Bishop Score in Induction of Labor in Unfavorable Cervix and Success of Labor

Background and objectives: The ripeness of the cervix has a potential impact on the successful of labor induction; however, an unfavorable or unripe cervix hinders the labor induction process. Thus, we aimed to determine the relationship between Bishop score and the success of labor induction in the unfavorable cervix. Methods: This cross-sectional prospective study was conducted on 100 pregnant women with an unfavorable cervix and a Bishop score <5 at Sulaimani Maternity Teaching Hospital, Sulaimaniyah, Iraq, from May 2022 to May 2023. The women's primary and clinical data were reported. Various medications at various doses and routes were used for labor induction. Then, correlations between variables and different maternal factors were found. Results: Most women (55%) were aged 20-30 years, multipara (59%), urban (61%), literate (92%) and had gestational age of 40-41 weeks (89%) with O+ blood group (41%). Additionally, most women (40%) received a combination of misoprostol and pitocin for labor induction and had a normal vaginal delivery (73%), with a 100% alive baby born. Moreover, the score of labor induction were significantly higher (p?0.05) in normal vaginal delivery than in caesarian delivery. Finally, the parity was significantly (p=0.002), and the bishop score was highly significantly (p<0.001) associated with the success of labor. Conclusions: A combination therapy resulted in the most successful labor induction and most vaginal delivery. Parity was related to successful labor induction, while maternal age did not. Increased bishop score is directly related to normal vaginal delivery.