Transvaginal Ultrasound Cervical Length as an Indicator for Successful Induction of Labor

Abstract

Background: Induction of labour is a common obstetric practice which refers to the process where the uterine contractions are initiated by medical and surgical means before the onset of spontaneous labour. The aim of this work was to evaluate the role of Preinduction transvaginal ultrasonographic measurement of cervical length as an indicator of a successful induction of labor. Methods: A cross-sectional study was carried out in Zagazig University Maternity Hospital during the period from May 2017 till November 2018. Included 171 pregnant women admitted for induction of labour.40 women delivered by Cesarean section (positive group) and 131 women delivered vaginally (negative group). All patients were subjected to full history taking, general, abdominal and pelvic examinations and investigations (including CBC, Rh, transvaginal ultrasound and non-stress test). All patients had vaginal examination for assessing the Bishop score before induction of labour and transvaginal ultrasound for assessment of cervical length. Results: Our study showed that the cervical length was significantly higher (31 ± 5.93 mm versus 22.61 ±3.67, p-value =0.00) and the Bishop Score significantly lower (5.95 ± 1.13 versus 7.87 ± 1, p-value = 0.00, respectively) in patients undergoing cesarean delivery compared with those delivering vaginally. Conclusions: Transvaginal ultrasonography proved to be better in predicting the success of induction of labor by having higher sensitivity, specificity, higher predictive value and better tolerability and less inter and intra observer variation.