Comparison Of Preinduction Sonographic Cervical Length And Bishop Score İn Prediction Of Successful Vaginal Delivery After Labor İnduction With Sublingual And Vaginal Misoprostol

Year 2016, Volume: 13 Issue: 3, 107 - 111, 01.07.2016

İsmail Burak Gültekin , Ragıp Atakan Al Serap Gültekin İsmail Dölen

Abstract

Aim: To analyze and compare preinduction sonographic cervical length and Bishop score in prediction of successful vaginal delivery after labor induction with sublingual and vaginal misoprostol.Material and Methods: A total of 241 women with singleton pregnancies between 37th-42nd weeks of gestation were enrolled to the study. Subjects were randomly assigned into one of two groups in regard to the route of misoprostol administration, either sublingual or sublingual with vaginal. Preinduction cervical assessments were performed with transvaginal sonographic cervical length measurement and Bishop score.Results: Sonographic cervical length, Bishop score and parity were found as independent contributors in the prediction of likelihood of delivering vaginally within 19 hours of induction. The cut-off points for prediction of successful vaginal delivery were a cervical length of 38 mm and a Bishop score of 3. Neither method had superiority over each other with sensitivities and specificities of 61.9 and 82.6 for Bishop score and 89.9 and 43.5 for cervical length, respectively. Groups were found to have similar discriminatory results in prediction of successful vaginal delivery.Conclusion: Preinduction Bishop score with higher specificity and cervical length with higher sensitivity can both be used complementary to each other in prediction of successful vaginal delivery.

Keywords

Bishop score, cervical length, induction of labor, misoprostol, vaginal delivery

Sublingual ve Vajinal Misoprostol İle Doğum İndüksiyonu Sonrasında Başarılı Vajinal Doğumu Öngörmede Sonografik Servikal Uzunluk ve Bishop Skorunun Karşılaştırılması

Abstract

Amaç: Sublingual and vajinal misoprostol ile doğum indüksiyonu uygulanan gebelerde başarılı vajinal doğumu öngörmede sonografik servikal uzunluk ve Bishop skorunun karşılaştırılması.Gereç ve Yöntemler: Çalışmaya 37.- 42. gestasyonel haftalar arası tekil gebeliğe sahip, toplam 241 kadın dahil edildi. Misoprostol uygulama yoluna göre sublingual veya sublingual+vajinal vakalar randomize edilerek gruplara ayrıldı. Preindüksiyon servikal değerlendirme transvajinal sonografik serviks uzunluk ölçümü ve Bishop skoru ile yapıldı.Bulgular: İndüksiyon sonrası 19 saat içerisinde vajinal doğum öngörüsünde sonografik servikal uzunluk, Bishop skoru ve paritenin bağımsız katkılarının olduğu saptandı. Başarılı vajinal doğumu öngörmede eşik değerler servikal uzunluk için 38 mm ve Bishop skoru için 3 olarak bulundu. İki metodun da birbirine üstünlüğü bulunamadı. Sensitivite ve spesifisite değerleri sırası ile Bishop skoru için 61.9 ve 82.6 ve servikal uzunluk için 89.9 ve 43.5 olarak hesaplandı. Her iki metodun eşdeğer öngörü gücüne sahip olduğu saptandı.Sonuç: Daha yüksek sensitiviteye sahip servikal uzunluk ve spesifisiteye sahip Bishop skoru başarılı vajinal doğum öngörüsünde tamamlayıcı yöntemler olarak uygulanabilir.

Keywords

Bishop skoru, doğum indüksiyonu, misoprostol, servikal uzunluk, vajinal doğum.

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