Online ISSN: 2515-8260

Keywords : Induction of labour

Elastography of the cervix for prediction of induction of labour

Dr. Sanjivani Wanjari; Dr. Suresh Phatak; Dr. Deepti Shrivastava

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1936-1945

Abstract: Background –Labour can be induced for various indications. This is done when
it appears that benefits of induction outweigh its risk. Bishop score is the gold standard
that is used to determine whether labour can be induced. However, the assessment of the
cervix with digital examination is subjective and less reproducible. Elastography is an
upcoming modality which is an ultrasound-based imaging technique used for assessing
elasticity of tissues. It is based on the premise that softer tissues get more compressed than
harder tissues when pressure is applied with ultrasound probe. Thereafter colour mapping
is done depending on the gradient values of strain.
Aim - to assess whether elastography findings of uterine cervix can be used to predict
successful induction of labour.
Objectives -
1) To examine the cervix by digital examination.
2) To determine the length of the cervix with the help of trans-vaginal ultrasound.
3) To perform strain elastography of the cervix.
4) To observe within how many hours labour starts after induction.
Materials & methods –
A prospective observational study will be done at AVBRH over a three years period from
October 2018 to October 2021. Inclusion criteria - Pregnant women with gestation of 36-41
weeks, having no contraindication for labour induction, will be included in the study.
Sampling procedure –Simple Random Sampling. Sample size – estimated sample size for
study is 80 cases. Strain Elastography of the cervix will be performed before labour
induction in the sample population and the outcome will be assessed. A score will be
devised based on the colour mapping of elastography.
Up till now we have had encouraging results. A colour map showing various colours from
blue/purple through green/ yellow and then orange/red were noted. The colour red



European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2174-2181

Background: Progressive cervical effacement, cervix dilatation and decent of the presenting part leading to vaginal delivery by iatrogenic uterine contractions of a healthy baby is known as induction of labour.
Cervical length measurement by transvaginal ultrasonography is more objective way for assessing cervical status In late pregnancy, measurement of length of the cervix could help in predicting the spontaneous onset of labour and could assist clinicians in assessing favourability for the induction of labour.
Aim: This aim to find the significance of length of cervical by transvaginal sonography in predicting the successful induction of labour in near term women.
1. To evaluate the cervical length by Transvaginal sonography. 2. To assess the progress of labour in women with different cervical length after induction by misoprostol tablets in relation to cervical length within 24 hours. 3. To assess the overall course of induction in terms of maternal and neonatal outcome.
Material and methods:
In the study, Near term women undergoing induction of labour, will be subjected to history taking, examination and required investigations. A formula is used to measure the sample size, which has the desired level of accuracy, the desired level of confidence, and the approximate proportion of the attribute in the population. Total study participants will be selected among term pregnant primigravida women admitted for delivery after screening through inclusion and exclusion criteria. Prior to the enrolment, written informed consent will be obtained from eligible participants. Selected cases will be subjected to trans-vaginal sonography for cervical length assessment and routine digital examination and then induction of labour will be done with misoprostol.
Expected Results: Women having smaller cervical length are expected to have more favourable outcome of induction in comparison to women with longer cervix near term.