Intrapartum transperineal ultrasound assessment of fetal head progression in active second stage of labor and mode of delivery
Article first published online: 25 MAR 2013
Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 41, Issue 4, pages 430–435, April 2013
How to Cite
Ghi, T., Youssef, A., Maroni, E., Arcangeli, T., De Musso, F., Bellussi, F., Nanni, M., Giorgetta, F., Morselli-Labate, A. M., Iammarino, M. T., Paccapelo, A., Cariello, L., Rizzo, N. and Pilu, G. (2013), Intrapartum transperineal ultrasound assessment of fetal head progression in active second stage of labor and mode of delivery. Ultrasound Obstet Gynecol, 41: 430–435. doi: 10.1002/uog.12379
- Issue published online: 25 MAR 2013
- Article first published online: 25 MAR 2013
- Accepted manuscript online: 3 JAN 2013 05:17AM EST
- Manuscript Accepted: 14 DEC 2012
- mode of delivery;
- second stage;
To compare longitudinal changes in angle of progression (AoP) and midline angle (MLA) during the active second stage of labor according to the mode of delivery.
A three-dimensional transperineal ultrasound volume was acquired in a series of nulliparous women at the beginning of the active second stage (T1) and every 20 min thereafter (T2, T3, T4, T5 and T6). Following delivery, all ultrasound volumes were analyzed and AoP and MLA were measured.
Among 71 women included in the study, 58 underwent spontaneous vaginal delivery (Group A) and 13 underwent operative delivery (Group B) (eight by vacuum extraction and five by Cesarean section). When compared with Group B, Group A had a wider AoP only at T1 (140.0 ± 20.2° vs 122.9 ± 16.7°; P = 0.010) and T2 (149.7 ± 20.7° vs 126.9 ± 17.5°; P = 0.006). MLA was narrower in Group A only at T3 (21.2 ± 11.7° vs 40.8 ± 27.9°; P = 0.043), T4 (18.2 ± 15.0° vs 47.4 ± 29.6°; P = 0.020) and T5 (18.3 ± 6.0° vs 34.7 ± 4.2°; P = 0.034). On stepwise forward multiple logistic regression analysis, both AoP and MLA were independently associated with operative delivery (OR = 0.955 and OR = 1.018, respectively).
Ultrasonographic assessment of fetal head descent in the second stage of labor may play a role in the prediction of the mode of delivery. Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.