Background: The evaluation of the cervix using the Bishop score before induction is very subjective, and various studies have demonstrated its limited predictive utility, especially for women with low Bishop scores. On the other hand, transvaginal ultrasonographic cervical measurement is a method that provides precise numerical data and may be easily evaluated. Integrating uterocervical angle (UCA) assessment using transvaginal ultrasonography with Bishop scoring could enhance the accuracy of predicting the success of labor induction.

Aim: To evaluate the role of adding uterocervical angle measurements by transvaginal ultrasound to Bishop scoring in prediction of successful induction of labor (IOL).

Methods: This prospective cohort study was conducted on 134 cases in obstetrics and gynecology emergency hospital , Zagazig university hospitals, Sharkia, Egypt, and OB-GYN fetal medicine unit. Singleton pregnancy, living fetus, cephalic presentation, 37-41 weeks of gestation with no contraindication to vaginal delivery were included. All patients were subjected to complete history taking, examination, baseline investigation and vaginal examination to assess the Bishop score of the cervix. All women had transvaginal ultrasound for assessment of uterocervical angle.

Results: Uterocervical angle shows a significant increasing in mean value within vaginal delivery mode so the each of bishop score and uterocervical angle were good predictor to vaginal delivery.

Conclusion: UCA was not superior to the Bishop score in predicting successful IOL. However, UCA combined with Bishop score showed higher accuracy and can help predict successful IOL.