Comparative Analysis of Trans Vaginal Ultrasound and Bishop Score For Successful Prediction of Induction of Labor in Term Primigravidas

Abstract

Successful prediction of labor induction outcomes in term primigravidas has significant implications for maternal and neonatal health. Objective: To compare trans vaginal ultrasound (TVS) and bishop score for successful prediction of induction of labor in term primigravidas. Methods: This cross sectional comparative study was carried out at Department of Gynecology and Obstetrics and Department of Radiology of Shahida Islam Medial Complex, Lodhran, Pakistan using non-probability purposive sampling technique. The duration of study was six months from October 2023 to March 2024. Booked primigravidas in-between 18 to 40 years at 37-40 gestational week having singleton pregnancy were included Each female underwent Bishop scoring and TVS ultrasound Results: From total 151 pregnant females mean age was 28.63 ± 8.12 years, mean gestational age was 40.24 ± 0.77 weeks, mean bishop score and mean cervical length measured by TVS was 6.95 ± 2.21 and 27.2 ± 3.98 mm respectively. 117 (77.48 %) females had positive Bishop Score, 106 (70.2 %) positive Cervical Length (>27 mm) and 90 (59.6 %) induction of labor. Diagnostic accuracy of Bishop Score was 65.9 % while for TVS ultrasound was 80.2 %. Significant difference of p<0.001 was reported in-between cervical length >27 mm on TVS and successful induction of labor. TVS showed higher sensitivity 89.7%, specificity 62.3%, positive predictive value 77% and negative predictive value 82.1% as compared to Bishop Score. Conclusions: The results of this study concluded that the assessment of cervical length on TVUS was more accurate than Bishop Score in predicting successful induction of labor in term primigravidas.