Measurement of fetal head descent using the ‘angle of progression’ on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise

Dückelmann, Anna M.; Bamberg, Christian; Michaelis, S. A. M.; Lange, J.; Nonnenmacher, A; Dudenhausen, Joachim W.; Kalache, Karim

doi:10.1002/uog.7521

Cited by 153 publications

(119 citation statements)

References 21 publications

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“…The angle between these two lines (AOP) was measured. This measurement is independent of the obstetrician's experience, based on the identification of two visible bone structures easily [9,10]. All ultrasound examinations were carried out by the authors using an Acuson Antares machine with a 2-3MHz convex transducer.…”

Section: Methodsmentioning

confidence: 99%

“…Molina et al [7], among other authors [13,14], evaluated the reproducibility of the different ultrasound parameters used to assess the evolution of delivery and concluded that the angle of descent is the most reproducible parameter for measuring fetal head progression during labor, whereas Duckelmann et al [10], showed that the determination of this ultrasound parameter is also independent of the professional's experience.…”

Section: Spontaneous Vaginal Delivery Occurred In 72 (71%) Women Insmentioning

confidence: 99%

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Role of intrapartum transperineal ultrasound: Angle of progression cut-off and correlation with delivery mode

Pérez¹,

Seguer²,

Pujadas³

et al. 2017

Clin Obstet Gynecol Reprod Med

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Objective: The aim of this study was to investigate the role of the 'angle of progression' (AOP) in the prediction of vaginal delivery and establish a cut-off value.Method: 101 pregnant women were included in this prospective study. They were admitted in labor to our hospital and had singleton cephalic presentations and full-term pregnancies. AOP was measured at admission time. We analyzed the results of all the women included but also a subgroup of 66 singleton pregnant women whose assessment of the AOP was performed at the beginning of the second stage of labor.Results: Ninety-one patients had a vaginal delivery (90%) and 19 a cesarean section (10%).The area under the curve was 0.85 (95% confidence interval [CI], 0.77-0.92)and the value of the AOP that optimizes the curve was 125º (S 67.1% E 100%). In the subgroup that was assessed at the second stage of labor, the area under the curve was 0.97 (95%CI,0.90-0.99) and a value of the AOP that optimizes the curve was also 125º (S 91.38% E 100%). Conclusions:The angle of progression is a simple and reliable intrapartum ultrasound parameter for the evaluation of fetal head descent. Transperineal ultrasound assessment could help to decide the method of delivery. In our experience, the sensitivity of the ultrasound measurement increases when this is taken in the second stage of childbirth.

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Section: Methodsmentioning

confidence: 99%

Section: Spontaneous Vaginal Delivery Occurred In 72 (71%) Women Insmentioning

confidence: 99%

Role of intrapartum transperineal ultrasound: Angle of progression cut-off and correlation with delivery mode

Pérez¹,

Seguer²,

Pujadas³

et al. 2017

Clin Obstet Gynecol Reprod Med

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“…Digital transvaginal examination, which is highly dependent on the clinician's ability and is still regarded 'gold standard' for obstetric practice, has several limitations. 3 A relatively new potential purpose for ultrasound in tracking the progress of labor is therefore developing and the process of gathering knowledge is underway to demonstrate its effectiveness and applicability. 4 By merit of its safety and non-invasive nature, given appropriate circumstances intrapartum ultrasound examination is applicable for most, if not all, indications currently considered in the antepartum arena.…”

Section: Intrapartum Ultrasonography For Prediction Of Vaginal Delivementioning

confidence: 99%

“…Recent surveys have indicated that ultrasound imaging might allow dynamic and objective quantification of the degree of fetal head descent in the birth canal. 3 Various sonographic modalities have been employed in the intrapartum determination of the fetal head engagement. 5 Success in nonoperative vaginal birth mainly depends on the fetal descent and thus it is a central element in the clinical evaluation of progress of labor.…”

Section: Intrapartum Ultrasonography For Prediction Of Vaginal Delivementioning

confidence: 99%

“…12 Recent reports suggest that intrapartum ultrasound imaging may be of assistance in overcoming these problems by facilitating application of a series of evaluations for determination of fetal head position and progression during labor. [1][2][3][4][5][6] This would offer a better prediction of successful vaginal delivery.…”

