gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

New methods of ultrasonographic assessment of uterine cervix before an induction of labour



Introduction. An assessment of uterine cervix is the basis for choosing a method of labour induction. Usually the cervix is assessed with the Bishop scale and ultrasonographic measurements of the cervical canal and the width of the internal orifice. The texture of the cervix is evaluated subjectively in an internal examination. An objective method, such as elastography, could improve the effectiveness of predictions as to the results of labour induction and of assessment of the risk of premature labour. Aim of the study. The authors attempted to apply elastography for an assessment of uterine cervix in pregnancy. Material and methods. Pregnant women prepared for an induction of labour were subject to internal examination and transvaginal ultrasonographic examination. An elastographic image of the uterinecervix was recorded and evaluated. The elastography was described in terms of consecutive numbers from 0 to 4, corresponding to different textures reflected in the image as different colours. The colour scale no. 2 was selected for analysis, being the simplest to describe: violet corresponding to the hardest areas was marked as 0, red, being the softest, was marked as 4. The hardest area of the cervix in the photographs was always its posterior lip, while other parts, such as the area of the internal and external orifice and the anterior lip, were described in terms of a difference between their texture and the texture of the posterior lip. The results of labour induction and the route of delivery were recorded, too. Evaluations were made of the correlation between the Bishop scale and elastography as well as between elastography and the result of labour induction. Results. No correlation was discovered between elastography and an assessment of the uterine cervix in the Bishop scale. A statistically significant correlation was found between the number evaluating the internal orifice in elastography and the result of labour induction. Correlations between other areas of the cervix and the result of labour induction were not statistically significant, but a larger group of pregnant women is required for obtaining credible results. Conclusions. Elastography is a safe, simple, and effective method of assessing the texture of uterine cervix. It may be a useful tool for supporting an assessment of the risk of premature labour and the results of labour induction.