Ultraschall Med 2021; 42(05): 520-528
DOI: 10.1055/a-1131-7736
Original Article

Cervical and Lower Uterine Parameter Ultrasound and Elastographic Parameters for the Prediction of a Successful Induction of Labor

Die Wertigkeit von Ultraschall- und Elastografieparametern der Zervix und des unteren Uterus bei der Prädiktion einer erfolgreichen Geburtseinleitung
Amr Hamza
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
,
Julia Radosa
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
,
Christoph Gerlinger
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
,
Erich Franz Solomayer
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
,
Russalina Ströder
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
,
Gabriele Meyberg-Solomayer
Department of Obstetrics and Gynecology, Saarland-University, Saarbrücken, Germany
› Author Affiliations

Abstract

Purpose The prediction of successful induction of labor (IOL) has been the subject of a series of studies. The predictive role of cervical sonographic and elastographic parameters has been controversially discussed. Lower uterine segment (LUS) thickness and strain values have not been discussed yet in this regard.

Materials and Methods A prospective cohort study was performed to examine the predictive power of Bishop score parameters, sonographic cervical length (CL), cervical funneling, cervical strain values, LUS thickness and its strain values regarding successful IOL within 24 hours and intervals to onset of labor, ROM and delivery of the fetus. A p-value of < 0.05 was considered statistically significant.

Results 135 patients were examined. A cervical length of 25 mm, the presence of cervical funneling and digital shorter cervix was significant for the prediction of successful induction of labor (IOL) within 24 hours. There was weak correlation between the functional CL and the onset of labor (r2 = 0.10) and ROM (r2 = 0.13). There was also a weak correlation between the cervical funnel width and the time interval to the onset of labor (r2 = 0.25), ROM (r2 = 0.23) and delivery of the fetus (r2 = 0.22). Cervical elastography, LUS thickness and strain values were not significant for the prediction of a successful IOL.

Conclusion We were able to show that cervical structural changes at the level of the internal os, i. e., shortening through funneling, may be the determining factor for successful IOL.

Zusamenfassung

Ziel Die Prädiktion einer erfolgreichen Geburtseinleitung („induction of labor“, IOL) war Gegenstand einer Reihe von Studien. Der prädiktive Wert von sonografischen und elastografischen Parametern der Zervix wurde kontrovers diskutiert. Dicke und Strainwerte des unteren Uterinsegments (LUS) wurden in diesem Zusammenhang noch nicht diskutiert.

Material und Methoden Eine prospektive Kohortenstudie wurde durchgeführt, um die Vorhersagekraft der Bishop-Score-Parameter, der sonografischen Zervixlänge (CL), des Zervixtrichters, der zervikalen Strainwerte, der LUS-Dicke und ihrer Strainwerte in Bezug auf eine erfolgreiche IOL innerhalb von 24 Stunden und auf die Intervalle bis zum Einsetzen der Wehen, zur ROM und zur Geburt zu untersuchen. Ein p-Wert von < 0,05 war statistisch signifikant.

Ergebnisse Es wurden 135 Patienten untersucht. Eine Zervixlänge von 25 mm, das Vorhandensein des Zervixtrichters und einer digital kürzeren Zervix waren signifikant für die Vorhersage einer erfolgreichen Einleitung der Wehen (IOL) innerhalb von 24 Stunden. Eine schwache Korrelation gab es zwischen der funktionellen CL und dem Einsetzen der Wehen (r2 = 0,10) und der ROM (r2 = 0,13). Es bestand auch eine schwache Korrelation zwischen der Breite des Zervixtrichters und dem Zeitintervall bis zum Einsetzen der Wehen (r2 = 0,25), der ROM (r2 = 0,23) und der Entbindung (r2 = 0,22). Die zervikale Elastografie, LUS-Dicke und Strainwerte waren nicht signifikant für die Vorhersage einer erfolgreichen IOL.

Schlussfolgerung Wir konnten zeigen, dass zervikale Strukturveränderungen im Bereich des inneren Muttermundes, d. h. die Verkürzung durch Trichterbildung, der entscheidende Faktor für eine erfolgreiche IOL sein können.



Publication History

Received: 29 July 2019

Accepted: 14 February 2020

Article published online:
20 March 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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