivery and the total amount of prostaglandins administered for preinduction cervical ripening.</p><p><strong>Results: </strong>There was no significant difference between the two groups with regard to the mode of delivery (<i>p</i> = 0.795), the total amount of prostaglandins administered for preinduction cervical ripening (105.0 ± 51.04 µg vs 111.90 ± 52.2 µg; <i>p</i> = 0.0671), the proportion of women who were administered prostaglandins due to an unfavourable cervix (41.7% vs 55.6%; <i>p</i> = 0.812), induction-to-the-active phase of the labour interval (11.00 ± 4.2 hours vs 11.82 ± 4.12 hours; <i>p</i> = 0.407) or the induction-delivery interval (20.15 ± 5.7 hours vs 22.66 ± 4.33 hours; <i>p</i> = 0.06) in both groups, respectively. Compared with those in the Bishop score group (Bishop score ⩾ 6), the induction-to-active phase of labour intervals (6.47 ± 0.77 hours vs 7.33 ± 1.21 hours, <i>p</i> = 0.024) and the induction-to-delivery intervals (14.97 ± 1.0 hours vs 18.39 ± 0.85 hours; <i>p</i> = 0.0001) in the transvaginal ultrasound group (cervical length < 28 mm) were significantly shorter, respectively.</p><p><strong>Conclusion: </strong>Preinduction cervical assessment using transvaginal ultrasound (cervical length < 28 mm) or the modified Bishop score is a successful predictor of the outcome of labour induction A larger multicentre studies are needed to identify optimal cervical length cutoffs and to determine if this could decrease unnecessary prostaglandin use or decrease caesarean section rate.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241288156"},"PeriodicalIF":0.8000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563529/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transvaginal ultrasonography-measured cervical length versus the modified Bishop score for preinduction cervical assessment at term: A randomised controlled trial.\",\"authors\":\"Chigozie G Okafor, George U Eleje, Joseph I Ikechebelu, Chisolum O Okafor, Betrand O Nwosu, Chidinma C Okafor, Gerald O Udigwe, Johnbosco E Mamah, Evaristus C Ezema, Chukwudi A Ogabido, Hillary I Obiagwu, Chukwuemeka C Okoro, Tobechi K Njoku, Chinedu L Olisa, Emmanuel I Okaforcha, Ifeanyi O Okonkwo, Lazarus U Okafor, Kelechi U Okoye, Obinna K Nnabuchi, Chiemezie M Agbanu, Ahizechukwu C Eke\",\"doi\":\"10.1177/1742271X241288156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The inducibility of the cervix for labour induction is usually determined by cervical status evaluation. The Bishop score is historically used to forecast the success of induction of labour, although it is subjective, and not reproducible. However, transvaginal ultrasound measurements of cervical length are rarely used for preinduction cervical assessment. The study compared cervical length measured via transvaginal ultrasound and the modified Bishop score for preinduction cervical assessment at term.</p><p><strong>Methods: </strong>The study involved 72 pregnant, nulliparous women for induction of labour at term. They were randomised into the transvaginal ultrasound group and the modified Bishop score group. The cervix was said to be 'ripe' when the transvaginal ultrasound cervical length (CL) was < 28 mm or the modified Bishop score was ⩾ 6. The cervix was considered 'unripe' when the Bishop score was < 6 or the transvaginal ultrasound was ⩾ 28 mm. Participants with ripe cervices had induction of labour with an oxytocin infusion, while those with unripe cervices had preinduction cervical ripening with misoprostol. The primary outcome measures were the mode of delivery and the total amount of prostaglandins administered for preinduction cervical ripening.</p><p><strong>Results: </strong>There was no significant difference between the two groups with regard to the mode of delivery (<i>p</i> = 0.795), the total amount of prostaglandins administered for preinduction cervical ripening (105.0 ± 51.04 µg vs 111.90 ± 52.2 µg; <i>p</i> = 0.0671), the proportion of women who were administered prostaglandins due to an unfavourable cervix (41.7% vs 55.6%; <i>p</i> = 0.812), induction-to-the-active phase of the labour interval (11.00 ± 4.2 hours vs 11.82 ± 4.12 hours; <i>p</i> = 0.407) or the induction-delivery interval (20.15 ± 5.7 hours vs 22.66 ± 4.33 hours; <i>p</i> = 0.06) in both groups, respectively. Compared with those in the Bishop score group (Bishop score ⩾ 6), the induction-to-active phase of labour intervals (6.47 ± 0.77 hours vs 7.33 ± 1.21 hours, <i>p</i> = 0.024) and the induction-to-delivery intervals (14.97 ± 1.0 hours vs 18.39 ± 0.85 hours; <i>p</i> = 0.0001) in the transvaginal ultrasound group (cervical length < 28 mm) were significantly shorter, respectively.</p><p><strong>Conclusion: </strong>Preinduction cervical assessment using transvaginal ultrasound (cervical length < 28 mm) or the modified Bishop score is a successful predictor of the outcome of labour induction A larger multicentre studies are needed to identify optimal cervical length cutoffs and to determine if this could decrease unnecessary prostaglandin use or decrease caesarean section rate.</p>\",\"PeriodicalId\":23440,\"journal\":{\"name\":\"Ultrasound\",\"volume\":\" \",\"pages\":\"1742271X241288156\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563529/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ultrasound\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/1742271X241288156\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/1742271X241288156","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

