Uteroservikal açı ve servikal uzunluk geç term-postterm nullipar gebelerde doğum indüksiyonunun başarısını belirleyebilir mi?

Year 2020, Volume: 45 Issue: 4, 1634 - 1643, 27.12.2020

Derya Kanza Gül

Abstract

Amaç: Bu çalışmada, geç ve post term gebeliklerde indüksiyon yapılmadan önce doğum indüksiyonunun başarısını öngörmede uteroservikal açının (USA) ve servikal uzunluğun (SU) rolünün araştırılması amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışma Ocak 2018-Nisan 2020 tarihleri arasında Medipol Üniversitesi Nisa Hastanesinde doğum indüksiyonu uygulanmış 260 nullipar geçterm ve postterm gebeye ait bilgiler kullanılarak yapılmıştır. Gebelerde indüksiyondan hemen önce uteroservikal açı ve servikal uzunluk değerleri değerlendirilmiştir. Çalışma populasyonumuz, başarılı (grup 1) ve başarısız (grup 2) doğum indüksiyonuna göre 2 grup olarak gruplandırılmıştır Birincil sonuç, doğum indüksiyonuna başarısını öngörmekteki etkinliktir. (latent faz ≤720 dk.).
Bulgular: Başarılı doğum induksiyon grubunda uteroservikal açı ortalaması 102,17 ± 4,26 derece iken başarısız grupta 94,25 ± 7,141 derece olarak saptanmıştır. Başarılı doğum induksiyon grubunda ortalama servikal uzunluk 27,85 ± 3,5 mm iken başarısız grupta 31,73 ± 2,71 mm olarak saptanmıştır. Gruplara göre serviks uzunluk ortalamaları ve uteroservikal açı ortalaması arasında istatistiksel olarak anlamlı bir farklılık saptanmıştır. USA ve SU) uzamış latent faz süresi önemli ölçüde belirleyicidir.
Sonuç: Bu çalışma, geç term ve postterm nullipar gebelerde hem uteroservikal açı hem de servikal uzunluk ölçümlerinin; başarılı doğum indüksiyonu ve normal doğumu tahmin etmede anlamlı belirleyiciliğe sahip olduğunu göstermiştir.

Keywords

Uterocervical angle, ; cervical length, induction of labor, transvaginal ultrasound

Supporting Institution

bulunmamaktadır

Project Number

10840098-604.01.01-E.14177

Can uterocervical angle and cervical length determine the success of induction of labor in late-term and post-term nulliparous pregnant women?

Abstract

Purpose: The aim og this study was to evaluate the role of uterocervical angle (UCA) and cervical length (CL) in predicting the success of induction of labor before induction was performed in late term and post-term pregnancies.
Materials and Methods: This retrospective study was carried out between January 2018 and April 2020, in Medipol University based on the data about 260 late-term and post-term nulliparous pregnant women who underwent induction of labor. UCA and CL values in pregnant women were assessed just before the induction was performed. Our study population was assigned into two groups: successful IoL group (group1) and failed (group 2) IoL group. The primary outcome of the study is the effectiveness of UCA and CL in predicting successful induction of labor (latent phase duration ≤720 min).
Results: While the mean UCA was 102.17 ± 4.26 degree in the successful labor induction group, it was 94.25 ± 7.141 degree in the unsuccessful group. While the mean CL was 27.85 ± 3.5 mm in the successful labor induction group, it was found as 31.73 ± 2.71 mm in the unsuccessful group. There was a statistically significant difference between the groups in terms of mean values for the CL and UCA. Both the UCA and the CLsignificantly predicted the duration of the prolonged latent phase.
Conclusions: This study indicated that both the UCA and CL measurements had a significant predictive value in predicting successful induction of labor and normal birth in late term and post-term nulliparous pregnant women.

