Accuracy of posterior cervical angle and cervical length in the prediction of successful induction of labor.


eMediNexus    16 December 2017

The purpose of a new study published in the International Journal of Gynaecology and Obstetrics was to determine the accuracy of the posterior cervical angle (PCA) compared to the cervical length and the Bishop score in predicting the outcome of induction of labor (IOL). This prospective observational study recruited 49 women with successful IOL and 21 women with unsuccessful IOL, who had their PCA and cervical length assessed by transvaginal ultrasonography and the Bishop score, between April 1 and July 31, 2017. Subsequently, the accuracy of these tests in predicting successful IOL (defined as vaginal delivery) was compared. The results showed that the suggested cut-offs for the prediction of successful IOL were a PCA of more than 99.5°, a cervical length of less than 34 mm, and a Bishop score of above 5. While the areas under the receiver operating characteristics (ROC) curves for these three measures were not remarkable dissimilar. On the other hand, a PCA of more than 99.5° had the best sensitivity (91.84%), specificity (90.48), positive predictive value (95.7%), negative predictive value (82.6%), positive likelihood ratio (9.64), and negative likelihood ratio (0.09) in comparison with the other two predictors. Thus, it was concluded that a PCA of more than 99.5° rendered the best accuracy in predicting successful IOL compared with the cervical length and the Bishop score.

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