TY - JOUR
T1 - Ultrasound examination at term for predicting the outcome of delivery in women with a previous cesarean section
AU - Comas, Montse
AU - Cochs, Belén
AU - Martí, Laia
AU - Ruiz, Raquel
AU - Maireles, Sònia
AU - Costa, Jordi
AU - Canet, Yolanda
PY - 2016/12/1
Y1 - 2016/12/1
N2 - © 2016 Informa UK Limited, trading as Taylor & Francis Group. Objective: To evaluate if ultrasound variables at term are associated with the mode of delivery in women with previous cesarean section (PCS). Methods: This was a prospective study of singleton pregnant women who planned a trial of vaginal birth after cesarean delivery. Cervical length, posterior cervical angle, head–perineum distance, and estimated fetal weight were measured at 37–39 weeks of gestation. Results: One hundred forty-four pregnancies were examined and vaginal delivery was achieved in 98 women (73%). Logistic regression analysis identified cervical length, head–perineum distance, age, previous vaginal delivery, previous cesarean for dystocia, and Bishop score as predictors of vaginal delivery. Combining ultrasound and clinical parameters, two models for risk scoring that differ in the variable Bishop score or cervical length were constructed. The AUC of these models was 0.867 and 0.855, respectively. Conclusions: In women with a PCS, measurement of cervical length and head–perineum distance at term is associated with the mode of delivery. A combination of clinical and sonographic parameters at term can predict the likelihood of vaginal delivery.
AB - © 2016 Informa UK Limited, trading as Taylor & Francis Group. Objective: To evaluate if ultrasound variables at term are associated with the mode of delivery in women with previous cesarean section (PCS). Methods: This was a prospective study of singleton pregnant women who planned a trial of vaginal birth after cesarean delivery. Cervical length, posterior cervical angle, head–perineum distance, and estimated fetal weight were measured at 37–39 weeks of gestation. Results: One hundred forty-four pregnancies were examined and vaginal delivery was achieved in 98 women (73%). Logistic regression analysis identified cervical length, head–perineum distance, age, previous vaginal delivery, previous cesarean for dystocia, and Bishop score as predictors of vaginal delivery. Combining ultrasound and clinical parameters, two models for risk scoring that differ in the variable Bishop score or cervical length were constructed. The AUC of these models was 0.867 and 0.855, respectively. Conclusions: In women with a PCS, measurement of cervical length and head–perineum distance at term is associated with the mode of delivery. A combination of clinical and sonographic parameters at term can predict the likelihood of vaginal delivery.
KW - Cervical length
KW - previous cesarean section
KW - ultrasound
KW - vaginal delivery
U2 - 10.3109/14767058.2016.1149566
DO - 10.3109/14767058.2016.1149566
M3 - Article
SN - 1476-7058
VL - 29
SP - 3870
EP - 3874
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 23
ER -