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BISHOP SCORE AND RISK OF HAVING CESAREAN DELIVERY AFTER INDUCTION OF LABOR IN NULLIPAROUS WOMEN
BISHOP SCORE AND RISK OF HAVING CESAREAN DELIVERY AFTER INDUCTION OF LABOR IN NULLIPAROUS WOMEN
Shokhan F. Ahmed a, and Sallama K. Nasir b
Shokhan F. Ahmed a, and Sallama K. Nasir b
a KBMS Trainee,Sulaimani Maternity Teaching Hospital, Ministry of Health, Kurdistan Region, Iraq.
b Dept. of Obstetrics and Gynecology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 6/6/2020; Accepted: 19/5/2021; Published: 21/6/2021
DOI Link: https://doi.org/10.17656/jsmc.10306
ABSTRACT
Background
Induction of labor (IOL) refers to the stimulation or artificially initiating uterine contractions before its spontaneous onset, to effect progressive effacement and dilatation of the cervix and, ultimately, delivery of a baby. The Bishop’s Score also known as the cervical score is a pre-labor scoring system to assist in predicting the success of labor induction.
Objectives
To assess the outcome of induction of labor (whether vaginal delivery or Cesarean Section) concerning Bishop Score.
Patients and Methods
This is a prospective cohort study, conducted at Sulaimani maternity teaching hospital for 10months startingfrom 1st April 2019 till 30th of January 2020. The study included 152 pregnant nulliparous women with singleton viable fetus, cephalic presentation, and intact membranes with no medical disease who were admitted to hospital for induction of labor because of postdate pregnancy (gestational age> 40 weeks). The studied women were divided into two groups according to their Bishop Score on admission. Group (1) are women with Bishop Score < 6 who underwent Labour induction with 25 microgram misoprostol followed by oxytocin drip. Group (2) are womenwhose Bishop Score ≥ 6 underwent induction of labor by oxytocin drip. Women in both groups were followed up throughout induction till delivery and the outcome of labor was compared between the two groups.
Results
There was statistically significant association between the bishop score at time of induction and mode of delivery since (40.4%) of women in group (1) delivered by C/S and (59.6%) delivered vaginally, while the majority (80.9%) of women in group (2) had successful induction of labor and delivered vaginally and only 19.1% delivered by C/S, (P value = 0.005). The main cause of C/S in group(1)was failure of progress in first stage of labor (38.8%), followed by meconium stained liquor (27.7%) and fetal distress (25.2%). While for group (2), the main cause of C/S was meconium stained liquor (50.0%), followed by fetal distress (33.4%) .The difference was statistically highly significant (p-value =0.01) also the duration of labor was significantly related to bishop score, women with bishop score < 6 has longer duration of labor compared to women with bishop score ≥ 6 in spite of using misoprostol as a ripening agent (p- value=0.05).
Conclusion
Assessment of bishop score at the time of induction of labor can predict the outcome of induction. Nulliparous woman with a low bishop score (<6) at the time of IOL is at risk of failure of induction and delivery by C/S despite using cervical ripening agents.
KEYWORDS
Bishop Score, Having Cesarean Delivery, Nulliparous women.
References
1. Leduc D, Biringer A, Lee L, Dy J, Clinical Practice Obstetrics C, Special C. Induction of labour. J ObstetGynaecol Can. 2013; 35(9):840-57.
2. Edmonds k. Dewhurst's Textbook of Obstetrics and Gynaecology.8th ed. UK:John Wiley and sons; 2012. P. 287 -293.
3. Kenny LC.Obstetrics by Tenteachers.19thed.UK:Hodder&Stoughton;2011. P. 219-222.
4. Hayman R. An Evidence based text for MRCOG.2nded. London:Edward Arnold; 2010. P. 288-290.
5. National Collaborating Centre for Women’s and Children’s Health; July 2008 Available from:
https://www.nice.org.uk/guidance/cg70/evidence/cg70-induction-of-labour-full-guideline2
6. Gomez LaencinaAM, Sanchez FG, Gimenez JH, Martinez MS, Valverde Martinez JA, Vizcaino VM. Comparison of ultrasonographic cervical length and the Bishop score in predicting successful labor induction. ActaObstetGynecol Scand. 2007; 86(7):799-804.
7. High Risk Pregnancy. 4th ed. David K. James MA MD FRCOG DCH, Philip J. Steer BS MD FRCOG FCOGSA, Carl P. Weiner MD, Bernard Gonik MD FACOG.December 17, 2010.
8 .Gray Cunningham F. Williams Obstetrics, 2ndMcGraw.Hill.pp.392, 500-503, 2010.
9. Obstetrics by Ten Teachers, 20th ed. KENNY ; January 1, 2017.
10. E M Xenakis , J M Piper, D L Conway, O Langer.Induction of labor in the nineties: Conquering the unfavorable cervix.Obstetrics & Gynecology. Volume 90, Issue 2, August 1997, Pages 235-239.
11. Karen E. Kaufman. MDa, Jennifer L. Bailit. MD, MPHb, William Grobman. MD MBAa. Elective induction: An analysis of economic and health consequences. Transactions of the twenty-second annual meeting of the society for maternal-fetal medicine, volume 187, issue 4, p858-863, October 01, 2002.
12. Hamm RF, Downes KL, Srinivas SK, Levine LD. Using the Probability of Cesarean from a Validated Cesarean Prediction Calculator to Predict Labor Length and Morbidity. Am J Perinatol. 2019; 36(6):561-566.
13. Mozurkewich EL, Chiliming JL, Berman DR, Perni UC, Romero VC, King VJ, et al. Method of induction of labour: a systemic review. BMC Pregnancy Childbirth.2011;11:84.
14. Francis PJM Vrouenraets, Frans JME Roumen, Frans JME Roumen, Cary Oberije, Esther JT Scheve. Bishop Score and Risk of Cesarean Delivery After Induction of Labor in Nulliparous Women. May 2005Obstetrics and Gynecology 105(4):690-7.
15. David P. Johnson, Nancy R. Davis, Allen J. Brown.Risk of cesarean delivery after induction at term in nulliparous women with an unfavorable cervix.Transactions of thesixty-ninth annual meeting of the pacific coast obstetrical and gynecological society| volume 188, issue 6, p1565-1572, June 01, 2003.
16. ArinzeChidiebeleIkeotuonye, Chidebe Christian Anikwe, Johnson AkumaObuna, Bartholomew ChukwunonyeOkorochukwu, Brown NnamdiEjikeme, ChineduChukwuemekaIfemelumma, Ifeoma Cecilia Ekwunife, Francis ChigozieOkoroafor.Relationship between Bishop Score and Success of Induction of Labour in Federal Teaching Hospital, Abakaliki, Ebonyi State.Open Journal of Obstetrics and Gynecology, 2018, 8, 980-992.
17. Vahratian A, Zhang J, Troendle JF, Sciscione AC, Hoffman MK. Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstet Gynecol. 2005; 105(4):698-704.
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