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KMID : 0877920100120020055
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Korean Journal of Ultrasound in Obstetrics and Gynocology
2010 Volume.12 No. 2 p.55 ~ p.59
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Sonographic Cervical Length Measurement Before Labor Induction in VBAC
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Jo Yun-Sung
Chung Hyun-Sik
Kim Sa-Jin
Lee Young
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Abstract
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Objective: Vaginal birth after cesarean section (VBAC) is associated with a small but significant risk of uterine rupture with poor outcomes for both mother and infant. The purpose of this study was to determine if transvaginal sonographic measurement of the cervical length is a useful method to predict successful labor induction in VBAC.
Methods: A total of 57 women who were scheduled for medically indicated induction of labor had a transvaginal sonographic measurement of the cervical length before labor induction. Induction of labor was performed within 4 hours of the ultrasonographic examination, by oxytocin only. The length of labor and delivery mode was checked. We constructed a receiver operator characteristic (ROC) curve to determine the optimal cut-off point of the cervical length, to predict cesarean section.
Result: VBAC success rate was 54.4%. Bishop score and cervical length were significantly associated with labor duration. The ROC curve showed that the optimal cut?off point of cervical length was 2.17 cm. The predictive values of cervical length on VBAC failure were: 76.5% of sensitivity; 52.5% of specificity; respectively.
Conclusion: Transvaginal sonographic measurement of cervical length is good predictor of a failure of VBAC.
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KEYWORD
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Vaginal birth after cesarean, VBAC, Cervical length, Induction, Labor duration
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