Transvaginal ultrasound measurement of cervical length in prediction of successful induction of normal labour

Background: The subjectivity of the Bishop score has led to a study exploring cervical length as a more objective predictor of labor induction success. Aim: To determine the value of transvaginal measurements of cervical length in the prediction of successful induction of labor. Patients and methods: This was cross-sectional research that was conducted at Al Hussine Hospital, Faculty of Medicine, Al-Azhar University, during the period from 6/2024 to 6/2025. Included were 100 pregnant females admitted for induction of labor. Results: Vaginal delivery was attained in 71% of cases, whereas 29% required cesarean section. A statistically significant variance has been observed among groups regarding parity, but insignificant variances in gestational age, age, body mass index (BMI), or Bishop score (p = 0.056). Cervical length was significantly shorter in the vaginal delivery group (29.01 ± 5.86 mm) compared to the cesarean group(37.3 ± 5.6 mm) with p < 0.001, indicating a strong association with successful vaginal delivery. ROC curve analysis illustrated cervical length had an excellent predictive accuracy, with an AUC of 0.841, a cutoff of 33.4 mm, sensitivity of 77.5%, and specificity of 79.3%. The Bishop score showed moderate predictive value (AUC = 0.637), with a cutoff of 4.5, sensitivity of 60.6%, and specificity of 62.1% (p = 0.032). A positive association has been observed between cervical length and induction outcome. Conclusion: Cervical length better predicts induction success than Bishop score and may help reduce cesarean deliveries.