Value of Bishop score and ultrasound cervical length measurement in the prediction of cesarean delivery

Abstract

Aim: The aim of this study was to evaluate the role of Bishop score and cervical length in predicting the outcome of induced labor.

Material and methods: A prospective observational study was performed during a year in women undergoing labor induction. Prior to the procedure, Bishop score was evaluated by transvaginal digital examination and cervical length was measured by transvaginal ultrasound. Demographic data and labor details were recorded.

Results: A total of 197 women were analyzed; 166 women had a vaginal delivery (84.3%) and 31 had a cesarean section (15.7%). On univariate analysis, nulliparity, Bishop score >5 and cervical length <30 mm were all associated with cesarean delivery. On multivariate analysis, only nulliparity remained significantly associated with cesarean delivery and the other characteristics did not achieve statistical significance. When women were stratified according to parity, there was a significant association between cesarean delivery and nulliparity, but not multiparity.

Conclusions: Our results suggest that Bishop score and cervical length are good predictors of successful induction of labor, particularly in nulliparous women.

Keywords: Bishop score; cervical length; cesarean delivery; labor induction; transvaginal ultrasound.