Predictive factors of labour onset using ultrasonography.

ABSTRACT

We analysed the effectiveness of transvaginal ultrasonographic and foetal/maternal pulse Doppler findings as predictors of labour onset within 1 week. We included 22 single normal pregnancies and evaluated the one-point and short- and long-term differences in uterine artery pulsatility index (PI), umbilical artery PI, middle cerebral artery PI (MCA-PI), peak systolic velocity, and cervical length (CL). Presence of funnelling and membrane separation over the internal cervical os was evaluated. Significant changes were observed in the one-point measurement of and short-term and long-term differences in CL, the one-point measurement of and long-term difference in MCA-PI, and the presence of membrane separation (Grade 2). In multivariate analysis, the significant predictors were short-term differences in CL (odds ratio [OR] 5.27), long-term differences in MCA-PI (OR 13.3), and presence of membrane separation (Grade 2) (OR 5.38). Transvaginal ultrasonographic and foetal pulse Doppler findings were effective predictors of labour onset within 1 week.Impact statementWhat is already known on this subject? Parameters reported to predict labour onset include the Bishop score, cervical length, decreased long-term cervical length, funnelling of the internal cervical os, and adrenal gland volume.What do the results of this study add? Short-term changes in cervical length, long-term changes in middle cerebral artery pulsatility index, and the presence of membrane separation Grade 2 were found to be useful predictive factors of labour onset in this study.What are the implications of these findings for clinical practice and/or further research? The prediction of labour onset enables clinicians to properly manage pregnancy and delivery considering maternal and foetal conditions.