الفهرس 
Induction of LaborOnly 14 pages are availabe for public view
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Abstract
Objectives: Assess the role of the cervical sliding sign (CSS) as a marker in
the prediction of the outcome of induction of labor (IOL) at term gestation.
Study design: This investigation employed a prospective observational cohort
design. The study population consisted of a non-consecutive series of uncomplicated term pregnant women with Singleton living fetus attending Ain Shams University Maternity Hospital for induction of labor with the following criteria: Inclusion criteria: 1. women age: from 18 to 35 years old. 2. Single living term fetus with gestational age ≥ 37 weeks. 3- Eligible for IOL. 4- Bishop score < 6.
The Bishop score was assessed through a transvaginal digital examination. Additionally, cervical sliding sign (CSS) was evaluated using transvaginal ultrasound. The presence of CSS was defined as the movement of the anterior cervical lip against the posterior one upon gentle pressure applied with the transvaginal ultrasound probe.
The primary outcome measure of the study was successful vaginal delivery. The secondary outcome measure was: (1- induction-to-active-labor time interval. 2-Active -labor-to-delivery time interval.3- Mode of Delivery (vaginal/ Instrumental/ Cesarean))
Results: Over a period of 8 months, 134 women were included. The CSS was present in 64 patients (47.8 %) and was associated with a higher rate of vaginal delivery (58/64 or 90.6% vs 48/70 or 68.6% P-value < 0.001), shorter induction-to-active-labor time (360.42 ± 145.15 min vs 586.6 ± 236.03 min, P < 0.001). The univariate logistic regression analysis shows that multigravida, CSS and Bishop score > 2 were significantly associated with vaginal delivery. Also, the multivariate logistic regression analysis shows that the most important factor associated with vaginal delivery was multigravida with p-value = 0.007 and OR (95% CI) of 5.082 (1.548 – 16.687) followed by Bishop score > 2 with p-value = 0.024 and OR (95% CI) of 3.321 (1.171 – 9.421). The statistical study shows that the sensitivity and specificity of CSS to detect normal vaginal delivery were 79.2% and 53.6% respectively with accuracy of 58.2%. Positive predictive value of 27.1% and a negative predictive value of 92.2%
Conclusion: In women undergoing IOL with a bishop score <6, the CSS is associated with a higher frequency of vaginal delivery and a shorter induction-to-active-labor time.