Assessment of infrapubic arc angle using 3D perineal ultrasound and relation to obstetric parameters

Albrich, Stefan; Laterza, RM; Skala, Christine; Merinsky, A; Naumann, G; Koelbl, Heinz

doi:10.1055/s-0030-1266851

Cited by 5 publications

(9 citation statements)

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“…Utilizing the same 3D ultrasound technology but with a different method of measurement on a different cohort of patients, S.B.A. recently found a mean SPAA of 99.71° ± 10.89° for one examiner and 101.4° ± 10.33° for another. The mean pubic arch angle published by Gilboa et al .…”

Section: Discussionmentioning

confidence: 99%

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Measurement of subpubic arch angle by three-dimensional transperineal ultrasound and impact on vaginal delivery

Albrich

Shek

Krahn

et al. 2015

Ultrasound Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

“…Several groups have studied the angle created by the inferior rami of the pubic bone, and have given it different terms. As our method to measure this angle was based on that described by Choi et al , we decided to use their term ‘subpubic arch angle’ with the abbreviation of SPAA.…”

Section: Discussionmentioning

confidence: 99%

Measurement of subpubic arch angle by three-dimensional transperineal ultrasound and impact on vaginal delivery

Albrich

Shek

Krahn

et al. 2015

Ultrasound Obstet Gynecol

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“…Furthermore, the SPA measurement proved to be an independent predictor of the mode of delivery and duration of labor. In the last few years, sonographic measurement of the SPA has been heralded as a reliable and simple index of maternal pelvimetry [13]. Initial reports have shown higher risks of caesarean section in patients with small SPA values measured during labor [15].…”

Section: Discussionmentioning

confidence: 99%

“…Classic pelvimetry based upon clinical or radiological examination has been abandoned due to its low accuracy, reproducibility, and costeffectiveness [3]. Very recently, the use of ultrasound has proved to be reliable in assessing the subpubic arch angle (SPA) [11,12], whose size is related to the transverse diameter of the birth canal [13]. Some independent studies have shown that, in the general population, a narrow SPA at antepartum ultrasound is associated with prolonged labor [14][15][16] and an increased risk of obstetric intervention [17,18].…”

Section: Correlation Between Subpubic Arch Angle and Mode Of Deliverymentioning

confidence: 99%

Correlation between Subpubic Arch Angle and Mode of Delivery in Large-for-Gestational-Age Fetuses

Ghi

Dall’Asta²,

Suprani³

et al. 2017

Fetal Diagn Ther

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Objectives: A narrow subpubic arch angle (SPA) has been associated with a higher risk of operative delivery and prolonged labor. The aim of this study was to evaluate the correlation between SPA and labor outcome in a cohort of women delivering a large-for-gestational-age (LGA) fetus. Methods: An observational study involving two Italian tertiary centers (Parma and Rome) was carried out. Nulliparous women referred to the antepartum clinic between 35 and 39 weeks due to an increased risk of having an LGA fetus at birth were prospectively selected for the study purpose. Within the study cohort, SPA measurements were obtained by means of transperineal 3D ultrasound. Elective caesarean section and birth weight below 3,750 g represented exclusion criteria. In the final study group, SPA values were compared between the patients who underwent spontaneous vaginal delivery (SVD) and those who were submitted to unplanned obstetric intervention (UOI) due to prolonged or arrested labor (vacuum delivery or caesarean section). Results: Overall, 129 women were included, and the mean birthweight of the neonates was 4,066 ± 263.03 g. SVD occurred in 63 patients (48.8%), whereas UOI due to prolonged or arrested labor was performed in 66 (51.2%), including 21 cases of vacuum delivery and 45 caesarean sections. The SPA was significantly smaller among women who underwent UOI than in those who achieved SVD (107.9 ± 13.4 vs. 120.7 ± 9.4°, p < 0.001). Furthermore, SPA width was inversely correlated with labor length (p < 0.001). Multivariable logistic regression analysis showed that a smaller SPA (OR 1.091, 95% CI 1.051-1.134, p < 0.001) and an increased birthweight (OR 1.002, 95% CI 1.000-1.004, p = 0.037) were independent risk factors for operative delivery. Conclusion: SPA measurement before labor is helpful in predicting the risk of operative delivery due to prolonged or arrested labor among nulliparous women delivering LGA fetuses.

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“…Ultrasound enables us to identify and evaluate the interpubic gap and the infrapubic arc with a high interrater agreement. It has been shown that infrapubic angle is not associated with length of second stage of labor and the occurrence of levator ani defects (24). …”

Section: Discussionmentioning

confidence: 99%

New Measures for Predicting Birth-Related Pelvic Floor Trauma

Rostaminia¹,

Peck

Delft

et al. 2016

Female Pelvic Med Reconstr Surg

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Objectives The aim of this study was to establish the predictive role of obstetric variables for obstetric outcomes and birth related levator ani muscle trauma. Methods In this prospective study, women underwent 3D pelvic floor ultrasound at their first appointment at 36 weeks and also 3 months postpartum. The measurements included Minimal Levator Hiatus Circumference (MLHC), and the ratio of fetal head circumference (FHC) to MLHC = head induced stretch ratio (HISR) as an indicator of the discrepancy between passage and passing canal. To derive the true impact of baby’s mass on the levator ani musculature, we devised the levator ani stretch ratio (LASR), which was calculated by multiplying the HISR and the baby’s weight. Results Dataset of 173 women were available for analysis. Mean HISR and LASR values were statistically different across all binary outcome categories, with one exception for HISR and levator ani injury. The odds ratios for LASR indicated positive and statistically significant associations with all obstetric outcomes examined. The probability of the LASR correctly classifying those with the adverse obstetric outcome, as estimated by the area under the curve (AUC), ranged from 0.64 to 0.80 with the strongest discriminatory ability observed for severe levator ani muscle trauma. Conclusions Fetal head circumference/ mother minimal levator hiatus circumference ratio (HISR) is associated with longer length of second stage of labor, assisted delivery and increased severity of perineal trauma. Similar associations were observed for LASR, but in addition, LASR had good discriminatory ability to identify severe levator ani muscle trauma.

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Assessment of infrapubic arc angle using 3D perineal ultrasound and relation to obstetric parameters

Cited by 5 publications

References 0 publications

Measurement of subpubic arch angle by three-dimensional transperineal ultrasound and impact on vaginal delivery

Measurement of subpubic arch angle by three-dimensional transperineal ultrasound and impact on vaginal delivery

Correlation between Subpubic Arch Angle and Mode of Delivery in Large-for-Gestational-Age Fetuses

New Measures for Predicting Birth-Related Pelvic Floor Trauma

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