Some of the term gestations will need induction of labor due to various reasons. The outcome of these pregnancies is not known beforehand. Engagement of fetal head is assessed clinically by abdominal and vaginal examination, but clinical assessment is a poor predictor for the course of labor Per vaginal examinations are done after induction/active labor for assessment of progression of labor and bishop score calculation, but this score varies from examiner to examiner. With advancement in technology there are improved procedures to assess the progression of labor by measuring foetal head to perineal distance by trans perineal ultrasound. The Trans perineal ultrasound is simple easy, reliable and done only once prior to the induction or augmentation of labor. This can be used to remove the observer bias in per vaginal examination and also multiple per vaginal examinations can also be avoided. The aim of the study is to measure the foetal head to perineal distance by transperineal ultrasound prior to induction or augmentation of labor for better outcome.
Methods & Methodology: Prospective study done over18 months with sample size of 150 pregnant women with singleton pregnancy in cephalic presentation at 38 or more than 38 weeks period of gestation planning for induction or in early labor at Dr. PSIMS & RF.
Result: In our study 150 pregnant women with singleton pregnancy, cephalic presentation at or more than 38 weeks period of gestation prior to induction or augmentation of labor in patients with FHPD < 7cm 95.24% had vaginal deliveries and 4.76% has caesarean section in patients with FHPD > 7 cm had 22.2%vaginal deliveries, 55% caesarean section, 22.22% instrumental deliveries.
Conclusion: In this study it is seen that FHPD has more predictability than bishop score when measured at 38 or more than 38 weeks period of gestation planning for induction or in early labor but Pelvic examinations are mandatory to rule out the colour of liquor in foetal distress or cord prolapse.In settings where the relevant technology and experience are available, foetal head to perineal distance can be utilised as an adjunct method to bishop score in predicting the mode of delivery and in selecting patients for trail of labour.