Prediction of time to delivery by transperineal ultrasound in second stage of labor

Yonetani, Naoto; Yamamoto, Ryo; Murata, Masaru; Nakajima, Erika; Taguchi, Takako; Ishii, Keisuke; Mitsuda, Nobuaki

doi:10.1002/uog.15944

Cited by 26 publications

(20 citation statements)

References 29 publications

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“…Regarding the interval time to delivery, in accordance to other prospective studies [36,41,42], we demonstrated that in nulliparous women there is a signi cant correlation between the US-assessed fetal head station at prolonged second stage and the remaining time to delivery. However, our study's retrospective nature precludes us from providing a reliable estimation of the remaining time to delivery according to the AOP measurement since there is no uniformity in the clinical management of the second stage among physicians.…”

Section: Discussionsupporting

confidence: 91%

“…During the last decade, intrapartum ultrasound (IPUS) played an essential role in the management of labor [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. IPUS was found to be more accurate in determining fetal head position [24][25][26][27][28], station [29][30][31] and descent [32][33][34][35][36][37][38][39], as well as in estimating the interval time to delivery [40][41][42]. In 2018, the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) issued guidelines recommending to performed IPUS in any delay in the second stage of labor [43].…”

Section: Introductionmentioning

confidence: 99%

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Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

Katzir¹,

Brezinov²,

Kharish³

et al. 2021

Preprint

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Purpose To determine the validity of Intrapartum ultrasound (IPUS), and particularly the angle of progression (AOP), in predicting delivery mode when measured in real-life clinical practice among women with protracted second stages of labor. Methods Using electronic medical records, nulliparous women with a second stage of labor of ≥ 3hours ("prolonged") and a documented AOP measurement during the second stage were identified. The ability of a single AOP measurement in "prolonged" second stage to predict a vaginal delivery (VD) was assessed. Fetal head descend, measured by AOP change/hour (calculated from serial measurements) was compared between women who delivered vaginally and those who had a cesarean delivery (CD) for arrest of descent. Results Of the 191 women who met the inclusion criteria, 62 (32.5%) delivered spontaneously, 96 (50.2%) had a vacuum extraction (VE) and 33 (17.3%) had a CD. The mean AOP was wider among women who had VD (spontaneous or VE) compared to those who had CD (153º±19 vs. 133º±17, p < 0.001). Wider AOPs were associated with higher rates of VD and an AOP ≥ 127º was associated with a VD rate of 88.6% (148/167). Among the 87 women who had more than one AOP measurement, the mean AOP change per hour was higher in the VD group than in the CD group (15.1º±11.4º vs. 6.2º±6.3º, p < 0.001). Conclusion Ultrasound assessed fetal head station in nulliparous women with a protracted second stage of labor can be an accurate and objective additive tool in predicting mode and interval time to delivery in real-life clinical practice.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

Katzir¹,

Brezinov²,

Kharish³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Instinctively, one would expect the AoP to be inversely related to the duration of the second stage of labor, and this has been found in our study as well as other prior investiga-tions. 9,17,[19][20][21] Understanding the relationship between the AoP at full dilation and the duration of a second stage can be helpful in the management of labor, especially in cases where the fetal heart tracing is not reassuring or there is a maternal indication that warrants a shorter duration of the second stage.…”

Section: Commentmentioning

confidence: 99%

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

et al. 2017

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“…The stationbased partogram, measured objectively with ultrasound, can serve as the physiological basis for future studies on predictability of mode of delivery. While some of the recent studies are promising, 12,23 they lack their applicability outside specific criteria and limit their generalizability. Using the measurements of our database, we are currently evaluating the role of various labor parameters in prediction of mode of delivery.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Ultrasound-based station measurements might be advantageous over digital station determination since it is objective, noninvasive, more accurate, and, when used serially, provides information on head descent. 13 Different techniques for sonographic determination of station during labor (e.g., head-perineum distance, [14][15][16] angle of progression, [17][18][19][20] and midline angle [21][22][23] ) have been studied. None of these techniques has been used to design a useful partogram.…”

Section: Discussionmentioning

confidence: 99%

A Novel Partogram for Stages 1 and 2 of Labor Based on Fetal Head Station Measured by Ultrasound: A Prospective Multicenter Cohort Study

et al. 2020

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Objective This study was aimed to describe continuous labor curves, including second stage, based on fetal head station. Study Design We performed a prospective multicenter cohort study. The inclusion criteria were women with singleton uncomplicated cephalic term pregnancies in labor, who delivered vaginally. We used a device that combines ultrasound imaging with position-tracking technology to monitor the head station noninvasively throughout labor. We collected data on demographics, labor parameters, and delivery and neonatal outcomes. Results A total of 613 women delivered vaginally, 327 (53.3%) were nulliparous, while 286 (46.7%) were multiparous. Time to delivery (TTD) diminished progressively with descent of the fetal head. When the head is engaged, the labor curve of multiparous women demonstrated a more prominent downward shift in curve as compared with nulliparous women. When comparing multipara and nullipara at engagement level, the median TTD was 1 and 1.62 hours, respectively. In 95% of women with unengaged head during the second stage, TTD of nulliparous and multiparous women were less than 3.8 and 3 hours, respectively. Conclusion While current labor curves end at full dilatation, the described curves were developed throughout stages 1 and 2 of labor. The TTD, according to the station curves, shows an acceleration of labor, once passed the engagement level, especially in multiparous women.

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Prediction of time to delivery by transperineal ultrasound in second stage of labor

Abstract: TPS assessment of AoP and MLA in the second stage of labor was useful for predicting the time remaining in labor and had higher predictive value than did digital vaginal examination in nulliparous women. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 26 publications

References 29 publications

Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

A Novel Partogram for Stages 1 and 2 of Labor Based on Fetal Head Station Measured by Ultrasound: A Prospective Multicenter Cohort Study

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