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Semeiotics of Intrapartum Ultrasonography: New Diagnostic Sonographic Sign of Fetal Malpositions and Malrotations

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Intrapartum Ultrasonography for Labor Management

Abstract

For several years the use of ultrasound in labor has been widespread, showing this as an effective, accurate, and reproducible tool for the assessment of the fetal head position, station, and attitude. Literature affirmed that traditional transvaginal digital examination is highly inaccurate and subjective. However, transvaginal examination cannot be replaced by intrapartum ultrasound. Rather, intrapartum ultrasound and transvaginal examination should be considered complementary approaches in order to ensure better childbirth assistance and reduce adverse neonatal outcomes. During each fetal head movement, there is a very specific relationship between fetal head landmarks and well-identified maternal structures, so the ultrasound diagnosis is performed step by step. In this review, we summarized the malposition of the fetal head by comparing the clinical situation of the fetal head in the pelvis and the ultrasonographic signs. Furthermore we collected the ultrasonographic measurements to evaluate the station, the progression, and the rotations of the fetal head in the birth canal.

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Abbreviations

LOA:

Left occiput anterior

LOP:

Left occiput posterior

LOT:

Left occiput transverse

OAP:

Occiput anterior position

OPP:

Occiput posterior position

OT:

Occiput transverse

ROA:

Right occiput anterior

ROP:

Right occiput posterior

ROT:

Right occiput transverse

TVE:

Transvaginal examination

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Acknowledgments

Special thanks from the author of this chapter Renata Beck, in memory of her father Anton Beck, obstetrician and gynecologist, pioneer of modern Croatian Semeitics, for all the teachings he has passed on the future generations.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care & Research, Bari, Italy

    Antonio Malvasi

  2. International Translational Medicine and Biomodelling Research Group, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow, Russia

    Antonio Malvasi & Andrea Tinelli

  3. Laboratory of Human Physiology, Faculty of Biological and Medical Physics, Phystech BioMed School, Moscow Institute of Physics and Technology (State University), Moscow, Russia

    Antonio Malvasi & Andrea Tinelli

  4. Santa Maria della Misericordia University Hospital, University of Perugia, Perugia, Italy

    Antonio Malvasi

  5. Department of Obstetrics and Gynecology, “Veris delli Ponti” Hospital, Lecce, Italy

    Sarah Gustapane

  6. Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy

    Mariaelena Malvasi

  7. Department of Obstetrics and Gynecology, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy

    Marina Vinciguerra

  8. Department of Obstetrics and Gynecology, “Veris delli Ponti” Hospital, Scorrano, Lecce, Italy

    Andrea Tinelli

  9. Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Riuniti Foggia, University of Foggia, Foggia, Italy

    Renata Beck

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  1. Antonio Malvasi
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  2. Sarah Gustapane
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  3. Mariaelena Malvasi
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  4. Marina Vinciguerra
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  5. Andrea Tinelli
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  6. Renata Beck
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Editors and Affiliations

  1. Department of Obstetric and Gynecology, Santa Maria Hospital, GVM Care and Research, Bari, Italy

    Antonio Malvasi

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Malvasi, A., Gustapane, S., Malvasi, M., Vinciguerra, M., Tinelli, A., Beck, R. (2021). Semeiotics of Intrapartum Ultrasonography: New Diagnostic Sonographic Sign of Fetal Malpositions and Malrotations. In: Malvasi, A. (eds) Intrapartum Ultrasonography for Labor Management. Springer, Cham. https://doi.org/10.1007/978-3-030-57595-3_22

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  • DOI: https://doi.org/10.1007/978-3-030-57595-3_22

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