Skip to main content
Log in

Comparison of the Bishop score, body mass index and transvaginal cervical length in predicting the success of labor induction

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the role of ultrasonographic and various maternal and fetal parameters in predicting successful labor induction.

Methods

Body mass index, cervical length, dilatation, effacement, Bishop score, parity, maternal age and birth weight were evaluated in 189 singleton pregnant women at 37–42 weeks of gestation and having induction of labor. All underwent induction of labor with oxytocin. Body mass index was calculated using the formula weight (kg)/height2 (m), cervical measurement was performed by transvaginal ultrasonography and Bishop score was determined by digital examination of cervix.

Results

Logistic regression analysis indicated that the cervical length and body mass index were independent variables in determining the risk of cesarean section (OR = 1.206, P = 0.000, CI 95% = 1.117–1.303; OR = 1.223, P = 0.007, CI 95% = 1.058–1.414 respectively). In multiple linear regression analysis, the effect of cervical length and body mass index on induction delivery interval was found to be statistically significant (t = 5.738, P = 0.000; t = 2.680, P = 0.009, respectively). ROC curve showed that the best parameter in predicting the risk of cesarean section was cervical length and that cervical length and body mass index were better parameters compared to the Bishop score (the areas under the curve are 0.819, 0.701 and 0.416, respectively).

Conclusions

Body mass index and transvaginal cervical length were better predictors compared to the Bishop score in determining the success of labor induction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Pandis GK, Papageorghiou AT, Ramanathan VG, Thompson MO, Nicolaides KH (2001) Preinduction sonographic measurement of cervical length in the prediction of successful induction of labor. Ultrasound Obstet Gynecol 18:623–628. doi:10.1046/j.0960-7692.2001.00580.x

    Article  PubMed  CAS  Google Scholar 

  2. Crowley P (2003) Interventions for preventing or improving the outcome of delivery at or beyond term. The Cochrane Library, issue 2. http://www. update-software.com. Accessed 14 Dec 2003

  3. Fuentes A, Williams M (1995) Cervical assessment. Clin Obstet Gynecol 38(2):224–231. doi:10.1097/00003081-199506000-00005

    Article  PubMed  CAS  Google Scholar 

  4. Bishop EH (1964) Pelvic scoring for elective induction. Obstet Gynecol 24:266–268

    PubMed  CAS  Google Scholar 

  5. Sadoul G, Beuret T, Lewin D (1981) The different elements constituting the Bishop score in the induction of labour with epidural analgesia (author’s transl). J Gynecol Obstet Biol Reprod (Paris) 10(3):269–273

    CAS  Google Scholar 

  6. Jackson GM, Ludmir J, Bader TJ (1992) The accuracy of digital examination and ultrasound in the evaluation of cervical length. Obstet Gynecol 79(2):214–218

    PubMed  CAS  Google Scholar 

  7. Hughey MJ, McElin TW, Bird CC (1976) An evaluation of preinduction scoring systems. Obstet Gynecol 48(6):635–641

    PubMed  CAS  Google Scholar 

  8. Dhall K, Mittal SC, Kumar A (1987) Evaluation of preinduction scoring systems. Aust N Z J Obstet Gynaecol 27(4):309–311. doi:10.1111/j.1479-828X.1987.tb01015.x

    Article  PubMed  CAS  Google Scholar 

  9. Park KH (2007) Transvaginal ultrasonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. J Korean Med Sci 22(4):722–727

    Article  PubMed  Google Scholar 

  10. Gómez Laencina AM, Sánchez FG, Gimenez JH, Martínez MS, Valverde Martínez JA, Vizcaíno VM (2007) Comparison of ultrasonographic cervical length and the Bishop score in predicting successful labor induction. Acta Obstet Gynecol Scand 86(7):799–804. doi:10.1080/00016340701409858

    Article  PubMed  Google Scholar 

  11. Elghorori MR, Hassan I, Dartey W, Abdel-Aziz E, Bradley M (2006) Comparison between subjective and objective assessments of the cervix before induction of labour. J Obstet Gynaecol 26(6):521–526. doi:10.1080/01443610600797459

    Article  PubMed  CAS  Google Scholar 

  12. Gabriel R, Darnaud T, Chalot F, Gonzalez N, Leymarie F, Quereux C (2002) Transvaginal sonography of the uterine cervix prior to labor induction. Ultrasound Obstet Gynecol 19(3):254–257. doi:10.1046/j.1469-0705.2002.00643.x

    Article  PubMed  CAS  Google Scholar 

  13. Ware V, Raynor BD (2000) Transvaginal ultrasonographic cervical measurement as a predictor of successful labor induction. Am J Obstet Gynecol 182(5):1030–1032. doi:10.1067/mob.2000.105399

    Article  PubMed  CAS  Google Scholar 

  14. Watson WJ, Stevens D, Welter S, Day D (1996) Factors predicting successful labor induction. Obstet Gynecol 88(6):990–992. doi:10.1016/S0029-7844(96)00321-3

    Article  PubMed  CAS  Google Scholar 

  15. Boozarjomehri F, Timor-Tritsch I, Chao CR, Fox HE (1994) Transvaginal ultrasonographic evaluation of the cervix before labor: presence of cervical wedging is associated with shorter duration of induced labor. Am J Obstet Gynecol 171(4):1081–1087

    PubMed  CAS  Google Scholar 

  16. Edwards RK, Richards DS (2000) Preinduction cervical assessment. Clin Obstet Gynecol 43(3):440–446. doi:10.1097/00003081-200009000-00004

