Prediction of Labour and Delivery by Ascertaining the Fetal Head Position with Transabdominal Ultrasound in Pregnancies with Prelabour Rupture of Membranes after 37 weeks

Abstract

Transabdominal ultrasound examination can determine the fetal head position before the start of labour, but the position of the head did not predict the course of labour, probably because the fetal head may rotate during labour even after PROM.

Ultrasonographic fetal head position to predict mode of delivery: a systematic review and bivariate meta‐analysis

“…Rane et al showed, in a study among 600 women, that an OP position was associated with an increased risk of Cesarean section (likelihood ratio (LR) = 4.4; 95% CI, 2.2–7.5)8. In contrast, Gardberg et al and Eggebo et al concluded that the fetal head position before the start of labor or at the beginning of active labor was not predictive for the occurrence of Cesarean delivery1, 9.…”

Fetal head–perineum distance measured by transperineal ultrasound imaging as a predictive factor for successful induction of labor

“…When the head is not engaged, the method tends to be less reliable because of fetal movement [5]. When the head is not engaged, the method tends to be less reliable because of fetal movement [5].…”

“…However, other investigators evaluated ultrasound-measured engagement of the fetal head as a predictive factor for outcome in spontaneous labors by relating the fetal head to the symphysis pubis [8]. Eggeb et al [5] reported that the ischial spine was difficult to visualize with ultrasound imaging. Eggeb et al [5] reported that the ischial spine was difficult to visualize with ultrasound imaging.…”

“…The interobserver and intraobserver variability of the method is to be acceptable [5]. The examiner will meet firm resistance when the perineal soft tissue is compressed, without causing discomfort to the woman.…”

“…The fetal head-perineal distance was measured as the shortest distance from the outer bony limit of fetal skull to the skin surface of the perineum by the transperineal ultrasound examination in transverse view with the probe held over the ischial tuberosity with firm pressure but without creating any discomfort for the women, and the transducer was moved and angled until the shortest distance to the fetal head was visualized as described by Eggeb et al [5]. The fetal head-perineal distance was measured as the shortest distance from the outer bony limit of fetal skull to the skin surface of the perineum by the transperineal ultrasound examination in transverse view with the probe held over the ischial tuberosity with firm pressure but without creating any discomfort for the women, and the transducer was moved and angled until the shortest distance to the fetal head was visualized as described by Eggeb et al [5].…”