[Prediction of labor induction outcome using different clinical parameters].

INTRODUCTION: Induction of labor is one of the most common obstetric interventions in contemporary obstetrics. OBJECTIVE: The aim of the study was to evaluate the clinical and sonographic parameters in prediction of success of labor induction. METHODS: The prospective study included 422 women in whom induction of labor was carried out at the Department of Obstetrics and Gynecology of Clinical Centre of Vojvodina. The role of body mass index and age of women, parity Bishop score, cervical length measured by transvaginal ultrasound was evaluated in regard of the success of induction, which was considered successful if a vaginal delivery occurred within 24 hours after the onset of induction. Data were statistically analyzed by univariate statistical analysis and Pearson's chi2 test. RESULTS: Out of 422 women, induction of labor was successful in 356 (84.4%), and it failed in 66 (15.6%) cases. The values of Bishop score and cervical length had positive correlation with the success of induction. CONCLUSION: Bishop score and transvaginal cervical length were both reliable predictors in determining the success of labor induction, as well as parity and BMI. These parameters are mostly complementary, not competitive in prediction of labor induction success.

Validity of clinical and ultrasound variables to predict the risk of cesarean delivery after induction of labor.

OBJECTIVE: To evaluate a previously described score to predict the risk of cesarean delivery after induction of labor. METHODS: We conducted a multicenter prospective study among women at 36 weeks of gestation or more undergoing induction of labor in the maternity units of Geneva, Switzerland, and Novi Sad, Serbia. Before induction, we calculated the risk score for cesarean delivery including data on maternal height, body mass index, parity, and transvaginal ultrasonographic cervical length. We calculated the sensitivity and specificity of the score using different cutoffs of calculated risk. RESULTS: Of the 537 women included in the analysis, 92 (17%) had a cesarean delivery. Among the variables tested, only the transvaginal ultrasonographic cervical length was associated with the risk of cesarean delivery (P<.001). Using the different cutoffs of calculated risk of cesarean delivery (20%, 30%, and 40%), we calculated the sensitivity (69.6%, 54.3%, and 45.7%, respectively), specificity (42.0%, 58.2%, and 69.2%, respectively), and positive predictive value (19.9%, 21.0%, and 23.5%, respectively) of the risk score. The area under the receiver operating characteristic curve was 0.59. There was a poor association between the outcome of labor induction (vaginal delivery or cesarean delivery) and the predicted risk. CONCLUSION: The evaluated score was not useful to predict the outcome of women undergoing labor induction. Our results show the necessity of validating existing scores in different settings and patient populations before widespread implementation in clinical care.