ROLE OF TVS CERVICAL SCORE AND BISHOP'S SCORE IN PREDICTION OF SUCCESSFUL LABOR INDUCTION AT TERTIARY CARE CENTRE

Background:Induction of labour (IOL) is dened as the articial initiation of uterine contractions after the fetus reaches viability with the ultimate goal of achieving vaginal delivery. It is the most widely practiced procedure in obstetrics, forming an integral part of modern medical management of pregnancy. The decision to induce labour requires careful assessment and selection of cases to maximize the likelihood of success while minimizing risks. Among the factors inuencing induction success, cervical status is regarded as one of the most critical determinants. Methodology: This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Hospital, Jaipur, over approximately 18 months. The study included 70 pregnant women at term (37-42 weeks) requiring labor induction with Bishop score ≤6. Both Bishop Score assessment and transvaginal ultrasonography (TVS) were performed before induction to evaluate cervical parameters including cervical length, funnel length, funnel width, cervical position, and distance between presenting part and external os. Results: The mean age of participants was 25.4 years, with 47.1% in the 21-25 years age group. Primigravida constituted 44.3% while multigravida comprised 55.7%. The most common indication for induction was postdatism (37.1%), followed by premature rupture of membranes (21.4%). The mean Bishop score was 4.00 (SD 1.865), while the mean TVS cervical score was 5.20 (SD 2.602). TVS cervical score demonstrated superior predictive accuracy with an area under the curve (AUC) of 0.717 compared to Bishop score AUC of 0.431 (p<0.023). TVS score showed higher sensitivity (81.8%) and specicity (72.6%) compared to Bishop score sensitivity (62.7%) and specicity (54.5%). Conclusion: TVS cervical score is a more reliable and objective predictor of successful labor induction compared to the traditional Bishop score. The objective parameters measured by TVS provide better discrimination between successful and failed inductions, offering clinicians a more accurate tool for pre-induction cervical assessment and patient counseling.