Comparison of cervical length measurement by transvaginal ultrasonograghy and bishop score in predicting successful labor induction

This study was conducted to explore the value of the transvaginal ultrasonography of the cervical length measurement in comparison with Bishop Score in predicting the mode of delivery in the pregnancies in which labor is induced. A total of 148 pregnancies at 37 to 42 weeks of gestation were included for induction. At first, the cervical length was measured by transvaginal ultrasonograghy and then was compared with Bishop Score to predict the mode of delivery. The cut off points was considered as 27 mm for the former and as score 4 for the latter. Mean preinduction cervical length was 24.5 +/- 7.92 mm. Seventy-three percent of pregnancies were primipara whereas 27% were multipara. Eighty eight women delivered vaginally and 60 underwent cesarean section. In the study, the rate of cesarean in the primipara was more than multipara [P<0.01]. The sensitivity and specificity of the length of the cervix in comparison with Bishop Score were [71.6 vs 53.4%], [45 vs 66.7%] respectively. The cervical length measurement and Bishop Score correctly predicted the model of delivery in 90 cases [60.8%] and 87 cases [58.8%], while the rate of incorrect prediction were 58 cases [39.2%] and 61 cases [42.2%] respectively [P= 0.81]. This study suggested that the cervical length measurement by transvaginal ultrasonograghy with cut-of-point of 27 mm and the Bishop Score of 4 are equally successful in predicting the type of delivery

[Rate of bleeding, abortion and ectopic pregnancy and their relationship with the patient's age in three different methods of infertility treatment; induction ovulation, IUI and IVF]

The aim of the study was determination of the rate of bleeding, abortion, and ectopic pregnancy in three methods of treatment of infertility in patients with different ages and realization of the predictive value of bleeding result. This study was done prospectively on 252 female patients who had become pregnant through infertility treatment at the IVF ward of Imam Khomeini Hospital [Ahwaz]. They were followed until the end of the 20 th week of pregnancy. Three groups of patients included 100 patients who had become pregnant through induction ovulation, 122 patients who had become pregnant through IUI and 30 patients who had become pregnant through IVF. Group I[ Pregnant women via induction Ovulation]: 37% had bleeding of which 35% were aborted. 63% did not have bleeding of which 11% were aborted and one EP was detected as well. 40% of the bleeding cases were younger than 30 years old and 29% of them were older then 30 years. The rate of abortion in this group was 20% and EP was 1%. The highest abortion rate was detected inpatients older than 36 years. Group II: Pregnant women via IUI: 37% had bleeding of which 31% had abortion. 63% didn't have bleeding of which 10% had abortion and 3 cases had EP. The rate of abortion was 18% and EP 3% The rate of abortion increased with age but the rate of bleeding stayed constant. Group III: Pregnant women via IVF: 36% had bleeding of which 27% had abortion. 64% didn't have bleeding of which 10.5% had abortion. The rate of abortion was 17% and EP 6.6%. All of them were greater than 30 years old. The rate of abortion and bleeding was not different in three groups and did not disagree with world's statistics. The rate of EP in IVF group was higher than other groups but similar to world's data [2-8%] . The rate of bleeding didn't increase with age. However, bleeding in all ages and groups could predict a 2.5-3 fold increase in the rate of abortion [PV =0.008, 0.014 and 0.05 in three groups]. Also, 11% of all abortions were without bleeding