Repeatability and Reproducibility of Potential Ultrasonographic Bishop Score Parameters

Młodawski, Jakub; Mlodawska, Marta; Płusajska, Justyna; Detka, Karolina; Białek, Katarzyna; Grzegorz, SWIERCZ,

doi:10.3390/jcm12134492

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…Furthermore, while we addressed non-compressive cervical strain elastography in the mid-trimester there are other reports of using the same technology at later gestational ages to assess cervical ripeness before induction of labor. 42,43 Rigorous assessment of elastography as a QIB for these indications should also be assessed, especially since there is more cervical heterogeneity with advancing gestational age.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Non‐Compressive Transvaginal Cervical Elastography as a Quantitative Imaging Biomarker in Pregnancy

Janssen,

Koelper,

Weatherby

et al. 2023

J of Ultrasound Medicine

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ObjectivesNon‐compressive strain elastography has been proposed as a novel quantitative imaging biomarker for assessing the structure and function of the cervix. The current study aims to assess the repeatability, and intra‐ and inter‐observer reliability of transvaginal non‐compressive cervical strain elastography in a clinical setting.MethodsWe conducted a dual‐phase single‐center prospective feasibility study of singleton gestations >16‐weeks gestation that required a clinically‐indicated transvaginal ultrasound. Each study participant, n = 43 in phase 1 and n = 13 in phase 2, had elastography performed by two trained observers that each performed multiple image acquisitions. We performed a multivariable regression to adjust for changes in clinical characteristics between study phases and calculated the repeatability coefficients, limits of agreement, and intraclass correlations for each quantitative elastography parameter. We compared quantitative elastography parameters to cervical length measurements, acquired from the same images.ResultsThe repeatability coefficients and percent limits of agreement were wide for all of the quantitative elastography parameters, demonstrating poor repeatability. Intraclass correlation coefficients were poor–moderate for both intra‐observer (0.31–0.77) and inter‐observer reliability (0.35–0.77) in both study phases, while cervical length showed excellent reliability with intraclass correlations consistently >0.90.ConclusionsNon‐compressive transvaginal strain cervical elastography did not demonstrate adequate repeatability or reliability. Our results highlight the importance of rigorously assessing novel quantitative imaging biomarkers before clinical application.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Non‐Compressive Transvaginal Cervical Elastography as a Quantitative Imaging Biomarker in Pregnancy

Janssen,

Koelper,

Weatherby

et al. 2023

J of Ultrasound Medicine

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The Effect of Preinduction Cervical Ripening With Synthetic Hygroscopic Dilators on Maternal Outcomes of Women With Previous Caesarean Pregnancy: A Single‐Group Clinical Trial

Dorairajan,

Ravi,

Chinnakili

2024

Journal of Pregnancy

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Background: Preinduction cervical ripening in previous caesarean pregnancy is limited to intracervical Foley catheter. This study is aimed at finding the vaginal birth rates, improvement of Bishop score, and safety of osmotic dilator (Dilapan‐S) among women with previous caesarean pregnancy.Methods: We conducted this single‐group clinical study after the approval of the institute ethics committee, clinical trial registration, and obtaining informed consent. We recruited women above 18 years with a prior caesarean section at term and a Bishop score of less than 6 by systematic random sampling prospectively. The first or second author inserted two to a maximum of five osmotic dilators (Dilapan‐S) in the cervical canal. After 24 h, we removed Dilapan and induced labour with a low‐dose oxytocin regimen up to a maximum dose of 24 mIU/min. We assessed the improvement of the Bishop score and vaginal birth rates for efficacy and safety concerns like bleeding, fragmentation, displacement, infections, and scar dehiscence.Results: Eighty‐two women completed the study. The Bishop score significantly improved from a mean of 2.6 before to 5.3 after Dilapan. Three opted for a caesarean section after Dilapan removal and refused oxytocin infusion. Seventy‐nine women completed the trial of labour. Forty‐one (52%) achieved active labour (52%). Twenty‐seven delivered vaginally, and 52 required emergency caesarean section (34% vaginal birth rate; 18 spontaneous, nine instrumental, four with forceps, and five with vacuum). None had entrapment, fragmentation, or upward displacement of Dilapan. Two women had scar dehiscence, and one had a traumatic postpartum haemorrhage. There was no maternal or perinatal mortality.Conclusions: We conclude that the hygroscopic dilator Dilapan effectively ripens the cervix before labour induction in women with a previous caesarean scar. They are safe, but more extensive studies are needed to evaluate scar‐related complications during labour.Trial Registration: Clinical Trial Registry of India: CTRI/2019/03/017927

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Effect of cervical Bishop score on induction of labor at term in primiparas using Foley catheter balloon: a retrospective study

Li,

Ju,

Feng

2024

BMC Pregnancy Childbirth

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Background Previous studies had found that the mechanical methods were as effective as pharmacological methods in achieving vaginal delivery. However, whether balloon catheter induction is suitable for women with severe cervical immaturity and whether it will increase the related risks still need to be further explored. Research aim To evaluate the efficacy and safety of Foley catheter balloon for labor induction at term in primiparas with different cervical scores. Methods A total of 688 primiparas who received cervical ripening with a Foley catheter balloon were recruited in this study. They were divided into 2 groups: Group 1 (Bishop score ≤ 3) and Group 2 (3 < Bishop score < 7). Detailed medical data before and after using of balloon were faithfully recorded. Results The cervical Bishop scores of the two groups after catheter placement were all significantly higher than those before (Group 1: 5.49 ± 1.31 VS 2.83 ± 0.39, P<0.05; Group 2: 6.09 ± 1.00 VS 4.45 ± 0.59, P<0.05). The success rate of labor induction in group 2 was higher than that in group 1 (P<0.05). The incidence of intrauterine infection in Group 1 was higher than that in Group 2 (18.3% VS 11.3%, P<0.05). Conclusion The success rates of induction of labor by Foley catheter balloon were different in primiparas with different cervical conditions, the failure rate of induction of labor and the incidence of intrauterine infection were higher in primiparas with severe cervical immaturity.

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Repeatability and Reproducibility of Potential Ultrasonographic Bishop Score Parameters

Cited by 4 publications

References 33 publications

Evaluation of Non‐Compressive Transvaginal Cervical Elastography as a Quantitative Imaging Biomarker in Pregnancy

Evaluation of Non‐Compressive Transvaginal Cervical Elastography as a Quantitative Imaging Biomarker in Pregnancy

The Effect of Preinduction Cervical Ripening With Synthetic Hygroscopic Dilators on Maternal Outcomes of Women With Previous Caesarean Pregnancy: A Single‐Group Clinical Trial

Effect of cervical Bishop score on induction of labor at term in primiparas using Foley catheter balloon: a retrospective study

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