الفهرس 
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Abstract
Induction of labor is a widely used intervention on the modern labor and
delivery unit. While it follows electronic fetal monitoring and ultrasound in
frequency, the use of this procedure has increased 9.5% in 1990 to 20.6 in 2002-
2003.
The Bishop Score ,since its description in 1964, remains the gold standard
for assessing favorability for induction of labor, However ,the pre induction
“favorability “of the cervix as assessed by the Bishop Score is very subjective and
several studies have demonstrated a poor predictive value for the outcome of
induction especially in women with a low Bishop score.
As the supra -vaginal portion of the cervix makes up about 50% of the
cervical length and varies from one women to another. This portion of the cervix
is difficult to estimate digitally and it makes assessment highly subjective, so
Transvaginal ultrasonography measurement of cervical length may be a more
objective method for assessing cervical status.
Aim of the study to compare between ultrasound measurement of cervical
length and detection of IGFBP-1 in cervical secretions in prediction of successful
induction of labor after 37 weeks.
In this study 140 women 37-42 weeks pregnancy underwent induction of
labor due to post date, gestational diabetes and PIH. Using 25micro g misoprostol
vaginally. The doses were given at 6 hours interval for maximum of 4 doses.
Before induction the attending obstetrician detect IGFBP-1 in cervical secretions
by Actim partus test then performed a digital examination of the cervix and noted
Bishop Score. Cervical length was then measured by TVUS. And when uterine
contractions start external CTG was regularly performed to monitor the condition
of the fetus.
The mean age was 23.34±4.09 years.
The BMI mean was 29.12±2.57kg/M2.
The GA mean was 39.85±1.41 weeks.
The most common cause of induction was postdate (67 women) followed
by PIH (40 women) then gestational diabetes (33 women).
97 pregnant women were delivered vaginally and 43 were delivered by
caesarian section.
Indications of C.S were mainly due to failed induction (patient received 4
doses of misoprostol 25 microgram with 6 hours interval and no labor pains nor
cervical dilatation or effacement were noted ), fetal distress, and failure to
progress.
The mean age of females delivered vaginally was 23.34±4.13 years while
was 23.35±4.05 in those who delivered by CS.
The mean BMI of patients delivered vaginally was 29.06±2.51 kg/M 2
while was 29.26±2.70 kg/M 2 in those who delivered by CS.
The mean GA of females delivered vaginally was 39.80±1.41 weeks and it
was 39.97±1.43 weeks delivered by CS.The mean cervical length measured by TVUS in females delivered
vaginally was 24.89±5.48 mm. While it was 26.79±3.06 mm in females delivered
CS.
The mean Bishop Score in patients delivered vaginally was 6.21±1.45
while it was 4.79±1.45 in those who delivered by C.S.
IGFBP-1 was positive in 71females delivered vaginally .and positive in17
females delivered by CS.
from the previous data we found a statistically significant positive
correlation between cervical length measured by TVUS and detection of IGFBP-1
in cervical secretions by Actim partus test and successful induction of labor after
37 weeks.