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Cervix assessment for the management of labor induction: Reliability of cervical length and B ishop score determined by residents
Author(s) -
GarciaSimon Raquel,
Oros Daniel,
GraciaCólera Daniel,
Moreno Esther,
Paules Cristina,
Cañizares Silvia,
Gascón Elena,
Fabre Ernesto
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12553
Subject(s) - medicine , intraclass correlation , cervix , bishop score , ultrasound , reliability (semiconductor) , labor induction , obstetrics and gynaecology , obstetrics , gynecology , radiology , pregnancy , clinical psychology , power (physics) , physics , genetics , cancer , quantum mechanics , oxytocin , biology , psychometrics
Aim To evaluate the reliability of two techniques of cervical ripeness assessment at the beginning of labor induction, as assessed by inexperienced observers. Methods A total of 120 women were prospectively studied at admission for labor induction. Two independent physicians examined consenting women successively but separately. One experienced consultant and one of the six first‐year obstetrics residents composed the pairs of observers. The trainees had very limited prior experience with cervical ultrasound scan or evaluating B ishop score. Cervical length and B ishop score were evaluated according to standard methodology. Reliability was described by intraclass correlation coefficients ( ICC ) and coefficients of variation ( COV ). Ultrasound cervical length was plotted according to the B land– A ltman method. Results The median B ishop score and mean cervical length were similar for all observers. Ultrasound cervical length and B ishop score were highly reliable when evaluated by first‐year residents. Ultrasound cervical length showed the highest interobserver agreement, with ICC values over 0.9 and COV values of approximately 10% or less for all trainees. The B ishop score was also reliable, but with lower ICC and higher COV values. Conclusion B ishop score and ultrasound cervical length examination for the management of labor induction are accurate and easy to learn by inexperienced first‐year residents. However, cervical length showed higher reliability than the B ishop score.