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Prediction of the risk of cesarean delivery after labor induction in twin gestations based on clinical and ultrasound parameters
Author(s) -
Han Bo Ryoung,
Park Kyo Hoon,
Lee Sung Youn,
Jung Eun Young,
Park Jeong Woo
Publication year - 2016
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.13038
Subject(s) - medicine , gestation , labor induction , logistic regression , obstetrics , gestational age , bishop score , parity (physics) , receiver operating characteristic , retrospective cohort study , gynecology , pregnancy , oxytocin , cervix , surgery , genetics , physics , particle physics , cancer , biology
Abstract Aims To develop a model based on clinical and ultrasound parameters to predict the risk of cesarean delivery after labor induction in near‐term twin gestations. Methods This retrospective cohort study included 189 consecutive women with twin gestations at ≥ 36.0 weeks scheduled for labor induction. The Bishop score and transvaginal ultrasonographic measurements of cervical length were obtained immediately before labor induction. Parameters studied included maternal age, height, weight, parity, gestational age, Bishop score, cervical length, epidural analgesia, method of conception, chorionicity and birth weight. Prostaglandin E 2 (dinoprostone) and oxytocin were used for labor induction. Logistic regression analysis and receiver operating characteristic curve were used to generate a predictive model for cesarean delivery. Results Fifty (26.5%) of the 189 women had cesarean deliveries. According to logistic regression analysis, maternal height ( P = 0.004), parity ( P = 0.005) and cervical length ( P = 0.016), but not Bishop score ( P = 0.920 ), were identified as independent predictors of cesarean delivery. A risk score based on a model of these three parameters was calculated for each patient. The model was shown to have an adequate goodness of fit ( P = 0.201 ) and the area under the curve was 0.722 , indicating fairly good discrimination. Conclusions Maternal height, parity and cervical length were independent parameters for predicting the risk of cesarean delivery after labor induction in twin gestations. A predictive model using these parameters may provide useful information for deciding whether or not to induce labor.