摘要

引言引产时宫颈的可引性通常由宫颈状态评估决定。毕夏普评分历来被用来预测引产的成功率,尽管它是主观的,而且不具有可重复性。然而,经阴道超声测量宫颈长度很少用于引产前的宫颈评估。该研究比较了经阴道超声测量的宫颈长度和用于临产前宫颈评估的改良毕夏普评分:该研究涉及 72 名接受临产引产的无阴道孕妇。她们被随机分为经阴道超声组和改良毕夏普评分组。当经阴道超声检查宫颈长度(CL)小于 28 毫米或改良毕晓普评分小于 6 分时,宫颈被视为 "成熟"。当 Bishop 评分小于 6 或经阴道超声检查宫颈长度小于 28 毫米时,宫颈被视为 "未成熟"。宫颈成熟的参试者使用催产素进行引产,而宫颈不成熟的参试者则使用米索前列醇进行引产前宫颈催熟。主要结果指标是分娩方式和引产前宫颈成熟术中使用的前列腺素总量:结果:两组在分娩方式(p = 0.795)、宫颈诱导前催熟的前列腺素总量(105.0 ± 51.04 µg vs 111.90 ± 52.2 µg;p = 0.0671)、因宫颈不佳而使用前列腺素的妇女比例(41.7% vs 55.6%; p = 0.812)、引产到活跃期的间隔(11.00 ± 4.2 小时 vs 11.82 ± 4.12 小时;p = 0.407)或引产到分娩的间隔(20.15 ± 5.7 小时 vs 22.66 ± 4.33 小时;p = 0.06)。与 Bishop 评分组(Bishop 评分 ⩾ 6)相比,经阴道超声组(宫颈长度小于 28 毫米)的引产至活跃期间隔(6.47 ± 0.77 小时 vs 7.33 ± 1.21 小时,p = 0.024)和引产至分娩间隔(14.97 ± 1.0 小时 vs 18.39 ± 0.85 小时,p = 0.0001)分别明显缩短:需要进行更大规模的多中心研究,以确定最佳宫颈长度临界值,并确定这是否能减少不必要的前列腺素使用或降低剖宫产率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transvaginal ultrasonography-measured cervical length versus the modified Bishop score for preinduction cervical assessment at term: A randomised controlled trial.

Introduction: The inducibility of the cervix for labour induction is usually determined by cervical status evaluation. The Bishop score is historically used to forecast the success of induction of labour, although it is subjective, and not reproducible. However, transvaginal ultrasound measurements of cervical length are rarely used for preinduction cervical assessment. The study compared cervical length measured via transvaginal ultrasound and the modified Bishop score for preinduction cervical assessment at term.

Methods: The study involved 72 pregnant, nulliparous women for induction of labour at term. They were randomised into the transvaginal ultrasound group and the modified Bishop score group. The cervix was said to be 'ripe' when the transvaginal ultrasound cervical length (CL) was < 28 mm or the modified Bishop score was ⩾ 6. The cervix was considered 'unripe' when the Bishop score was < 6 or the transvaginal ultrasound was ⩾ 28 mm. Participants with ripe cervices had induction of labour with an oxytocin infusion, while those with unripe cervices had preinduction cervical ripening with misoprostol. The primary outcome measures were the mode of delivery and the total amount of prostaglandins administered for preinduction cervical ripening.

Results: There was no significant difference between the two groups with regard to the mode of delivery (p = 0.795), the total amount of prostaglandins administered for preinduction cervical ripening (105.0 ± 51.04 µg vs 111.90 ± 52.2 µg; p = 0.0671), the proportion of women who were administered prostaglandins due to an unfavourable cervix (41.7% vs 55.6%; p = 0.812), induction-to-the-active phase of the labour interval (11.00 ± 4.2 hours vs 11.82 ± 4.12 hours; p = 0.407) or the induction-delivery interval (20.15 ± 5.7 hours vs 22.66 ± 4.33 hours; p = 0.06) in both groups, respectively. Compared with those in the Bishop score group (Bishop score ⩾ 6), the induction-to-active phase of labour intervals (6.47 ± 0.77 hours vs 7.33 ± 1.21 hours, p = 0.024) and the induction-to-delivery intervals (14.97 ± 1.0 hours vs 18.39 ± 0.85 hours; p = 0.0001) in the transvaginal ultrasound group (cervical length < 28 mm) were significantly shorter, respectively.

Conclusion: Preinduction cervical assessment using transvaginal ultrasound (cervical length < 28 mm) or the modified Bishop score is a successful predictor of the outcome of labour induction A larger multicentre studies are needed to identify optimal cervical length cutoffs and to determine if this could decrease unnecessary prostaglandin use or decrease caesarean section rate.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信