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Observational Study
. 2023 Jun;161(3):934-941.
doi: 10.1002/ijgo.14591. Epub 2022 Dec 13.

Predictors of efficacy for cervical ripening among the Bishop score criteria in nulliparous women at term

Guillaume Ducarme  1 , Laura Berthommier  1 , Lucie Planche  2
Affiliations
Observational Study

Predictors of efficacy for cervical ripening among the Bishop score criteria in nulliparous women at term

Guillaume Ducarme et al. Int J Gynaecol Obstet. 2023 Jun.

Abstract

Objective: To determine predictors of efficacy for cervical ripening among the Bishop score criteria in nulliparous women at term.

Method: Prospective observational study of nulliparous women with singleton term fetuses in vertex presentation, intact membranes, and an unfavorable cervix (Bishop score < 6) who underwent cervical ripening with a cervical-ripening balloon (CRB; n = 47) or dinoprostone vaginal insert (PG; n = 28). The authors analyzed Bishop score criteria (dilatation, effacement, fetal station, consistency, position) before and after device removal. Primary outcome was favorable cervix (Bishop score ≥ 6) after device removal. Secondary outcomes were vaginal delivery, modification of Bishop score criteria, and perinatal morbidity.

Results: Rates of favorable cervix after cervical ripening were similar between groups (66.7% with CRB vs. 59.3% with PG; P = 0.526). Vaginal delivery (76.6% vs. 78.6%; P = 0.843) and perinatal morbidity did not differ between groups. CRB appeared to be more effective than PG in increasing consistency (+0.7 ± 0.2 vs. +0.3 ± 0.2; P = 0.001) and dilatation of the cervix (+1.3 ± 0.3 vs. +0.9 ± 0.3; P = 0.005). No Bishop score criterion was found as a significant predictor for vaginal delivery.

Conclusion: CRB seems to be more effective than PG in increasing the consistency and dilatation of the cervix. Efficacy of CRB and PG for vaginal delivery was similar.

Keywords: bishop score; cervical ripening; cervical-ripening balloon; dinoprostone; induction of labor; vaginal delivery.

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References

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