الفهرس 
NORMAL LABOROnly 14 pages are availabe for public view
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Abstract
I
nduction of labor is done in practice and is considered to be one of the most common aspects of current obstetric practice. Induction of labor is done in about 20 % of pregnancies before spontaneous labor onset.
Because of the importance of labor induction in practice, the challenging part is identifying factors that could predict this procedure’s success.
Bishop score introduced in practice as a predictor of successful induction of labor and it is the most important and useful scoring system. Because of its limitations, it is necessary to find an alternative way to detect successful induction of labor so using transvaginal ultrasound is a very good way to give us a better predictive value for successful induction of labor.
Transvaginal ultrasound to measure the cervical length and post cervical angle is a more reliable and objective method to detect labour’s successful induction. In addition, detection of internal os changes.
This study aims to evaluate the accuracy of measuring the posterior cervical angle and the cervical length by using the transvaginal ultrasound in comparison to Bishop Score for the prediction of successful induction of labor.
This study was conducted at Ain Shams University Maternity Hospital 100 Pregnant females aged from 18-39 with a mean value of 24.173.94 with gestational age from 37-41 weeks admitted for induction of labor.
Induction was unsuccessful in 17 cases (17%) where 8 (8%) of them had fetal distress induction success in 83 cases (83%). Also, (83%) of cases delivered by VD while 17 cases (17%) delivered by LSCS.
Maternal ages, BMI, gestational age, and usage of Vagiprost showed no statistically significant difference in prediction for induction outcome.
Induction to delivery time ranging from 6-24 with the mean value. The induction time shows a significant positive correlation with induction to delivery and Vagiprost. Also, the induction to delivery time show a significant positive correlation with Vagiprost.
There was a statistically significant difference between induction outcome regarding Bishop Score (P < 0.05). For the prediction of successful induction of labor at a cut-off value of > 5, Bishop Score showed sensitivity, specificity, and accuracy of 61.0, 83.0, and 78.0 respectively with PPV of 64.0 and NPV of 83.0.
There was a statistically significant difference between induction outcome regarding cervical length (P < 0.05). For the prediction of successful induction of labor at cut-off < 34 mm, the cervical length showed sensitivity, specificity, and accuracy of 91, 83.0, and 86.0 respectively with PPV of 86.0 and NPV of 80.0. In addition, cervical length showed a negative correlation with cervical angle, and a significant positive correlation with induction time, induction to delivery, and Vagiprost.
There was a statistically significant difference between induction outcomes regarding post cx angle (P < 0.05). For the prediction of successful induction of labor at a cut-off value of > 99.0, post cx angle showed sensitivity, specificity, and accuracy of 92.0, 89.0, and 89.0, respectively with PPV of 90.0 and NPV of 88.0. In addition, cervical angle shows a significant negative correlation with induction time, induction to delivery, and Vagiprost.
Sensitivity, specificity, and accuracy of both cervical length and post cervical angle to predict successful induction was 94.0, 91.0, 91.0 with PPV of 94.0 and NPV of 95.0. while sensitivity, specificity, and accuracy of both Bishop Score and cervical length to predict successful induction was 90.0, 88.0, 89 with PPV of 91.0 and NPV of 87.0
In addition, the sensitivity, specificity, and accuracy of both Bishop Score and post cervical angle to predict successful induction was 92.0, 89.0, 90 with PPV of 91.0 and NPV of 88.0.
Overall, PCA is a good indicator for Induction of labor outcome especially in the combination with cervical length measurement or with Bishop S.