Is the Bishop-score significant in predicting the success of labor induction in multiparous women?

OBJECTIVE

To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women.

STUDY DESIGN

A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter. The women were divided into two groups-Bishop-score <6 and Bishop-score ⩾6. We evaluated labor course, maternal complications (postpartum hemorrhage, manual lysis, uterine revision, perineal tear grade 3-4, need for blood transfusions, relaparotomy, prolonged hospitalization) and neonatal outcomes (Apgar score, cord pH, hospitalization in the neonatal intensive care unit, prolonged hospitalization).

RESULTS

Both groups had a high rate of vaginal deliveries-93.7% and 94.9%, respectively. There was no difference between the two groups in terms of maternal or neonatal outcomes.

CONCLUSION

Labor induction in multiparous women is safe and successful regardless of the initial Bishop-score. In multiparous women the Bishop-score is not a good predictor for the success of labor induction, nor is it a predictor for maternal of neonatal adverse outcomes and complications.

Expression of D-type cyclins in colon cancer and in cell lines from colon carcinomas

Cyclins D1, D2 and D3 play important roles in cell proliferation and differentiation. Although their abnormal expression has been linked to cancer development and progression in a number of tissues, the expression of cyclin D2 and D3 proteins in colon cancer has not yet been characterised. In this study, we examined cyclin D1, D2 and D3 protein expression by Western blot analysis in tumour and adjacent normal colon tissues of 57 patients. In addition, we examined D-type cyclins protein expression in HT29 and LoVo39 cell lines from colon carcinomas, as a function of induced proliferation and differentiation. In both cell lines, the expression of the three D-type cyclins increased as a result of induced proliferation, whereas the expression of cyclin D3 increased as a result of induced differentiation. In colon tumours, cyclin D1 was overexpressed in 44%, cyclin D2 was overexpressed in 53% and cyclin D3 was overexpressed in 35% of the cases. We also found that in 16% of the cases, cyclin D3 protein expression was reduced in the tumour, as compared to the adjacent normal tissue. Examination of D-type cyclin protein overexpression in relation to the TNM stage of the tumours revealed that overexpression of cyclins D1 and/or D2, but not cyclin D3, is linked to colon carcinogenesis and that overexpression of cyclin D2 may be related to a higher TNM stage of the tumour.