الفهرس 
Chapter 1: Cervix during pregnancyOnly 14 pages are availabe for public view
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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 woman 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, posterior cervical angle, and many other sonographic parameters as, angle of progression, and internal os diameter may be more objective for assessing cervical status.
Aim of this study to compare between ultrasound measurement of cervical length, posterior cervical angle, and Bishop score in prediction of successful induction of labor.
This study was carried out in Department of Obstetrics and Gynecology, Menoufia University Hospitals. 90 women 37-42 weeks pregnancy, underwent induction of labor due to post date, ROM, gestational diabetes &, PIH. Using vaginal misoprostol and oxytocin infusion. Before induction, cervical length and posterior cervical angle were measured by trans vaginal ultrasound. A digital examination of the cervix is done and Bishop score is noted. And when uterine contractions start external cardio toco graphy was regularly performed to monitor the fetal condition.
The age ranged between 18-37 years old with mean age (28.39 ).
The BMI ranged between (23-37) with the mean was (29.37 ).
The gestational age ranged between 37-42 week with the mean gestational age (39.70 )
The most common cause of induction was post date (41) female followed by ROM (33) then DM (10) then (7) were PIH, and there was (1) case due to fetal distress(fetal tachycardia).
(60) pregnant women were delivered vaginally and (30) were delivered by caesarean section.
Indication of cesarean were failed induction(patient received 4 doses vaginal misoprostol 25 UG with 6 hours interval and no cervical dilatation or effacement were noted, fetal distress(fetal tachycardia), and other causes (Abruptioplacenta).
The mean age of patients delivered vaginally was 27.62 and the mean age of patients delivered by cs was 29.93
The mean BMI of patients delivered vaginally was 29.12 and the mean BMI of patients delivered by cs was 29.87
The mean gestational age of patients delivered vaginally was 39.65 and the mean gestational age of patients delivered by cs was 39.80 there was no statistically significant correlation between age, height, BMI or gestational age and success of labor induction.
The mean cervical length measured by transvaginal ultrasound patients delivered vaginally was 2.89 and the mean cervical length in patients delivered by C.S. was 3.58