Longitud cervical como predictor de exito en induccion de trabajo de parto en nuliparas

Abstract

The labor induction has demonstrated a simultaneous increment on Caesarean operation ratios, specifically in nulliparous patients with clinically unfavorable cervix. Although widely used, the clinical evaluation of the cervix is a subjective method; for this reason, the purpose of the present manuscript is to determine the usefulness of the cervix length ultrasound measurement, compared with the Bishop score, in the prediction of labor induction success in nulliparous patients at Hospital Universitario Clinica San Rafael Obstetrics Department. Materials and methods: We describe an observational study with the evaluation of a prospective cohort of 80 pregnant patients, all of them were performed ultrasound and clinical evaluation of the cervix before the labor induction. Results: The bivariate analysis demonstrated that patients with cervix length >20 mm are 1.57 times more likely to end in caesarean delivery (RR 1.57 IC95% 1.03-2.39 p <0.05). Similarly, patients with Bishop score 0 to 3 are 2.33 more likely to end in Caesarean delivery (RR 2.33 IC95% 1.28-4.23 p <0.05). Binary logistic regression showed that maternal age and cervical length were the only independent parameters with statistical significance for the prediction of labor induction success. Conclusions: Cervix length ultrasound measurement is more useful than clinical evaluation in the prediction of labor induction success in nulliparous patients.