The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations

Bellussi, Federica; Ghi, T.; Youssef, A.; Salsi, G.; Giorgetta, F.; Parma, Dila; Simonazzi, Giuliana; Pilu, Gianluigi

doi:10.1016/j.ajog.2017.07.025

Cited by 81 publications

(37 citation statements)

References 71 publications

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“…Secondary outcomes included the incidence of operative delivery and complications of labor.Results Forty women were recruited into the study. Those who received sonographic coaching had a shorter active phase of the second stage (30 min (interquartile range (IQR), 24-42 min) vs 45 min (IQR,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55); P = 0.01) and a greater increase in the angle of progression (13.5 • (IQR,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) • ) vs 5 • (IQR, 3-9.5 • ); P = 0.01) in the first 20 min of the active second stage of labor than did those who had traditional coaching. No differences were found in the secondary outcomes between the two groups.…”

mentioning

confidence: 99%

Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial

Bellussi

Alcamisi

Guizzardi

et al. 2018

Ultrasound in Obstet & Gyne

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confidence: 99%

Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial

Bellussi

Alcamisi

Guizzardi

et al. 2018

Ultrasound in Obstet & Gyne

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“…When the positional anomaly is occipitoposterior after the transabdominal exploration, we can find the fetal orbits facing upwards. the flexion is inferred by the profile view of the face that shows the chin resting on the chest, the choroid plexuses diverge later, in the sagittal examination the third ventricle can be seen, in the variety of transverse occipito position, the fetal spine a Often found lateral, the fetal orbits are directed laterally, however, this publication focuses on the ease of reproduction of the strabismus sign which we can explore through the transabdominal route, orienting the transducer transversely, above the pubic symphysis, in the variety of occipito-posterior position we can observe the fetal orbits oriented upwards and flexion of the chin towards the fetal chest, in the occipito-transverse position the fetal cerebral midline is observed in a transverse section, and the sign of strabismus can be demonstrated by finding only a fetal orbit laterally, therefore, the literature Consider the sign of strabismus as pathognomonic of fetal malposition [4][5][6]…”

Section: Introductionmentioning

confidence: 78%

Obstetric Outcomes of Position Abnormalities Detected by Intrapartum Suprapubic Transabdominal Ultrasound

Mendoza¹,

Niño²,

Prado³

2018

Int. J. Gynecol. Obst. Res.

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Objective: to propose the use of ultrasound during abnormal labor, as a detection of position abnormalities, to evaluate the way of resolution of pregnancy and reduce maternal-fetal complications. Materials and Methods: Prospective, cross-sectional, descriptive study, carried out in term pregnant patients, carried out in a second level of care in December 2018 to July 2019, the population was divided into group 1 (it included 15 patients with evolution abnormal labor in which no ultrasound was performed to detect position abnormalities) and group 2 (15 patients with abnormal evolution of labor and ultrasound detection of position anomaly were included) to determine the usefulness of diagnosis by ultrasound and its association with maternal-fetal morbidity and mortality. Results: A total of 30 patients were registered, both groups with 15 patients each, in group 1, 11 patients with maternal and fetal morbidity were reported, whose resolution was vaginal in which position abnormalities were detected during the obstetric event, In group 2, 15 patients were reported with abnormal evolution of labor and with a diagnosis of position abnormalities, detected by ultrasound during the second period of labor, whose resolution of pregnancy was abdominal, without complications, in 4 Patients the indication was due to fetal compromise. Conclusions: Timely detection in the second period of labor for position abnormalities is an effective method to reduce maternal-fetal complications.

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“…In this period, ORs have been estimated to be in favor of FD vs VD for avulsion, and ranged between 3.42 and 10.0. However, when LAM avulsion rates were compared after the first year postpartum, values ranged from 55% to 89% after FD and 18% to 41% after VD; ORs were higher for FD and ranged from 5.3 to 11.4. These LAM avulsion rates decreased when FD and VD were compared 10 years after delivery, as did the ORs (4.2–5.0).…”

Section: Discussionmentioning

confidence: 95%

Malmström vacuum or Kielland forceps: which causes more damage to pelvic floor?

García‐Mejido

Martín‐Martinez

González-Díaz

et al. 2020

Ultrasound in Obstet & Gyne

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Objective To determine whether differences exist in the rate of levator ani muscle (LAM) avulsion between women who had undergone either Malmström vacuum delivery (MVD) or Kielland forceps delivery (KFD), allowing for potential confounding factors. Methods This was a prospective observational study of nulliparous women undergoing instrumental delivery using Malmström vacuum extractor or Kielland forceps, at two hospital centers in Spain. Fetal head position (anterior, posterior or transverse) and fetal head station (low or mid) were assessed by ultrasound and digital examination, respectively. Avulsion was defined on tomographic ultrasound imaging as an abnormal insertion of the LAM in the three central slices from the plane of minimal hiatal dimensions. Results In total, 414 patients were included in the study (212 MVD and 202 KFD). We observed a higher rate of LAM avulsion in the KFD group (KFD 49.5% vs MVD 32.5%; P = 0.001). When the results were evaluated according to fetal head position and station, we observed no differences in LAM avulsion. The crude odds ratio (OR) for the difference in avulsion between women in the KFD and MVD groups was 2.03 (95% CI, 1.36–3.03). However, when adjusted for duration of second stage of labor, fetal head circumference and fetal head station, the OR was no longer statistically significant (OR, 2.14 (95% CI, 0.95–4.85); P = 0.068). Conclusion When potential confounding factors are taken into account, the rate of LAM avulsion does not differ between women according to whether they have undergone KFD or MVD. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations

Cited by 81 publications

References 71 publications

Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial

Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial

Obstetric Outcomes of Position Abnormalities Detected by Intrapartum Suprapubic Transabdominal Ultrasound

Malmström vacuum or Kielland forceps: which causes more damage to pelvic floor?

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