Assessment of labor progression by intrapartum ultrasonography among term nulliparous women

Abstract

Objective To assess cervical dilation, fetal head station, and fetal head position by intrapartum ultrasonography and to compare the approach with digital vaginal examination (DVE). Methods An observational study conducted from October 2015 to January 2017 among term nulliparous women in active labor at a tertiary hospital in Delhi, India. Cervical dilation, head station, and head position were assessed by DVE, followed by ultrasonography within 10 minutes. The women's preference was also evaluated. Results Overall, 458 observations were obtained for 215 women. Cervical dilation measured by DVE was strongly correlated with ultrasonography findings (intraclass correlation coefficient, 0.945; 95% confidence interval, 0.932–0.956; κ=0.837; P<0.001). Data for fetal head station and head position showed a fair correlation (κ=0.353 and κ=0.554, respectively; both P<0.001). The majority of women (186/215, 87%) reported a preference for ultrasonography over DVE for assessment of labor progression in a future pregnancy. Conclusion Intrapartum ultrasonography was preferred as an objective assessment tool for labor progression among term nulliparous women and therefore should be practiced in all labor rooms. Further studies on interobserver variation are recommended to establish the reproducibility of intrapartum assessment by ultrasonography.

The role of intrapartum ultrasonography in assessment of labor progression among term women

“…This comes in comparison with the study of Mohan et al, 7 In the current work, we revealed that the embryonic head position distribution in the study group females according to ultrasonography and DVE examination and the agreement between them. The embryonic head position couldn't be identified in 21 (24.7%) of the females by the DVE examination.…”

“…It is suggested that females must be permitted to labour for extended periods so that vaginal birth can be done. 7 Conventionally, the evaluation and management of a female in labour is built on clinical results. The labour arrest diagnosis and decisions concerning the timing or type of intervention rely mostly on digital evaluation of cervical dilatation and embryonic head station and location.…”

“…Indeed, Mohan et al, 7 reported that the embryonic head location couldn't be assessed by DVE in 44 out of 458 (9.6%) observations because of the existence of a head. On the other hand, embryonic head location was assessed by trans-abdominal US in all patients.…”

Role of intrapartum ultrasound in modern obstetrics – current perspectives and literature review

“…In a study where the progress of labour was assessed both traditionally (per vaginam) and by means of intrapartum sonography, a survey of patients' opinions and experiences revealed that 87% of them would prefer to be examined solely by transperineal ultrasound during their next birth (35) . Obstetricians have an equally favourable opinion of the method.…”

Simple models to predict vaginal delivery and spontaneous fetal occiput rotation based on intrapartum ultrasound and maternal characteristics

“…In the majority of studies, a single assessment of sonographic parameters was performed in either the first or second labor phase 30,[32][33][34][35] . Moreover, few studies have developed predictive models associated with successful internal rotation and vaginal delivery.…”