Induction of labor is an artificial method of initiating uterine contractions before the onset of spontaneous labour, leading to progressive cervical dilatation and effacement followed by delivery. Until now Modified Bishops score was the most commonly used method for evaluation of preindicting favourability of cervix but now TVS is becoming more reliable because the supravaginal portion of the cervix is hard to assess digitally. Hence to avoid subjective variations, role of TVS parameters are taken into consideration in Predicting outcomes of Labor Induction.  Most common indications include post-term pregnancy (27%), Rupture of membranes prior to labour (26%) 3. Appropriate selection of cases is crucial prior to induction, out of those, cervical status is one of the most important factors in predicting the likelyhood of successful induction of labour.

The Bishop scoring system is based on a digital cervical exam of a patient with a zero point minimum and 13 point maximum.  The scoring system utilizes cervical dilation, position, effacement, consistency of the cervix, and fetal station. Cervical dilation, effacement, and station are scored 0 to 3 points, while cervical position and consistency are scored 0 to 2 points 4. A Bishop score of 8 or greater is considered to be favourable for induction, or the chance of a vaginal delivery with induction is similar to spontaneous labor.  A score of 6 or less is considered to be unfavourable if an induction is indicated cervical ripening agents may be utilized.

Transvaginal sonography (TVS) as an objective method of assessment of cervix.  TVS cervical score comprises of five different parameters; cervical length, funneling at the internal os, distance from the presenting part to the external os, and cervix position 5.

These parameters were selected to match the components of Bishop’s Score—cervical length was comparable to effacement of cervix; cervical station was represented as distance of the presenting part to the external os and cervical dilatation was assessed by measurement of width and length of the funnel. The cervical funneling is an important predictor of successful induction as its presence may associated with reduction of delivery time [5]

Based on the description above, this study will aim to compare the success of labor induction with Cervical assessment using a Transvaginal ultrasonography and Bishop score assessment.

A randomised clinical compare study on patients aged 22–40 years, ANC patients in the time period between April 2023- October 2024 will be conducted. Data will be collected by using self design questionnaire. Entire data would be entered into a microsoft office software and appropriate statistical test will be applied and results will be calculated.