Patients of the institution requiring cervical ripening (i.e., Bishop score
of <5 using the modified Bishop score
criteria) and induction of labor were eligible for this study if they had a live singleton fetus with cephalic presentation at term, intact membranes with no evidence of labor, and no contraindications to a vaginal delivery and up to the third parity.
A detailed history was elicited followed by examination which included the pelvic examination and assessment of Bishop score
. Then informed consent were taken from the patients.
All the women were primiparous, and there were no significant differences between the groups regarding maternal age or gestational age and the Bishop score
at the beginning of the study.
The incidence of cumulative Bishop score
increases ≥3 within 12 h or vaginal delivery within 24 h in the misoprostol group was significantly higher than that in the placebo group (64.2% vs.
Keywords: VBAC, Predictive factors, Bishop score
, Caesarean section.
The modified Bishop score
was used to assess all patients admitted for induction of labour.
Contraindications to misoprostol (Allergies, asthma, Acute Cerebrovascular Disease, Coronary Artery Disease, seizures), placenta praevia, history of previous caesarean section or any uterine surgery, cephalopelvic disproportion, a Bishop score
of 4 and above, abnormal vaginal bleeding and oligohydramnios, IUGR, pre eclampsia, or any other medical conditions.
In order to assess suitability in patients with previous CS after induction of labour for successful VBAC, the current study looked at antenatal determinants, like maternal age, gestational age, indication of previous CS, VBAC history, Bishop score
and body mass index (BMI).
After adjusting for the effects of age, race, body mass index (BMI), parity, and Bishop score
, the risk for C-section was doubled with early vs.
Material and Methods: Total 114 patients were induced with misoprostol who had singleton pregnancy of more than 36 weeks with cephalic presentation, reactive CTG and unfavorable cervix (Bishop Score
4, nonreactive CTG, any contraindication to induction of labour and bishop score
> 4 were excluded from the study.
Data collected included cervicovaginal fluid for fetal fibronectin analysis, cervical length by transvaginal ultrasound, and assessment of Bishop score
. Assessment of contraction recordings was validated by repeat audits during which samples were re-analyzed.
Most had an initial Bishop score
of 4 or less, although 24 subjects had Bishop scores
as high as 7.