The Accuracy of Fetal Head to Perineum Distance and Cervical Length in Predicting the Outcomes of Labor Induction

Background: Induction of labor is defined as the process of artificially stimulating the uterus to start labor. It is usually performed by administering oxytocin or prostaglandins to the pregnant woman or by manually rupturing the amniotic membranes.Aim: The aim of the study is to assess the accuracy of fetal head to perineum distance and cervical length in predicting the outcomes of labor induction.Patients and Methods: This is a prospective, observational study aimed to assess the accuracy of fetal-head to perineum distance and cervical length measurement in predicting the outcomes of labor induction. The study was performed at Ain Shams University Maternity Hospital from December 2017 to July 2018, 112 pregnant women who met inclusion criteria and admitted for labor induction at term (between 37-41 weeks).Results: In predicting the outcomes of labor either vaginal delivery or CS, Bishop Score had low diagnostic performance while cervical length, FHPD and posterior cervical angle had moderate diagnostic performance. The mean for pain perception among women who had vaginal examination was 3.6±0.9 (range: 2.0-5.0) which is significantly higher than that among women who had perineal ultrasound 1.0±0.6 (range: 0.0-2.0).Conclusion: It can be concluded that, based on this study, the FHPD, CL and posterior cervical angle are useful in predicting the outcome of labor induction in comparison to Bishop Score. Ultrasound examination is better tolerated by women than pelvic examination.