    Article  PubMed  CAS  Google Scholar 

  17. Crane JM (2006) Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol 49(3):573–584. doi:10.1097/00003081-200609000-00017

    Article  PubMed  Google Scholar 

  18. RCOG 5 October 2006 press releases. http://www.rcog.org.uk/index.asp?PageID=97&PressReleaseID=126

  19. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson S (2001) Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 25(8):1175–1182. doi:10.1038/sj.ijo.0801670

    Article  PubMed  CAS  Google Scholar 

  20. Abrams B, Parker J (1988) Overweight and pregnancy complications. Int J Obes 12:293–303

    PubMed  CAS  Google Scholar 

  21. Rane SM, Pandis GK, Guirgis RR, Higgins B, Nicolaides KH (2003) Pre-induction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in the prediction of induction-to-delivery interval. Ultrasound Obstet Gynecol 22(1):40–44. doi:10.1002/uog.165

    Article  PubMed  CAS  Google Scholar 

  22. Rane SM, Guirgis RR, Higgins B, Nicolaides KH (2004) The value of ultrasound in the prediction of successful induction of labor. Ultrasound Obstet Gynecol 24(5):538–549. doi:10.1002/uog.1100

    Article  PubMed  CAS  Google Scholar 

  23. Rovas L, Sladkevicius P, Strobel E, Valentin L (2005) Three-dimensional power Doppler ultrasound assessment of the cervix for the prediction of successful induction of labor with prostaglandin in prolonged pregnancy. J Ultrasound Med 24(7):933–939

    PubMed  Google Scholar 

  24. Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J (2007) Transvaginal sonographic measurement of cervical length vs. Bishop score in labor induction at term: tolerability and prediction of Cesarean delivery. Ultrasound Obstet Gynecol 29(5):568–573. doi:10.1002/uog.4018

    Article  PubMed  CAS  Google Scholar 

  25. Gonen R, Degani S, Ron A (1998) Prediction of successful induction of labor: comparison of transvaginal ultrasonography and the Bishop score. Eur J Ultrasound 7(3):183–187. doi:10.1016/S0929-8266(98)00042-1

    Article  PubMed  CAS  Google Scholar 

  26. Paterson-Brown S, Fisk NM, Edmonds DK, Rodeck CH (1991) Preinduction cervical assessment by Bishop’s score and transvaginal ultrasound. Eur J Obstet Gynecol Reprod Biol. 40(1):17–23

    Article  PubMed  CAS  Google Scholar 

  27. Rane SM, Guirgis RR, Higgins B, Nicolaides KH (2003) Pre-induction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in the prediction of the need for Cesarean section. Ultrasound Obstet Gynecol 22(1):45–48. doi:10.1002/uog.166

    Article  PubMed  CAS  Google Scholar 

  28. Young TK, Woodmansee B (2002) Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 187(2):312–318. doi:10.1067/mob.2002.126200

    Article  PubMed  Google Scholar 

  29. Baeten JM, Bukusi EA, Lambe M (2001) Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 91(3):436–440. doi:10.2105/AJPH.91.3.436

    Article  PubMed  CAS  Google Scholar 

  30. Cnattingius R, Cnattingius S, Notzon FC (1998) Obstacles to reducing cesarean rates in a low-cesarean setting: the effect of maternal age, height, and weight. Obstet Gynecol 92(4 Pt 1):501–506. doi:10.1016/S0029-7844(98)00244-0

    Article  PubMed  CAS  Google Scholar 

  31. Kaiser PS, Kirby RS (2001) Obesity as a risk factor for cesarean in a low-risk population. Obstet Gynecol 97(1):39–43. doi:10.1016/S0029-7844(00)01078-4

    Article  PubMed  CAS  Google Scholar 

  32. Peregrine E, O’Brien P, Omar R, Jauniaux E (2006) Clinical and ultrasound parameters to predict the risk of cesarean delivery after induction of labor. Obstet Gynecol 107(2 Pt 1):227–233

    PubMed  Google Scholar 

  33. Cnattingius R, Höglund B, Kieler H (2005) Emergency cesarean delivery in induction of labor: an evaluation of risk factors. Acta Obstet Gynecol Scand 84(5):456–462. doi:10.1111/j.0001-6349.2005.00620.x

    Article  PubMed  Google Scholar 

  34. Usha Kiran TS, Hemmadi S, Bethel J, Evans J (2005) Outcome of pregnancy in a woman with an increased body mass index. BJOG 112(6):768–772. doi:10.1111/j.1471-0528.2004.00546.x

    Article  PubMed  CAS  Google Scholar 

  35. Braems G, Norhausen I (2007) Induction of labor with prostaglandins for medical reasons: determining explanatory variables of the induction to delivery time interval for vaginal deliveries and caesarean section. Eur J Obstet Gynecol Reprod Biol 135(2):164–169. doi:10.1016/j.ejogrb.2006.12.004

    Article  PubMed  Google Scholar 

  36. Nuthalapaty FS, Rouse DJ, Owen J (2004) The association of maternal weight with cesarean risk, labor duration, and cervical dilation rate during labor induction. Obstet Gynecol 103(3):452–456

    PubMed  Google Scholar 

  37. Kabiru W, Raynor BD (2004) Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol 191(3):928–932. doi:10.1016/j.ajog.2004.06.051

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yildiz Uyar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uyar, Y., Erbay, G., Demir, B.C. et al. Comparison of the Bishop score, body mass index and transvaginal cervical length in predicting the success of labor induction. Arch Gynecol Obstet 280, 357–362 (2009). https://doi.org/10.1007/s00404-008-0915-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-008-0915-x

Keywords

Navigation