THE EFFECTS OF ULTRASOUND MEASURED PRE- INDUCTION CERVICAL LENGTH ON DELIVERY OUTCOME

Abstract

BACKGROUND

The aim of antenatal care and labour management is to deliver a healthy baby to a healthy and satisfied mother. This can be achieved by effecting induction of labour at a time when the continuation of the pregnancy is deemed detrimental to the wellbeing of the mother/ fetus or both. Induction of labour is not without risk as it is associated with 20-24% risk of caesarean delivery especially in nulliparous women. This calls for a method that will be sensitive enough to predict successful labour induction. Bishop score assessment is affected by its subjectiveness, inter and intra observer differences, poor objectivity and the inability to assess the supra vaginal part of the cervix which constitute 50% of the cervix.

AIM

The aim of this study is to evaluate the role of Transvaginal ultrasonographic cervical length measurement at Term in the prediction of successful induction of labour.

DESIGN

This was a prospective study.

SETTING

The study was carried out in the department of Obstetrics and Gynaecology of Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria.

MATERIALS AND METHODS

The study population comprised pregnant women who met the inclusion criteria and consented to participate in the study. They were recruited by the research team via the simple random method between 10th of July to 30th of November 2014 from the Antenatal clinic and ward of the department. The sample size was 60 using Cochran’s formula withaddition of 20% for attrition. Pre- induction Bishop Score and cervical length were assessed before induction of labour. Intracervical cervical, extra-amniotic Foley catheter was used to improve the Bishop score. Induction of labour was commenced in the morning and managed according to the Unit and Departmental protocol. Categorical variables were analyzed using simple percentage and Chi square (X2). Independent t test was done to compare the means and correlation analyzed using Pearson correlation. The level of significance was at P < 0.05.

Result

This study showed that pre-induction cervical length is a good predictor of induction delivery interval (p=0.001). Parturients with pre-induction cervical length of less than 3 cm were likely to have labour lasting less than 6 hours {OR 13.8 (95% CI 3.93-48.42)}

Conclusion

Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of duration of labour following induction of labour.

THE EFFECTS OF ULTRASOUND MEASURED PRE- INDUCTION CERVICAL LENGTH ON DELIVERY OUTCOME