Document Detail


The role of ultrasound and fetal fibronectin in predicting the length of induced labor when the cervix is unfavorable.
MedLine Citation:
PMID:  15170797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare cervical clinical data, ultrasound parameters and fetal fibronectin assessment in the prediction of the duration of induced labor when the cervix is unfavorable. METHODS: This was a prospective study of 90 pregnant women with a Bishop score </= 5 undergoing labor induction. The Bishop score and its components, parity, cervical ultrasound parameters and fetal fibronectin level were analyzed using Cox's model in order to determine the most predictive factors for the duration of the latent and active phases of labor as well as its total duration. RESULTS: There was a significant correlation between duration of the latent phase and the whole of labor, and digitally assessed cervical dilatation (P = 0.003 and P < 0.001, respectively), parity (P = 0.006 and P < 0.001), the Bishop score (P = 0.019 and P = 0.003) and ultrasound-determined cervical length (P = 0.035 and P = 0.003). The length of the active phase of labor did not correlate with the cervical status. Funneling did not appear to be predictive of the duration of labor and it had a poor correlation with digital cervical dilatation. The length of the latent phase and that of the whole of labor was significantly longer when cervical dilatation was </= 2 cm (P < 0.001 in each case), when women were nulliparous (P = 0.002 and P < 0.001) and when ultrasound cervical length was >/= 27 mm (P = 0.002 and P = 0.005). CONCLUSION: Cervical dilatation as assessed by digital examination is the best predictor of the duration of the latent phase and of that of the whole of labor. Ultrasound measurement of cervical length is not more accurate at predicting the duration of labor than are clinical data.
Authors:
H Roman; E Verspyck; L Vercoustre; S Degre; J Y Col; J M Firmin; P Caron; L Marpeau
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  23     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-01     Completed Date:  2004-10-12     Revised Date:  2005-10-04    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  567-73     Citation Subset:  IM    
Copyright Information:
Copyright 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Gynaecology and Obstetrics, General Hospital, Le Havre, France. horace.roman@libertysurf.fr
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cervix Uteri / anatomy & histology,  ultrasonography*
Cesarean Section
Female
Fetus / metabolism
Fibronectins*
Gestational Age
Glycoproteins / blood*
Humans
Labor Stage, First
Labor, Induced*
Predictive Value of Tests
Pregnancy
Prospective Studies
Time Factors
Ultrasonography, Prenatal / methods*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FFN protein, human; 0/Fibronectins; 0/Glycoproteins

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