Objective: The objectives of this review were to identify the predictive factors of induction of labor (IOL) failure or success as well as to highlight the current heterogeneity regarding the definition and diagnosis of failed IOL. Materials and Methods: Only studies in which the main or secondary outcome was failed IOL, defined as not entering the active phase of labor after 24 h of prostaglandin administration ± 12 h of oxytocin infusion, were included in the review. The data collected were: study design, definition of failed IOL, induction method, IOL indications, failed IOL rate, cesarean section because of failed IOL and predictors of failed IOL. Results: The database search detected 507 publications. The main reason for exclusion was that the primary or secondary outcomes were not the predetermined definition of failed IOL (not achieving active phase of labor). Finally, 7 studies were eligible. The main predictive factors identified in the review were cervical status, evaluated by the Bishop score or cervical length. Discussion: Failed IOL should be defined as the inability to achieve the active phase of labor, considering that the definition of IOL is to enter the active phase of labor. A universal definition of failed IOL is an essential requisite to analyze and obtain solid results and conclusions on this issue. An important finding of this review is that only 7 of all the studies reviewed assessed achieving the active phase of labor as a primary or secondary IOL outcome. Another conclusion is that cervical status remains the most important predictor of IOL outcome, although the value of the parameters explored up to now is limited. To find or develop predictive tools to identify those women exposed to IOL who may not reach the active phase of labor is crucial to minimize the risks and costs associated with IOL failure while opening a great opportunity for investigation. Therefore, other predictive tools should be studied in order to improve IOL outcome in terms of health and economic burden.

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Second-trimester CCI is a better predictor of sPTB < 37 weeks in low-risk pregnancies than is CL. External validation is needed as well as studies assessing the value of CCI as a screening tool in unselected and high-risk populations. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

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SYNOPSIS. In fish, the structural and functional characteristics of insulin and IGF-I receptors have been well studied. Current evidence indicates that all gnatostome animals, from fish to mammals, contain separate insulin and IGF-I molecules and specific receptors for insulin and IGF-I. However, qualitative differences in the functional aspects of insulin and IGF-I receptors among vertebrate species can account for variations in the biological activity of insulin and IGF-I. In this paper we will focus on the functional evolution of the insulin and IGF-I receptors in vertebrates and on the appearance of the unrelated IGF-II receptors.

Insulin and insulin-like growth factor (IGF-I) receptor binding and tyrosine kinase activity were characterized in cardiac and skeletal muscles of several vertebrates. Specific insulin binding per unit weight of skeletal muscle was clearly higher in pigeon and rat than in ectothermic vertebrates (32 +/- 5 and 25 +/- 2.7%/100 mg initial tissue in pigeon and rat, respectively, vs. 4.4 +/- 0.2%/100 mg in carp samples). Insulin binding clearly predominated over IGF-I binding in skeletal muscle of endotherms (IGF-I binding was 7.7 +/- 0.5%/100 mg in rat). In ectothermic vertebrates the situation was reversed, and IGF-I binding was higher than insulin binding. In cardiac muscle, specific binding of both insulin and especially IGF-I was higher than the values found in skeletal muscle of the same species (IGF-I binding was 60 +/- 4, 103 +/- 2, and 20 +/- 3%/100 mg in carp, turtle, and rat, respectively). The tyrosine kinase activity of insulin and IGF-I receptors of all species studied presented basal phosphotransferase rates (250-1,600 fmol P.micrograms protein-1.30 min-1) and percentage of stimulation (150-520%) with clear differences between species. The present data suggest that insulin and IGF-I binding to skeletal and cardiac muscles change through the vertebrate scale in both quantity and activity.

Background  Short cervical length (CL) has not been shown to be adequate as a single predictor of spontaneous preterm birth (sPTB) in high-risk pregnancies. Objective  The objective of this study was to evaluate the performance of the mid-trimester cervical consistency index (CCI) to predict sPTB in a cohort of high-risk pregnancies and to compare the results with those obtained with the CL. Study Design  Prospective cohort study including high-risk singleton pregnancies between 19 +0 and 24 +6 weeks. The ratio between the anteroposterior diameter of the uterine cervix at maximum compression and at rest was calculated offline to obtain the CCI. Results  Eighty-two high sPTB risk women were included. CCI (%) was significantly reduced in women who delivered <37 +0 weeks compared with those who delivered at term, while CL was not. The area under the curve (AUC) of the CCI to predict sPTB <37 +0 weeks was 0.73 (95% confidence interval [CI], 0.61–0.85), being 0.51 (95% CI, 0.35–0.67), p  = 0.03 for CL. The AUC of the CCI to predict sPTB <34 +0 weeks was 0.68 (95% CI, 0.54–0.82), being 0.49 (95% CI, 0.29–0.69), p  = 0.06 for CL. Conclusion  CCI performed better than sonographic CL to predict sPTB. Due to the limited predictive capacity of these two measurements, other tools are still needed to better identify women at increased risk.