Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial

Masturzo, Bianca; Farina, Antonio; Attamante, L.; Piazzese, Annalisa; Rolfo, Alessandro; Gaglioti, Pietro; Todros, Tullia

doi:10.1002/jcu.22477

Cited by 18 publications

(15 citation statements)

References 18 publications

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“…No significant differences were found in the growth of the vertebrae between the male and female fetuses in this study. One previous study reported that female fetuses mature more rapidly than male fetuses 20 . This finding may be attributable to the small number of samples in that study or to the different imaging method used.…”

Section: Discussionmentioning

confidence: 77%

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Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging

et al. 2021

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Objective: Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. This study aims to characterize normal spinal growth in human fetuses during the second and third trimesters.Methods: Postmortem 3.0 T magnetic resonance imaging (MRI) was performed on 55 fetuses at 17-42 gestational weeks by using three-dimensional T2-weighted sequences. Morphological changes and quantitative measurements of the fetal spine were assessed. The correlation between centrum ossification center volume (COCV) and gestational age was investigated. Results:The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age (p < 0.05). No gender differences were found in the volumetric development of the cervical, thoracic, and lumbar centrum ossification centers (COCs). The average volumetric growth rate per COC was larger in the lumbar spine than in the cervical and thoracic spine. The L1-L5 COCVs also showed a linear positive relationship with gestational age.Consults: Postmortem 3.0 T MRI clearly demonstrated spinal changes in external contour and internal structure with gestational age. These findings expand our understanding of the early growth pattern of the human spine and could be further used to assess the developmental conditions of the fetal spine. Key pointsWhat's already known about this topic? � Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. � Many different measurements have been used to assess the spinal development on fetal computed tomography and ultrasound, but not comprehensively.Shuai Zhang and Xianshun Yuan contributed equally to this work and should be considered co-first authors. Xiangtao Lin and Ximing Wang contributed equally to this work and should be considered co-corresponding authors.

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Section: Discussionmentioning

confidence: 77%

“…One previous study reported that female fetuses mature more rapidly than male fetuses. 20 This finding may be attributable to the small number of samples in that study or to the different imaging method used.…”

mentioning

confidence: 91%

Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging

et al. 2021

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“…Digital (manual) vaginal examination correctly detects OP position about 80% of the time. 42 Diagnosis of OP position via digital examination is made by identifying the fetal sagittal suture and fontanels and their location in relationship to maternal pelvis and is confirmed when the posterior fontanel is palpated toward the sacrum and the anterior fontanel toward the symphysis. 41 Transabdominal ultrasonographic examination of fetal head position during the second stage of labor is highly accurate.…”

Section: Occiput Posterior Positionmentioning

confidence: 99%

Intrapartum ultrasound for the diagnosis of cephalic malpositions and malpresentations

Gimovsky

2021

American Journal of Obstetrics & Gynecology MFM

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Although the use of ultrasound is not a routine standard of care, the use of bedside ultrasound to confirm the location of the fetal back may be a valuable tool in the hands of trained practitioners to confirm the fetal position. A 2017 RCT demonstrated the use of bedside ultrasound to confirm head orientation and spine location significantly increased successful rotation ( P ≤ .001) and spontaneous vaginal birth ( P = .01) 20 . Additional literature highlighted the increased accuracy of bedside ultrasound to detect asynclitism, poor flexion, and occiput transverse presentation, as well as use of the occipital‐spinal angle to predict the likelihood of spontaneous vaginal birth 19 .…”

Section: Management Considerationsmentioning

confidence: 99%

Digital and Manual Rotation of the Persistent Occiput Posterior Fetus

Elmore

McBroom

Ellis

2020

J Midwife Womens Health

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Persistent fetal occiput posterior (OP) position is a topic of interest with implications for intrapartum management. Although studies report a low incidence of persistent OP position, anecdotal evidence suggests an increase in prevalence given changes in maternal demographics. Clinicians are often familiar with interventions such as position changes and the use of props and a rebozo to address persistent OP position in early labor; however, midwives remain uncomfortable with the techniques of digital and manual rotation. This article reviews current evidence and recommendations for the management of persistent OP position in the second stage of labor. Further research is needed to guide clinicians on the optimal timing and techniques for digital and manual rotation.

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Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial

Abstract: MRFO is a safe and useful procedure that should be performed in second-stage arrest in OPP. A better performance was observed when supported by the US knowledge of the spine position. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:472-476, 2017.

Cited by 18 publications

References 18 publications

Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging

Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging

Intrapartum ultrasound for the diagnosis of cephalic malpositions and malpresentations

Digital and Manual Rotation of the Persistent Occiput Posterior Fetus

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