Pubic arch angle in prolonged second stage of labor: clinical significance
Article first published online: 12 MAR 2013
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 41, Issue 4, pages 442–446, April 2013
How to Cite
Gilboa, Y., Kivilevitch, Z., Spira, M., Kedem, A., Katorza, E., Moran, O. and Achiron, R. (2013), Pubic arch angle in prolonged second stage of labor: clinical significance. Ultrasound Obstet Gynecol, 41: 442–446. doi: 10.1002/uog.12304
- Issue published online: 25 MAR 2013
- Article first published online: 12 MAR 2013
- Accepted manuscript online: 24 SEP 2012 03:54AM EST
- Manuscript Accepted: 31 AUG 2012
- pubic arch angle;
- second stage of labor;
- transperineal ultrasound
To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor.
We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal ultrasound (transverse plane) was used to measure the pubic arch angle. Correlations with fetomaternal characteristics, mode of delivery and perinatal outcome were evaluated.
The mean PAA was 101.1° (± 13.1°; range, 80°–135°). We found a negative correlation with maternal age. Patients with an occipitotransverse fetal position had a significantly smaller angle compared with those with occipitoanterior positions (94.3° ± 5.5° vs 103.2° ± 14.8°, P < 0.05), as did those with operative deliveries compared with those with spontaneous vaginal delivery (97.1° ± 11.5° vs 110.1° ± 14.0°, P < 0.05). The prediction of operative delivery in prolonged second stage of labor by receiver–operating characteristics curve using PAA alone yielded an area under the curve of 0.75. The predicted probability for operative delivery increased as PAA decreased, with an odds ratio of 0.933 for each decrease in angle of 1°.
Our study suggests a correlation between the PAA and mode of delivery in prolonged second stage of labor. This may be used as an adjunctive parameter when considering delivery mode. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.