Predictive value of cervical ultrasound parameters for induction success in women at risk of post-term pregnancy
DOI:
https://doi.org/10.15574/HW.2025.3(178).1217Keywords:
labor induction, ultrasonographic predictors, funneling, logistic regression, Bishop scoreAbstract
Aim - to evaluate the predictive value of ultrasonographic cervical parameters for the success of labor induction in nulliparous women with late-term pregnancy.
Materials and methods. A prospective cohort study included 201 nulliparous women at ≥41 weeks of gestation undergoing labor induction. Clinical data and sonographic parameters of the cervix — cervical length, funneling dimensions (length, width), and fetal head-to-external os distance — were collected before induction. Multivariate logistic regression analysis was applied to identify independent predictors of induction success.
Results. Successful induction occurred in 145 (72.1%) women, while 56 (27.9%) required cesarean delivery after failed induction. Independent predictors included shorter cervical length, greater funneling length and width, and reduced head-to-external os distance. The model achieved good discriminatory performance (AUC: 0.839; 95% CI: 0.781-0.897), with sensitivity of 66.3% and specificity of 82.6%. The Youden index was 0.489, indicating balanced predictive capacity. These results surpass the accuracy reported for the traditional Bishop score (AUC: 0.65-0.75).
Conclusions. Transvaginal ultrasonography assessing cervical length, funneling parameters, and fetal head position provides objective and reproducible predictors of labor induction success in nulliparous women. Incorporating these parameters may enhance pre-induction risk stratification and reduce failed inductions.
The study was conducted in accordance with the Declaration of Helsinki. The protocol was approved by the local ethics committee, and all participants gave written informed consent.
The authors declare no conflict of interest.
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