Project Number

10840098-604.01.01-E.14177

References

• 1.Management of Late-Term and Postterm Pregnancies. Practice Bulletin No 146. American College of Obstetricians and Gynecologists. Obstet and Gynecol. 2014;124(2):390-396.
• 2. Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Kirmeyer S, Mathews TJ, et al. Births: final data for 2009. Natl Vital Stat Rep. 2011;60(1):1–70.
• 3. Crane JM. Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol 2006;49(3):573–584.
• 4. Pevzner L, Rayburn WF, Rumney P, Wing DA. Factors predicting successful labor induction with dinoprostone and misoprostol vaginal inserts. Obstet Gynecol 2009;114(2):261–267.
• 5. Parkes I, Kabiri D, Hants Y, Ezra Y. The indication for induction of labor impacts the risk of cesarean delivery. J Matern Fetal Neonatal Med 2016;29(2):224–228.
• 6. Lazanakis M, Marsh M, Brockbank E, Economides D. Assessment of the cervix in the third trimester of pregnancy using transvaginal ultrasound scanning. Eur J Obstet Gynecol Reprod Biol 2002;105(1):31–35.
• 7. Sochacki-Wójcicka N, Wojcicki J, Bomba-Opon D, Wielgos M. Anterior cervical angle as a new biophysical ultrasound marker for prediction of spontaneous preterm birth. Ultrasound Obstet Gynecol 2015;46(3):377–378.
• 8. Dziadosz M, Bennett TA, Dolin C, West Honart A, Pham A, Lee SS, et al. Uterocervical angle: a novel ultrasound screening tool to predict spontaneous preterm birth. Am J Obstet Gynecol 2016;215(3):1-7. 9. Sepúlveda-Martínez A, Díaz F, Muñoz H, Valdés E, Parra-Cordero M. Second-trimester anterior cervical angle in a low-risk population as a marker for spontaneous preterm delivery. Fetal Diagn Ther 2017;41(3):220–225.
• 10. Eser A., Ozkaya E.Uterocervical angle: an ultrasound screening tool to predict satisfactory response to labor inductionJ Matern Fetal Neonatal Med. 2020;33(8):1295-1301.
• 11. Dagdeviren E, Aslan Çetin B, Aydogan Mathyk B, Koroglu N, Topcu EG, Yuksel MA. Can uterocervical angles successfully predict induction of labor in nulliparous women? Eur J Obstet Gynecol Reprod Biol. 2018;228:87-91.
• 12.Grobman WA, Simon C. Factors associated with the length of the latent phase during labor induction. Eur J Obstet Gynecol Reprod Biol. 2007;132(2):163–166.
• 13. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin Number 49, December 2003: dystocia and augmentation of labor. Obstet Gynecol. 2003;102(6):1445–1454.
• 14. Hassan SS, Romero R, Haddad R, et al. The transcriptome of the uterine cervix before and after spontaneous term parturition. Am J Obstet Gynecol. 2006;195(3):778–786.
• 15. Eggebø TM, Heien C, Økland I, Gjessing LK, Romundstad P, Salvesen KA. Ultrasound assessment of fetal head-perineum distance before induction of labor. Ultrasound Obstet Gynecol 2008;32(2):199–204.
• 16. Rane SM, Pandis GK, Guirgis RR, et al. 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. 2003;22(1):40–44.
• 17. Rovas L, Sladkevicius P, Strobel E, Valentin L. 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 2005;24(7):933–939.
• 18. Stupar ZT, Miki_c AN, Bogavac M, et al. Prediction of labor induction outcome using different clinical parameters. Srp Arh Celok Lek. 2013;141(11–12): 770–774.
• 19. Strobel E, Sladkevicius P, Rovas L, et al. Bishop score and ultrasound assessment of the cervix for prediction of time to onset of labor and time to delivery in prolonged pregnancy. Ultrasound Obstet Gynecol. 2006;28(3):298–305.
• 20. Daskalakis G, Thomakos N, Hatziioannou L, et al. Sonographic cervical length measurement before labor induction in term nulliparous women. Fetal Diagn Ther. 2006;21(1):34–38.
• 21. Rao A, Celik E, Poggi S, et al. Cervical length and maternal factors in expectantly managed prolonged pregnancy: prediction of onset of labor and mode of delivery. Ultrasound Obstet Gynecol. 2008;32(5):646–651.
• 22. Roos N, Sahlin L, Ekman-Ordeberg G, et al. Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction. Acta Obstet Gynecol Scand. 2010;89(8):1003–1010.
• 23. Farràs Llobet A, Regincós Martí L, Higueras T, Calero Fernández IZ, Gascón Portalés A, Goya Canino MM, et al. The uterocervical angle and its relationship with preterm birth. J Matern Fetal Neonatal Med 2018;31(14):1881-1884.
• 24. Bouzid A, Kehila M, Trabelsi H, et al. Sonographic landmarks to differentiate “false labor” and “early true labor” as a possible new application of ultrasound in labor ward. J Gynecol Obstet Hum Reprod. 2017;46(4):363–366.
• 25. Cetin BA, Aydogan Mathyk B, Tuten A, et al. The predictive nature of uterocervical angles in the termination of second trimester pregnancy. J Matern Fetal Neonatal Med. 2019;32(12):1952-1957.
• 26. Keepanasseril A, Suri V, Bagga R, et al. Pre-induction sonographic assessment of the cervix in the prediction of successful induction of labour in nulliparous women. Aust N Z J Obstet Gynaecol. 2007;47(5):389–393.