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Abstract：
Background and Objectives: The incidence of labor induction is steadily increasing worldwide. The main aim of this study was to evaluate the ultrasound parameters and their mutual correlation and to analyze the parameters\' predictive capability in assessing the success of labor induction. The secondary goal was to assess patients\' tolerability and acceptance of transvaginal ultrasound and digital gynecological examination. Materials and Methods: This prospective observational follow-up study included 252 women selected for labor induction. The transvaginal ultrasound examination measured the posterior cervical angle, cervical length, the length and width funneling of the cervix, the distance between the head of the fetus and the external uterine os, and the position of the fetal occiput. After the ultrasound, a digital vaginal examination was performed (according to the Bishop score), and the women were asked to rate their perception of pain for each procedure. Results: The most common indication for labor induction was post-term pregnancy (57.59%), and the most common method of labor induction was oxytocin with amniotomy (70%). The results showed that a significant independent prediction of vaginal delivery could be provided based on the Bishop score and cervical length. Other investigated ultrasound parameters, the length and width of the funneling of the cervix (p < 0.001), the fetal head stage (p < 0.001), and the size of the posterior cervical angle (p < 0.05), showed statistical significance in relation to the success of labor induction. Patients reported lower discomfort and pain during transvaginal ultrasound examination (mean score 2, IQR 3) compared to digital examination (mean score 5, IQR 4), with p < 0.001. Conclusions: The results imply that the assessment of ultrasound parameters before induction of labor is necessary to predict the outcome and reduce the possibility of complications. In terms of tolerability and choice by the patients, the transvaginal ultrasound examination was better rated than the vaginal gynecological examination.
摘要：
背景和目的：全球引产的发生率正在稳步上升。这项研究的主要目的是评估超声参数及其相互关系，并分析参数在评估引产成功方面的预测能力。次要目标是评估患者对经阴道超声和数字妇科检查的耐受性和接受度。材料和方法：这项前瞻性观察性随访研究包括252名选择引产的妇女。经阴道超声检查测量颈椎后角，宫颈长度,子宫颈的长度和宽度漏斗，胎儿头部和外部子宫之间的距离，还有胎儿枕骨的位置.超声检查后,进行了数字阴道检查（根据Bishop评分），并要求妇女对每个手术的疼痛感知进行评分。结果:引产最常见的指征是足月妊娠(57.59%),最常见的引产方法是缩宫素与羊膜切开术（70％）。结果表明，根据Bishop评分和宫颈长度，可以提供明显的阴道分娩独立预测。其他调查的超声参数，子宫颈漏斗的长度和宽度（p<0.001），胎头阶段（p<0.001），和颈椎后角的大小（p<0.05），与引产成功有关的统计学意义。与数字检查（平均评分5，IQR4）相比，经阴道超声检查（平均评分2，IQR3）患者的不适和疼痛较低，p<0.001。结论：结果暗示引产前评估超声参数对于预测结局和减少并发症的可能性是必要的。就患者的耐受性和选择而言，经阴道超声检查的评分优于经阴道妇科检查。
