The role of ultrasonographic and elastographic predictors of labor induction effectiveness in nulliparous women with term premature rupture of membranes

Aim - to determine the role of ultrasonographic and elastographic parameters of the cervix in predicting the effectiveness of labor induction in nulliparous women with term premature rupture of membranes (PROM). Materials and methods. A prospective cohort study was conducted involving 79 nulliparous women with term PROM who underwent labor induction. Clinical and ultrasonographic data, including cervical length, morphometric parameters, and elastographic characteristics of the cervix, were collected before the onset of induction. Logistic regression analysis was used to evaluate the prognostic factors for successful labor induction. Results. Ultrasonographic and elastographic parameters of the cervix, including the hardness ratio, IOS/EOS ratio, cervical length, and estimated fetal weight, showed a significant association with the outcome of labor induction in nulliparous women with term PROM. Multivariate logistic regression models built using these parameters demonstrated high diagnostic accuracy (AUC>0.8), surpassing the prognostic value of the traditional Bishop score. Conclusions. Ultrasound cervical elastography, combined with morphometric and clinical parameters, significantly improves the accuracy of predicting the effectiveness of labor induction in nulliparous women with term PROM compared to the traditional Bishop score. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Committee on bioethics and deontology of these institutions. The informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.