Transperineal sonographic assessment of angle of progression as a predictor of successful vaginal delivery following induction of labor

Gillor, Moshe; Vaisbuch, Edi; Zaks, S.; Barak, Oren; Hagay, Zion; Levy, Rivka

doi:10.1002/uog.15931

Cited by 33 publications

(24 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the inclusion of psAOP does not improve the predictive performance achieved by maternal factors and previous vaginal delivery. AOP is the most studied TPU parameter for the prediction of successful induction, but the results are contradictory [12,13]. Our results are consistent with those reported by Pereira et al [12], who evaluated the measurement of AOP by the sagittal approach (sAOP) prior to IOL in 99 singleton pregnancies at 35-42 weeks and showed that only transvaginal cervical length assessment, but not sAOP, was associated with the prediction of successful vaginal delivery and induction-todelivery interval.…”

Section: Discussionsupporting

confidence: 82%

“…Our results are consistent with those reported by Pereira et al [12], who evaluated the measurement of AOP by the sagittal approach (sAOP) prior to IOL in 99 singleton pregnancies at 35-42 weeks and showed that only transvaginal cervical length assessment, but not sAOP, was associated with the prediction of successful vaginal delivery and induction-todelivery interval. On the contrary, our results differ from a recent prospective, observational study in 150 nulliparous women with singleton pregnancy with a low Bishop score (< 7) undergoing IOL at term [13]. The authors demonstrated that the sAOP, but not cervical length assessed by TPU scan, was independently associated with successful induction and that an sAOP of > 92° was associated with a successful vaginal delivery in 95% of women, with a false-positive rate of 15%.…”

Section: Discussioncontrasting

confidence: 56%

“…The repeatability of the measurement of the TPU parameters by a single examiner and between two different examiners was investigated from the study in 30 participants according to standardized methodology [7,13]. One operator (P.C.)…”

Section: Intra-and Inter-observer Repeatability Of Tpu Parametersmentioning

confidence: 99%

“…The AOP is a quantitative measurement of the angle from the leading part of the fetal skull and the symphysis pubis in a midsagittal plane [6]. It has been shown to correlate with clinical estimation of fetal head descent (station), and its clinical utility in predicting successful induction has been subject to further investigations [11][12][13]. The notion of the ability of assessing fetal head station by TPU scan without digital vaginal examination is attractive.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pre-Induction Transperineal Ultrasound Assessment for the Prediction of Labor Outcome

et al. 2018

View full text Add to dashboard Cite

Objective: To examine (1) the concordance of manual and automated para-symphyseal angle of progression (psAOP) measurements, (2) the repeatability of psAOP, head-symphysis distance, head-perineum distance, and sonographic cervical dilatation, and (3) the value of transperineal ultrasound (TPU) in predicting induction of labor (IOL) outcome. Methods: We performed a prospective study in 308 women with singleton pregnancies undergoing IOL at term. Logistic regression analysis was used to determine which maternal factors, Bishop score, method of IOL, and TPU parameters were significant predictors of cesarean section (CS) and CS due to no progress (CS-NP). Results: There was vaginal delivery in 225 (83.0%) and CS in 46 (17.0%) cases. The intra-class correlation coefficient between manual and automated psAOP was 0.866, but automated psAOP was 4.6° wider than manual measurement. All TPU parameters had an inter-observer intra-class correlation coefficient > 0.800. Significant independent prediction of CS and CS-NP was provided by maternal factors, previous vaginal delivery, and psAOP. There was no improvement in area under the receiver-operating characteristic curve with the addition of psAOP to maternal factors. Conclusions: All TPU parameters are reproducible. Comparing the three TPU parameters for fetal head station, only psAOP is a significant independent predictor of CS; however, it is unlikely to be useful in predicting IOL outcome.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 56%

Section: Intra-and Inter-observer Repeatability Of Tpu Parametersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pre-Induction Transperineal Ultrasound Assessment for the Prediction of Labor Outcome

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Although some studies have shown that these ultrasonic measurements are superior to digital assessment, their predictive values remain suboptimal for clinical use. 7,8 One main reason for this is the inability to measure cervical consistency, a major component of BS, using conventional ultrasound technology. Hence strain-based sonoelastography has also been investigated for measuring uterine cervical stiffness.…”

Section: Introductionmentioning

confidence: 99%

The predictive value of cervical shear wave elastography in the outcome of labor induction

Cheng

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

Predictive Value of Angle of Progression in Term Nulliparous Women

Xu,

Zhang,

Zheng

et al. 2024

J of Ultrasound Medicine

View full text Add to dashboard Cite

ObjectivesThis study aims to explore the correlation between the angle of progression (AOP) and spontaneous vaginal delivery (SVD) for term nulliparous women before the onset of labor. Additionally, it evaluates the diagnostic efficacy of AOP in predicting SVD in term nulliparous women.MethodsIn this retrospective observational study, data from nulliparous women without contraindications for vaginal delivery, with a singleton pregnancy ≥37 weeks, and before the onset of labor were included. Transperineal ultrasound was performed to collect AOP. The date and mode of delivery were tracked, to assess the correlation between AOP and SVD in term nulliparous women. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of AOP in predicting SVD for term nulliparous women.ResultsThe SVD‐failure (SVD‐f) group exhibited a significantly lower AOP compared with the SVD group (88.43° vs 95.72°, P < .001). Logistic regression analysis revealed that AOP was associated with SVD in term nulliparous women (OR = 1.051). ROC curve analysis demonstrated that the area under the ROC curve with AOP 84° as the threshold was 0.663, with a sensitivity of 85.25% and specificity of 43.18%. Considering a sensitivity and specificity of 90%, the dual cut‐off values for term nulliparous women for SVD were 81° and 104°, respectively.ConclusionsA positive correlation was identified between AOP and SVD for nulliparous women after 37 weeks and before the onset of labor. Notably, term nulliparous women with AOP exceeding 104° exhibited a higher probability of SVD.

show abstract

Transperineal sonographic assessment of angle of progression as a predictor of successful vaginal delivery following induction of labor

Abstract: AOP may be a useful sonographic parameter for predicting successful vaginal delivery among nulliparous women at term undergoing IOL; an AOP wider than 92° is associated with a high rate of vaginal delivery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 33 publications

References 28 publications

Pre-Induction Transperineal Ultrasound Assessment for the Prediction of Labor Outcome

Pre-Induction Transperineal Ultrasound Assessment for the Prediction of Labor Outcome

The predictive value of cervical shear wave elastography in the outcome of labor induction

Predictive Value of Angle of Progression in Term Nulliparous Women

Contact Info

Product

Resources

About