Can uterocervical angles successfully predict induction of labor in nulliparous women?

Dagdeviren, Emrah; Çetin, Berna Aslan; Mathyk, Begüm Aydoğan; Köroğlu, Nadiye; Topçu, Elif Göknur; Yüksel, Mehmet Aytaç

doi:10.1016/j.ejogrb.2018.06.014

Cited by 15 publications

(17 citation statements)

References 15 publications

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“…According to abovementioned pathophysiologic correlations, UCA has been recently used to predict various obstetrics complications other than sPTB, such as success of induction of labor, differentiating false labor from the true one, and determining the mode of delivery [28][29][30]. Regarding the application of UCA for sPTB, a study by Sepúlveda-Martínez et al [14] demonstrated that the UCA measurement is independent of CL, which has been surprisingly shown to have a higher detection rate in identifying the pregnancies at the risk of sPTB, compared to CL [20].…”

Section: Discussion/conclusionmentioning

confidence: 99%

The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

et al. 2021

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The alteration of the uterocervical angle (UCA) has been proposed to play an important role in spontaneous preterm birth (sPTB). The aim of this systematic review and meta-analysis was to evaluate the evidence on the UCA predictive role in sPTB. In this study, PubMed, Web of Science, Scopus, and Google scholar were systematically searched from inception up to June 2020. Inter-study heterogeneity was also assessed using Cochrane’s Q test and the I2 statistic. Afterward, the random-effects model was used to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Eleven articles that reported second-trimester UCA of 5,061 pregnancies were included in this study. Our meta-analysis results indicate that a wider UCA significantly increases the risk of sPTB in following cases: all pregnancies (WMD = 15.25, 95% CI: 11.78–18.72, p < 0.001; I2 = 75.9%, p < 0.001), singleton (WMD = 14.43, 95% CI: 8.79–20.06, p < 0.001; I2 = 82.4%, p < 0.001), and twin pregnancies (WMD = 15.14, 95% CI: 13.42–16.87, p < 0.001; I2 = 0.0%, p = 0.464). A wider ultrasound-measured UCA in the second trimester seems to be associated with the increased risk of sPTB in both singleton and twin pregnancies, which reinforces the clinical evidence that UCA has the potential to be used as a predictive marker of sPTB.

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Section: Discussion/conclusionmentioning

confidence: 99%

The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

et al. 2021

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“…In studies, the UCA was more sensitive than the CL in terms of predicting preterm labor in women with twin pregnancies and cerclage in place [16][17][18][19][20]. However, another study found that the UCA of nulliparous women did not predict the outcomes of birth induction [21]. Another study between UCA and preterm delivery prediction was conducted with pregnant women with polyhydramniosis.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Measurement of the Uterocervical Angle for Predicting the Latent Period in Pregnancy Exhibiting Premature Membrane Rupture

Ercan

Yenigül

Başer

2021

Gynecol Obstet Invest

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Objectives: The duration of the latent period is uncertain in preterm premature rupture of membranes (PPROM). This time estimate provides information on the time of the corticosteroid to be applied and the time of delivery of the pregnant women. Here, we used transvaginal sonography to determine the relationship between the uterocervical angle (UCA) and PPROM latency and the risk for neonatal complications. Design: This is a prospective cohort study of 80 singleton pregnancies with PPROM. Participants/Materials, Setting, and Methods: This prospective cohort study was conducted at a tertiary center with a total of 80 singleton pregnancies with PPROM. The UCA and cervical length were measured in the first evaluation of PPROM in patients between 24 and 34 weeks of age. The study population was subdivided into 2 groups: group 1 (n = 27) included women who gave birth within 10 days after a PPROM diagnosis and group 2 (n = 53) included women who gave birth later than this. Our aim was latency prediction (more or less than 10 days) in PPROM patients undergoing regular UCA monitoring. Results: Of the women in group 1, 74.1% (n = 20) had spontaneous births and 7.4% (n = 2) had induced births because of clinical chorioamnionitis. Of the women in group 2, 71.6% (n = 38) had spontaneous births and 7.6% (n = 4) had induced births because of clinical chorioamnionitis (n = 3) or poor fetal condition (n = 1). We drew receiver operating characteristic curves to explore whether the UCA predicted birth within 10 days of PPROM. The area under the curve was 0.894 (p < 0.001). The optimal UCA cutoff was 108°, with 93% sensitivity and 85% specificity. Limitations: First, the sample size was small; it would have been better to have more patients. Second, we measured the UCA only once. Third, patients were not categorized by parity. Conclusions: The UCA, measured by the transvaginal route, can successfully predict latent period in PPROM. Measuring the UCA can be useful to determine the time of corticosteroid administration and to inform patients about the time of birth.

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“…Various studies have defined failed IOL differently, i.e., both as no vaginal delivery and inability to achieve the active phase of labor [ 6 ]. During pregnancy, while a favorable cervix is vital for successful delivery, an unfavorable cervix increases the need for cesarean sections (CS) [ 7 ]. Therefore, it is crucial to evaluate pre-delivery cervical status.…”

Section: Introductionmentioning

confidence: 99%

“…Some transvaginal sonographic (TVS) parameters appear promising as candidates for predicting IOL. Although TVS requires proper training for measurement, it is preferred over the traditional Bishop score due to its reproducibility [ 7 ]. Some parameters have been investigated in previous studies.…”

Section: Introductionmentioning

confidence: 99%

“…The force exerted by the uterus on the cervix varies depending on the UCA. In a recent study, Dagdeviren et al reported that patients with broader pre-induction UCAs were prone to have a shorter duration of the active phase [ 7 ]. Although a recent study reported that UCA combined with CL predicted labor induction more satisfactorily than CL alone, UCA is more reproducible than CL [ 21 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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The Uterocervical Angle Combined with Bishop Score as a Predictor for Successful Induction of Labor in Term Vaginal Delivery

Yang

Kim

Hwang

et al. 2021

JCM

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The objective of this study was to determine the value of uterocervical angle (UCA) in predicting successful induction of labor (IOL) in singleton pregnant women compared to the Bishop score and cervical length (CL). A total of 205 normal term, singleton labor-induction cases were analyzed. Successful IOL was defined as the onset of active labor of induction. A comparative analysis was performed to evaluate the effectiveness of UCA, Bishop score, and CL in predicting IOL. Compared to the non-successful IOL group, the women in the successful IOL group had significantly wider UCA (p = 0.012) and higher Bishop score (p = 0.001); however, the CL was not significantly different (p = 0.130). UCA alone did not perform better than the Bishop score when predicting successful IOL. However, UCA combined with the Bishop score showed higher performance in predicting IOL (combined UCA > 108.4° and favorable Bishop score as sensitivity of 44.6%, specificity of 96.0%, PPV of 96.2%, and NPV of 43.6; combined UCA > 108.4° or favorable Bishop score as sensitivity of 85.7%, specificity of 50.0%, PPV of 78.7%, and NPV of 61.9). In conclusion, UCA combined with Bishop score may be an effective sonographic method for predicting successful IOL.

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Can uterocervical angles successfully predict induction of labor in nulliparous women?

Cited by 15 publications

References 15 publications

The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

Measurement of the Uterocervical Angle for Predicting the Latent Period in Pregnancy Exhibiting Premature Membrane Rupture

The Uterocervical Angle Combined with Bishop Score as a Predictor for Successful Induction of Labor in Term Vaginal Delivery

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