Clinical and sonographic predictors for successful labor induction in preterm women / 대한산부인과학회지

OBJECTIVE: To identify the clinical and sonographic parameters which predict the likelihood of successful labor induction in preterm women. METHODS: This prospective observational study enrolled 103 consecutive preterm women (<37 weeks gestation) with singleton gestations scheduled for induction of labor. Transvaginal ultrasound for measurement of the cervical length was performed and the Bishop score was determined by digital examination. The parameters studied were gestational age at induction, parity, maternal age, Bishop score, sonographic cervical length, and current body mass index (BMI). Univariate and multivariate statistical methods were used for data analysis. RESULTS: Successful induction of labor occurred in 45 (44%) of women. Multiple logistic regression analysis identified parity, maternal BMI, and gestational age at induction as the independent predictors of successful labor induction in preterm women, although gestational age did not reach statistical significance (P=0.056). However, maternal age, sonographic cervical length, and Bishop score did not provide independent contribution to success of induction. CONCLUSION: In preterm women undergoing induction of labor parity, maternal BMI, and gestational age at induction were independent parameters in predicting successful induction of labor. However, sonographic cervical length and Bishop score had poor predictive values for success of labor induction.

Umbilical Artery Doppler Velocimetry in Small for Gestational Age Fetuses / 대한산부인과학회잡지

OBJECTIVE: To evaluate perinatal outcomes in high risk pregnancy fifty-four women who were delivered of small for gestational age infants were studied antenatally by serially umbilical artery doppler velocimetry in our unit. Five study subjects with loss of end diastolic velocities were excepted. METHODS: Forty-nine study subjects were separated with normal (group I, 12 subjects) and abnormal (group II, 37 subjects) systolic/diastolic (A/B) ratio of umbilical artery. Perinatal outcomes were compared with normal and abnormal group. Fisher's exact test and student t test were used for statistical analysis RESULTS: The group with an abnormal A/B ratio had a signifiamtly higher incidence cesarean section for fetal distress, admission into the neonatal intensive care unit, perinatal death, and adverse perinatal outcome. these data suggest that small for gestational age fetus with normal ratio is at significantly lower risk than are those with abnonnal ratio. CONCLUSION: An abnormal Doppler umbilical artery A/B ratio is a strong predictor of adverse perinatal outcome in small-for-gestational-age-fetuses.