Labor induction has become a significant part of obstetrics. The Bishop-score is the most commonly used method for evaluating cervical ripening prior to labor induction. Many studies regarding labor induction have demonstrated a high cesarean section rate in nulliparas with a low Bishop score, compared to those who had a ripened cervix prior to labor induction - a high Bishop-score. The purpose of this study was to assess if the Bishop-score predicts success of labor induction in multiparas, including maternal and neonatal outcomes.
A retrospective study based on the computerized database prospectively collected in the maternal-fetal medicine department regarding 600 multiparas who underwent labor induction between the years 2013-2014. Women were divided into two groups - women with a Bishop-score <6 and women with a Bishop score ≥6. We evaluated medical history, obstetric history, induction mode, course of labor, maternal and fetal outcomes.
There were no statistical differences between the two groups in terms of their background or indications for labor induction. In women who had a Bishop-score <6 the length of the induction of labor was longer than in women who had Bishop score ≥ 6 (P <0.05), but both groups had a similar and a high rate of vaginal deliveries - 93.7% and 94.9%, respectively (P = NS). Among those who had a cesarean delivery during their labor induction, there were no differences between the two groups regarding the indication for performing a cesarean delivery or in the cervical dilatation when the operation was performed. There was no statistical difference between the two groups in terms of maternal complications (fever during labor, post partum hemorrhage, manual lysis or uterine revision, perineal tears grade III-IV, need for blood transfusions, re-laparotomy, prolonged hospitalization) or fetal outcomes (Apgar score, Cord pH, hospitalization in NICU, prolonged hospitalization(.
This study demonstrates that the Bishop score is not a good predictor for success of labor induction of multiparas. It does not affect the rate of cesarean deliveries during labor induction of multiparas women, nor does it affect maternal or fetal outcomes and complications.
© 2016 Published by Elsevier Inc.