Role of ultrasound parameters in the prediction of failure of induction of labor using Dinoprostone
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Abstract
Introductio-Aim: Labor induction is the artificial induction of uterine contractions in a woman who was not already in labor in order to achieve a vaginal birth. The main objective of our study was to analyze the role of ultrasound parameters in the prediction of failure of induction of labor.
Methods: This was a prospective observational study performed in a tertiary care maternity. For all the women who met our inclusion criteria, we measured these ultrasound parameters: Cervical length (CL), cervical dilation, cervical posterior angle (CPA), fetal head-perineum distance (FHPD), fetal occiput position, biparietal diameter (BPD) and estimated fetal weight (EFW). We defined failure of induction of labor as the occurrence of a cesarean section at any moment after the start of the induction.
Results: we collected 150 cases of induction of labor that met our inclusion criteria. Failure of induction rate was 45 %. Ultrasound parameters that were significantly associated to failure of induction were Cervical length (p=0.003), cervical dilation (p=0.002), cervical posterior angle (p<10-3), fetal head-perineum distance (p<10-3) and estimated fetal weight (p=0.006). Multivariate regression analysis found that posterior cervical angle and fetal head-perineum distance were the variables independently affecting the outcome of the induction of labor with respective thresholds of 105° and 55mm.
Conclusion: Ultrasound can be very useful in predicting the failure of labor induction. The threshold values that we found should be tested and validated in future studies to create a model to predict failure of labor.
Keywords:
induction, labor, ultrasound##plugins.themes.academic_pro.article.details##

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