Role of preinduction transvaginal sonography in predicting outcomes of labour induction

TVS will be done for cervical length, position of fetal head, and posterior cervical angle

•then digitally cervical condition will be accessed by Modified Bishop Score.

•All women will be induced as per hospital protocol.

•The prediction of successful labor will be assessed for all parameters of TVS( Cervical length, posterior cervical angle and position of fetal head) and Bishop score. Foloowing are the methods that will be used for measuring TVS parameters

CERVICAL LENGTH : Cervical distortion will be avoided by placing the transducer away from the cervix. A sagittal view of the cervix  and echogenic endocervical mucosa will be visualised along the length of the endocervical canal. The image of the cervix is magnified to about 75% of the screen. The length of the cervix will be measured from the internal osto the external os.

•POSTERIOR CERVICAL ANGLE : The posterior cervical angle will be measured with a protractor applied to a hard copy picture taken in a sagittal plane at the level of the internal os and approximated to the nearest 10° .

•FOETAL HEAD POSITION : For determination of foetal head position, the ultrasound transducer will first be placed transversely in the suprapubic region of the maternal abdomen. The foetal orbits in the case of Occiput Posterior (OP) position, the midline cerebral echo in the case of Occiput Transverse (OT) positions and the cerebellum or occiput in the case of Occiput Anterior (OA) position will serve as landmarks for foetal head position.