Angle of fetal head progression measured using transperineal ultrasound as a predictive factor of vacuum extraction failure

Bultez, T.; Quibel, Thibaud; Bouhanna, P.; Popowski, Thomas; Resche‐Rigon, M.; Rozenberg, Patrick

doi:10.1002/uog.14951

Cited by 80 publications

(57 citation statements)

References 36 publications

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“…Several studies have suggested that an AoP of 120° was associated with successful vaginal delivery . By contrast, other studies suggested that AoP cutoff values of 105–145.5° were associated with difficult or failed instrumental delivery . However, it was difficult to make a direct comparison of these findings with those of the present study because of the different research methods used; for example, the present study recruited Asian women who had not used epidural analgesia.…”

Section: Discussioncontrasting

confidence: 64%

Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor

Chan

Lau

et al. 2018

Intl J Gynecology & Obste

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Objective To compare the angle of progression (AoP) measured by transperineal ultrasonography before indicating an instrumental delivery or cesarean delivery. Methods A prospective observational study was conducted among women with singleton term pregnancies with prolonged second stage of labor at Kwong Wah Hospital, Hong Kong, China, between May 16, 2011, and May 25, 2016. Transabdominal and transperineal ultrasonography were performed to determine fetal head position and AoP, respectively, both at rest and during uterine contraction with pushing. Mode of delivery was decided after vaginal examination without relying on ultrasonography. Results Of 143 women, 116 underwent successful instrumental delivery and 27 underwent cesarean delivery. Median AoP was 153.0° in the instrumental group versus 139.0° in the cesarean group at rest (P<0.001), and 182.5° in the instrumental group versus 156.5° in the cesarean group during contraction (P<0.001). The best predictive cutoff AoP for successful instrumental delivery was 138.7° at rest (sensitivity 86.2%, specificity 51.9%) and 160.9° during contraction (sensitivity 87.1%, specificity 74.1%). No between‐group differences in AoP were found for ease of vacuum extraction at rest (P=0.457) or during contraction with pushing (P=0.095). Conclusion The AoP predicted approximately 80% of successful instrumental deliveries performed for prolonged second stage of labor.

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Section: Discussioncontrasting

confidence: 64%

Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor

Chan

Lau

et al. 2018

Intl J Gynecology & Obste

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“…In addition, AoP width has a good correlation with labor outcome and may lead to better management in women with prolonged or obstructed labor [6,7,17,19,30] . Most importantly, since AoP is a strong predictor of complicated or failed instrumental delivery, its assessment may lead to better decision making before vacuum or forceps delivery [6,18,[31][32][33] . Very little is known, however, on the extent of use of ultrasound outside a research context.…”

Section: Discussionmentioning

confidence: 99%

Automated Measurement of the Angle of Progression in Labor: A Feasibility and Reliability Study

et al. 2016

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Objectives: The aim of this paper was to assess the feasibility and reliability of a new automated method for the measurement of the angle of progression (AoP) in labor. Methods: AoP was assessed using two-dimensional transperineal ultrasound by two operators in 52 women in active labor to evaluate intra- and interobserver reproducibility. The intermethod agreement between automated and manual techniques was analyzed by means of the intraclass correlation coefficient and Bland-Altman method. Results: Automated measurements were feasible in all cases. Automated assessments correctly depicted the pubic symphysis and fetal head in 133 (85.3%) out of 156 on first assessments and in all 156 after repeating measurements once in case of incorrect first evaluation. The automated technique showed good intra- and interobserver reproducibility and very good agreement with the manual technique. AoP measured by the automated method were significantly wider than those done by the manual technique (119 ± 20° vs. 130 ± 20°, p = 0.005). Conclusions: Automated assessment AoP is feasible and reproducible. However, measurements performed by the automated software are significantly different from those resulting from the previously published manual technique. In the light of our data, the automated technique does not seem ready yet for clinical use, and the AoP should be exclusively measured by the previously suggested manual technique.

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“…Ultrasound examination can, to some extent, distinguish those women destined for spontaneous vaginal delivery and those destined for operative delivery. Furthermore, there is growing evidence that ultrasound in labor may predict the outcome of instrumental vaginal delivery.…”

Section: Background and Introductionmentioning

confidence: 99%

ISUOG Practice Guidelines: intrapartum ultrasound

Ghi

Eggebø

Lees

et al. 2018

Ultrasound in Obstet & Gyne

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236

180

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The purpose of these Guidelines is to review the published techniques of ultrasound in labor and their practical applications, to summarize the level of evidence regarding the use of ultrasound in labor and to provide guidance to practitioners on when ultrasound in labor is clinically indicated and how the sonographic findings may affect labor management. We do not imply or suggest that ultrasound in labor is a necessary standard of care.

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Angle of fetal head progression measured using transperineal ultrasound as a predictive factor of vacuum extraction failure

Abstract: Objective

Cited by 80 publications

References 36 publications

Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor

Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor

Automated Measurement of the Angle of Progression in Labor: A Feasibility and Reliability Study

ISUOG Practice Guidelines: intrapartum ultrasound

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