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Am J Perinatol 2019; 36(14): 1485-1491
DOI: 10.1055/s-0039-1677866
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Using Cervical Dilation to Predict Labor Onset: A Tool for Elective Labor Induction Counseling

Danielle M. Panelli
1   Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Julian N. Robinson
2   Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Anjali J. Kaimal
3   Division of Maternal-Fetal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Kathryn L. Terry
1   Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Jiaxi Yang
1   Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Mark A. Clapp
3   Division of Maternal-Fetal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Sarah E. Little
2   Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
› Author Affiliations Funding This study was partially supported by an Expanding the Boundaries grant through Brigham and Women's Hospital.
Further Information

Publication History

29 August 2018

31 December 2018

Publication Date:
29 January 2019 (online)

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Abstract

Objective To evaluate whether cervical dilation predicts the timing and likelihood of spontaneous labor at term.

Study Design This was a retrospective cohort of nulliparous women with singleton pregnancies who delivered at term from 2013 to 2015. Outpatient cervical examinations performed after 37 weeks and prior to labor onset were collected. Survival analysis was used to analyze time to spontaneous labor with cervical dilation as the primary predictor, modeled as continuous and categorical variables (<1 cm, 1 cm, >1 cm).

Results Our cohort included 726 women; 407 (56%) spontaneously labored, 263 (36%) were induced, and 56 (8%) had an unlabored cesarean delivery. Women with >1-cm dilation were three times more likely to spontaneously labor (adjusted hazard ratio [aHR]: 3.1; 95% confidence interval [CI]: 2.4–4) than those with <1-cm dilation. At 39 weeks, 60% of women with >1-cm dilation went into spontaneous labor as compared with only 28% of those with <1-cm dilation (aHR: 2.9; 95% CI: 2–4.4).

Conclusion In our cohort of nulliparous women at term, those with cervical dilation > 1 cm were significantly more likely to go into labor in the following week. This information can aid in counseling about elective induction of labor.

Keywords

cervical dilation - elective induction - labor