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Bishop score and ultrasound assessment of the cervix for prediction of time to onset of labor and time to delivery in prolonged pregnancy.

Strobel, E ; Sladkevicius, Povilas LU ; Rovas, Linas LU ; De Smet, F ; Dejin Karlsson, E and Valentin, Lil LU orcid (2006) In Ultrasound in Obstetrics & Gynecology 28(3). p.298-305
Abstract
Objectives

To determine the ability of Bishop score and sonographic cervical length to predict time to spontaneous onset of labor and time to delivery in prolonged pregnancy.



Methods

Ninety-seven women underwent transvaginal ultrasound examination and palpation of the cervix at 291-296 days' gestation according to ultrasound fetometry at 12-20 weeks' gestation. Sonographic cervical length and Bishop score were recorded. Multivariate logistic regression analysis was used to determine which variables were independent predictors of the onset of labor/delivery 24 h, 48 h, and 96 h. Receiver-operating characteristics (ROC) curves were drawn to assess diagnostic performance.



... (More)
Objectives

To determine the ability of Bishop score and sonographic cervical length to predict time to spontaneous onset of labor and time to delivery in prolonged pregnancy.



Methods

Ninety-seven women underwent transvaginal ultrasound examination and palpation of the cervix at 291-296 days' gestation according to ultrasound fetometry at 12-20 weeks' gestation. Sonographic cervical length and Bishop score were recorded. Multivariate logistic regression analysis was used to determine which variables were independent predictors of the onset of labor/delivery 24 h, 48 h, and 96 h. Receiver-operating characteristics (ROC) curves were drawn to assess diagnostic performance.



Results

In nulliparous women (n = 45), both Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h and 48 h (area under ROC curve for the onset of labor 24 h 0.79 vs. 0.80, P = 0.94; for delivery 24 h 0.81 vs. 0.85, P = 0.64; for the onset of labor 48 h 0.73 vs. 0.74, P = 0.90; for delivery 48 h 0.77 vs. 0.71, P = 0.50). Only Bishop score discriminated between nulliparous women who went into labor/delivered 96 h or > 96 h. A logistic regression model including Bishop score and cervical length was superior to Bishop score alone in predicting delivery 24 h (area under ROC curve 0.93 vs. 0.81, P = 0.03) and superior to Bishop score alone and cervical length alone in predicting the onset of labor 24 h (area under ROC curve 0.90 vs. 0.79, P = 0.06; and 0.90 vs. 0.80, P = 0.06). In parous women (n = 52), Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h (area under ROC curve for the onset of labor 0.75 vs. 0.69, P = 0.49; for delivery 0.74 vs. 0.70, P = 0.62), but only Bishop score discriminated between women who went into labor/delivered 48 h and > 48 h. Three parous women had not gone into labor and six had not given birth at 96 h. In parous women logistic regression models including both Bishop score and cervical length did not substantially improve prediction of the time to onset of labor/delivery.



Conclusions

In prolonged pregnancy Bishop score and sonographic cervical length have a similar ability to predict the time to the onset of labor and delivery. In nulliparous women the use of logistic regression models including Bishop score and cervical length is likely to offer better prediction of the onset of labor/delivery 24 h than the use of the Bishop score alone. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cervix uteri, labor onset, prolonged pregnancy, ultrasonography
in
Ultrasound in Obstetrics & Gynecology
volume
28
issue
3
pages
298 - 305
publisher
John Wiley and Sons
external identifiers
  • wos:000240758100011
  • scopus:33748769499
ISSN
1469-0705
DOI
10.1002/uog.2746
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Obstetric, Gynaecological and Prenatal Ultrasound Research Unit (013242720), Pediatrics/Urology/Gynecology/Endocrinology (013240400)
id
c3aba326-a79c-429a-9299-5366191a521d (old id 159226)
date added to LUP
2016-04-01 15:32:16
date last changed
2021-06-30 04:24:22
@article{c3aba326-a79c-429a-9299-5366191a521d,
  abstract     = {Objectives<br/><br>
To determine the ability of Bishop score and sonographic cervical length to predict time to spontaneous onset of labor and time to delivery in prolonged pregnancy.<br/><br>
<br/><br>
Methods<br/><br>
Ninety-seven women underwent transvaginal ultrasound examination and palpation of the cervix at 291-296 days' gestation according to ultrasound fetometry at 12-20 weeks' gestation. Sonographic cervical length and Bishop score were recorded. Multivariate logistic regression analysis was used to determine which variables were independent predictors of the onset of labor/delivery 24 h, 48 h, and 96 h. Receiver-operating characteristics (ROC) curves were drawn to assess diagnostic performance.<br/><br>
<br/><br>
Results<br/><br>
In nulliparous women (n = 45), both Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h and 48 h (area under ROC curve for the onset of labor 24 h 0.79 vs. 0.80, P = 0.94; for delivery 24 h 0.81 vs. 0.85, P = 0.64; for the onset of labor 48 h 0.73 vs. 0.74, P = 0.90; for delivery 48 h 0.77 vs. 0.71, P = 0.50). Only Bishop score discriminated between nulliparous women who went into labor/delivered 96 h or &gt; 96 h. A logistic regression model including Bishop score and cervical length was superior to Bishop score alone in predicting delivery 24 h (area under ROC curve 0.93 vs. 0.81, P = 0.03) and superior to Bishop score alone and cervical length alone in predicting the onset of labor 24 h (area under ROC curve 0.90 vs. 0.79, P = 0.06; and 0.90 vs. 0.80, P = 0.06). In parous women (n = 52), Bishop score and sonographic cervical length predicted the onset of labor/delivery 24 h (area under ROC curve for the onset of labor 0.75 vs. 0.69, P = 0.49; for delivery 0.74 vs. 0.70, P = 0.62), but only Bishop score discriminated between women who went into labor/delivered 48 h and &gt; 48 h. Three parous women had not gone into labor and six had not given birth at 96 h. In parous women logistic regression models including both Bishop score and cervical length did not substantially improve prediction of the time to onset of labor/delivery.<br/><br>
<br/><br>
Conclusions<br/><br>
In prolonged pregnancy Bishop score and sonographic cervical length have a similar ability to predict the time to the onset of labor and delivery. In nulliparous women the use of logistic regression models including Bishop score and cervical length is likely to offer better prediction of the onset of labor/delivery 24 h than the use of the Bishop score alone.},
  author       = {Strobel, E and Sladkevicius, Povilas and Rovas, Linas and De Smet, F and Dejin Karlsson, E and Valentin, Lil},
  issn         = {1469-0705},
  language     = {eng},
  number       = {3},
  pages        = {298--305},
  publisher    = {John Wiley and Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Bishop score and ultrasound assessment of the cervix for prediction of time to onset of labor and time to delivery in prolonged pregnancy.},
  url          = {https://lup.lub.lu.se/search/files/4414830/625526.pdf},
  doi          = {10.1002/uog.2746},
  volume       = {28},
  year         = {2006},
}