INDUCTION OF LABOUR;

ACCURACY OF TRANSVAGINAL ULTRASONOGRAPHY AND BISHOP SCORE (MANUAL EXAMINATION) IN PREDICTION OF SUCCESSFUL INDUCTION OF LABOUR AT TERM.

Abstract

Background: Increased risk for the baby and higher perinatal mortality are related to birth after 42 weeks. To find out whether a delivery occurs within a span of 24 hours, assessment of cervix through Transvaginal ultrasonography (TVS) and Bishop’s Score are two methods. Objectives: To find out the accuracy of transvaginal ultrasound and Bishop’s Score for cervical length assessment to know the success of induction of labor in primigravidas at term. Setting: Department of Obs and Gynae of Civil Hospital, Bahawalpur. Study Design: Cross sectional study. Period: Nov 1^st 2016 to April 30th 2017. Material and Methods: Total 220 females were included through non probability, purposive sampling. Females underwent vaginal examination and Bishop Score was noted and case was labeled as positive or negative. TVS and cervical length was measured and case was labeled as positive or negative. After that, PGE1 50 ug was used and females were waited for labor to be started and normal delivery occurrence. Data was entered and analyzed using SPSS version 16.0. Results: The mean bishop score of females after induction was 6.78±2.66. There were 171 (78%) females who had bishop score >5 while 49 (22%) had bishop score <5. The mean cervical length of females after induction was 26.40±3.69mm. There were 154 (70%) females who had cervical length <27mm while 66 (30%) had cervical length >27mm. The mean induction to delivery interval was 23.01±4.66hours. There were 130 (59%) females who delivered within a period of 24 hours while 90 (41%) delivered after 24 hours. The calculated specificity, sensitivity, positive predictive value, negative predictive value along with diagnostic accuracy of Bishop score were 31%, 84%, 64%, 57% and 62% respectively. The calculated specificity, sensitivity, positive predictive value, negative predictive value along with diagnostic accuracy of cervical length were 59%, 90%, 76%, 80% and 77% respectively. Conclusion: Cervical length assessment on TVS had more accuracy than bishop score in primigravidas presenting at term for induction of labor helping avoidance of post-term pregnancy.