Comparative study Of TVS cervical score and Bishop score in prediction of successful labour induction

Abstract

Background In today's obstetric practice, induction of labour is a common procedure. Before the imaging era, the favourability of the cervix was assessed by manual examination scored as the Bishop Score. However, subjectivity and high inter- and intra-observer variability are limitations of this approach. This necessitates the implementation of an objective method of assessment. We used transvaginal sonography (TVS) as an objective method of assessment of cervix by TVS cervical score comprising of five different parameters; cervical length, funnelling at the internal os, distance from the presenting part to the external os, and cervix position. This study aims to evaluate the role of the pre-induction transvaginal ultrasonographic (TVS) cervical score in predicting labour outcome and comparing it to the Bishop score in patients undergoing induction of labour. Methodology This observational prospective study included 100 pregnant women admitted for labour induction at a single tertiary care centre. The TVS examination which consisted of five parameters was performed after the clinical Bishop scoring. The TVS scores were compared with the Bishop scores for all patients. Labour induction was done within one hour of examination and the outcome of the induction was recorded. Results The mean age was 25.87 years [SD = 4.35]. Labour induction was successful in 74% of patients. At cut-off Scores of ≥ 4, TVS cervical Score performed better than Bishop Score (Sensitivity 93.24 vs. 67.57%, Specificity 73.08 vs. 65.38%). ROC analysis indicated that Area Under Curve (AUC) was more for TVS Score (0.91, 95% CI 0.84–0.97), compared to Bishop Score. Conclusion Transvaginal ultrasonography is an objective method of cervical assessment. We conclude from our study that the use of TVS score which consists of five different parameters in cervical assessment provides a better prediction of successful labour induction than the Bishop score, and so can prevent various complications associated with induction failure.

Prediction of Successful Induction of Labour jointly using Bishop Score and Transvaginal Sonography in Primigravida Women in Pakistan

“…The same cutoff point for cervical length used in their study was applied in our present study to assess its predictive value. 20 In our study, the majority of patients were aged between 18 and 26 years, with a mean age of 20.64 (SD = 1.925), consistent with findings reported by Agrawal et al 21 Additionally, a large number of patients between the gestational age range of 37 to 41 weeks, that aligns with the results of a study conducted in Egypt by Garite et al 22 In our study, 77.1% of patients had successful inductions, while 22.9% of patients had unsuccessful inductions. These results were comparable with a study carried out by Agrawal et al but in a prospective cohort study by Kamel et al 90.1% had successful induction while only 9.9% of patients had failed induction of labour and underwent cesarean delivery.…”

“…These results were comparable with a study carried out by Agrawal et al but in a prospective cohort study by Kamel et al 90.1% had successful induction while only 9.9% of patients had failed induction of labour and underwent cesarean delivery. 21,23 Different researchers have recorded different predictive values of Bishop Score for outcome of labour induction. 24 In our study, 133 patients with favourable Bishop Score had successful IOL and only 16 patients had failed inductions.…”

Comparison of Bishop’s score with transvaginal sonographic cervical assessment to predict success of induction of labor

“…7 It also allows a better evaluation of cervical length, since the supra-vaginal part of cervix is difficult to measure digitally. 8 It also provides access to internal os, which cannot be reached in a closed cervix and where the effacement begins. 9 Various parameters that can be used for cervical evaluation using TVS are cervical length, cervical funneling, cervical position, posterior cervical angle, distance of presenting part from external os, uterocervical angle, etc.…”