Intrapartum diagnosis of posterior asynclitism using two‐dimensional transperineal ultrasound

Ghi, T.; Dall’Asta, A.; Kiener, A.; Volpe, N.; Suprani, Alice; Frusca, T.

doi:10.1002/uog.17302

Cited by 21 publications

(20 citation statements)

References 3 publications

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“…By reporting this first case of sonographic diagnosis of CP, we have further demonstrated that intrapartum ultrasound represents a useful tool to disclose or clarify the underlying cause of dystocia in the case of labor arrest [1,5]. This can reduce the likelihood of incorrect diagnosis, therefore improving overall intrapartum care.…”

Section: Intrapartum Sonographic Diagnosis Of Compound Hand-cephalic mentioning

confidence: 74%

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Intrapartum Sonographic Diagnosis of Compound Hand-Cephalic Presentation

Dall’Asta¹,

Volpe²,

Galli³

et al. 2017

Ultraschall in Med

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Section: Intrapartum Sonographic Diagnosis Of Compound Hand-cephalic mentioning

confidence: 74%

“…We have recently shown that intrapartum ultrasound is a useful tool in the diagnosis of fetal head malposition [1]. Compound presentation (CP) is a rare malpresentation occurring when an extremity prolapses alongside the presenting part, with both parts presenting simultaneously.…”

Section: Intrapartum Sonographic Diagnosis Of Compound Hand-cephalic mentioning

confidence: 99%

Intrapartum Sonographic Diagnosis of Compound Hand-Cephalic Presentation

Dall’Asta¹,

Volpe²,

Galli³

et al. 2017

Ultraschall in Med

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“…27 This sign is confirmed also with translabial sonography in both sagittal and transverse plane, when the clinician is unable to visualize the midline of the fetal head without angulating the probe. 29,30 Identifying asynclitism is important before considering instrumental delivery because it will help the clinician to apply the vacuum and forceps over the sagittal suture rather than on the parietal bone, thereby avoiding adding on tension forces of the tentorium cerebelli (TC) and hence birth trauma to the brain and skull. 31 In extreme situation whereby the fetal head is malpositioned with marked asynclitism, there might be deep transverse arrest and therefore Cesarean delivery might be a safer method of delivery.…”

Section: Assessment Of Asynclitismmentioning

confidence: 99%

“…31 In extreme situation whereby the fetal head is malpositioned with marked asynclitism, there might be deep transverse arrest and therefore Cesarean delivery might be a safer method of delivery. 30 Assessment of fetal head station Fetal head station is the level of the fetal head in the birth canal in relation to the imaginary line between the maternal ischial spines. The fetal head is considered to be "engaged" at station 0 when the leading part of the skull reaches this imaginary line.…”

Section: Assessment Of Asynclitismmentioning

confidence: 99%

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Intrapartum ultrasound and the choice between assisted vaginal and cesarean delivery

Chan

Lau

2021

American Journal of Obstetrics & Gynecology MFM

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Role of fetal head‐circumference‐to‐maternal‐height ratio in predicting Cesarean section for labor dystocia: prospective multicenter study

Dall’Asta

Zegarra

Corno

et al. 2023

Ultrasound in Obstet & Gyne

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Objective To evaluate the relationship between the fetal head‐circumference‐to‐maternal‐height (HC/MH) ratio measured shortly before delivery and the occurrence of Cesarean section (CS) for labor dystocia. Methods This was a multicenter prospective cohort study involving four tertiary maternity hospitals. An unselected cohort of women with a singleton fetus in cephalic presentation, at a gestational age beyond 36 + 0 weeks and without any contraindication for vaginal delivery, was enrolled between September 2020 and November 2021. The MH and fetal HC were measured on admission of the patient to the labor ward. The primary outcome of the study was the performance of the HC/MH ratio in the prediction of CS for labor dystocia. Women who underwent CS for any indication other than failed labor progression, including fetal distress, were excluded from the final analysis. Results A total of 783 women were included in the study. Vaginal delivery occurred in 744 (95.0%) women and CS for labor dystocia in 39 (5.0%). CS for labor dystocia was associated with shorter MH (mean ± SD, 160.4 ± 6.6 vs 164.5 ± 6.3 cm; P < 0.001), larger fetal HC (339.6 ± 9.5 vs 330.7 ± 13.0 mm; P < 0.001) and a higher HC/MH ratio (2.12 ± 0.11 vs 2.01 ± 0.10; P < 0.001) compared with vaginal delivery. Multivariate logistic regression analysis showed that the HC/MH ratio was associated independently with CS for labor dystocia (adjusted odds ratio, 2.65 (95% CI, 1.85–3.79); P < 0.001). The HC/MH ratio had an area under the receiver‐operating‐characteristics curve of 0.77 and an optimal cut‐off value for discriminating between vaginal delivery and CS for labor dystocia of 2.09, which was associated with a sensitivity of 0.62 (95% CI, 0.45–0.77), specificity of 0.79 (95% CI, 0.76–0.82), positive predictive value of 0.13 (95% CI, 0.09–0.19) and negative predictive value of 0.98 (95% CI, 0.96–0.99). Conclusions In a large cohort of unselected pregnancies, the HC/MH ratio performed better than did fetal HC and MH alone in identifying those cases that will undergo CS for labor dystocia, albeit with moderate predictive value. The HC/MH ratio could assist in the evaluation of women at risk for CS for labor dystocia. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

show abstract

Intrapartum diagnosis of posterior asynclitism using two‐dimensional transperineal ultrasound

Cited by 21 publications

References 3 publications

Intrapartum Sonographic Diagnosis of Compound Hand-Cephalic Presentation

Intrapartum Sonographic Diagnosis of Compound Hand-Cephalic Presentation

Intrapartum ultrasound and the choice between assisted vaginal and cesarean delivery

Role of fetal head‐circumference‐to‐maternal‐height ratio in predicting Cesarean section for labor dystocia: prospective multicenter study

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