Section: Intrapartum Ultrasound In Labormentioning

confidence: 99%

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Intrapartum Ultrasonography for Prediction of Vaginal Delivery: Review

Eser¹,

Köşüş²,

Köşüş³

2016

Turkiye Klinikleri J Gynecol Obst

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A AB BS S T TR RA AC CT T Intrapartum ultrasound imaging is gaining popularity, with increased application due to its relative ease of use and direct on-site accessibility. Though its use was initially restricted to esoteric indications and routinely applied antepartum, sonography is now increasingly being used for more mundane intrapartum indications, for example illustration of the precise fetal head position, assessment of fetal head engagement and estimation of the fetal weight. Advance evaluation of the complex physiology of childbirth is now possible with intrapartum ultrasonography, including Doppler flow velocimetry. It is not, however, in current use for the purposes of pure clinical management, i.e. development of labor or the lack thereof. The increased rate of cesarean delivery is a worldwide problem. Medico-legal problems, however, can arise from difficult vaginal deliveries. Internationally, finding ways to reduce cesarean delivery rates is a clinical priority. This includes development of new techniques for encouraging normal vaginal delivery. Appropriate use of intrapartum sonography could contribute to reduction of cesarean delivery rates and help to protect patients and doctors from possible complications of difficult vaginal delivery. Detection of advancing cervical dilatation and descent of the fetal head, however, are two important aspects currently beyond the clinical scope of intrapartum ultrasound imaging. Determination of the descent of the fetal head will be the ultimate challenge of clinical applicability of intrapartum ultrasound imaging. The hope is that imaging ultrasound will ultimately permit us to assess these two vital clinical parameters, which have up until now proven indefinable. K Ke ey y W Wo or rd ds s: : Parturition; ultrasonography; labor, obstetric Ö ÖZ ZE ET T İntrapartum ultrasonografik görüntülemenin, uygulama kolaylığı, direkt erişilebilirliği ve artan uygulama alanları ile popülerliği artmaktadır. Sonografinin ilk uygulama alanları yalnızca özel bilgisi olanlar tarafından anlaşılabilen endikasyonlar ve antepartum uygulamalar ile sınırlı olsa da, son zamanlarda olağan intrapartum endikasyonlar için de kullanılmaktadır. Bu uygulamalar, fetal baş pozisyonunun gösterimi, fetal baş angajmanının değerlendirmesi ve fetal ağırlık tahminini içermektedir. Günümüzde intrapartum ultrasonografi ile doğumun karmaşık fizyolojisinin (doppler akım çalışmalarını içeren) ileri değerlendirmesi mümkün olmaktadır. Klinik yö-netimin tamamında kullanılmamakla birlikte doğum seyrini (veya olamayacağını) tahminde yardımcıdır. Artan sezaryenle doğum oranları dünya genelinde bir problemdir. Bir başka problem ise zor vajinal doğumdan kaynaklanan mediko-legal olayların artıyor olmasıdır. Tüm dünya ülkeleri sezaryen doğum oranlarını azaltmanın yollarını aramaktadır. Normal vajinal doğumu teşvik edecek yeni yöntemler geliştirmenin arayışı içindedirler. Intrapartum sonografi tekniği, sezaryen doğum oranını azaltmanın yanısıra hastaları ve doktorları zor vajinal doğumda oluşabilecek komplikasyonlar...

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Malpresentation, Malposition, Cephalopelvic Disproportion and Obstetric Procedures

Arulkumaran

2012

Dewhurst's Textbook of Obstetrics &Amp; Gynaecology

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Measurement of fetal head descent using the ‘angle of progression’ on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise

Abstract: Objectives (overall ICC, 0.72; 95% CI,. ICCs were 0.82 (95% CI, 0.81 (95% CI, (ICC, 0.86; 95% CI,

Cited by 153 publications

References 21 publications

Role of intrapartum transperineal ultrasound: Angle of progression cut-off and correlation with delivery mode

Role of intrapartum transperineal ultrasound: Angle of progression cut-off and correlation with delivery mode

Intrapartum Ultrasonography for Prediction of Vaginal Delivery: Review

Malpresentation, Malposition, Cephalopelvic Disproportion and Obstetric Procedures

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