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The Angle of Progression: An Objective Assessment of Fetal Head Descent in the Birth Canal

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Intrapartum Ultrasonography for Labor Management

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Abstract

Assessment of fetal head engagement and station in the pelvic canal made by vaginal digital examination is very subjective, often difficult, and unreliable. The knowledge of this information, though, is of crucial importance prior to decide how to manage labor with second-stage dystocia. The need of an objective diagnosis found its solution in the use of transperineal ultrasound, able to measure the angle of progression that is the extension the fetal head goes through in its descent. The angle of progression is indeed the parameter that mirrors what is exactly happening to the fetal head during the second stage. Angle of progression cut-off value have been studied to provide the best diagnosis that will support the clinician in his/her daily decision: if to continue to attempt of vaginal delivery, either spontaneous or operative, or to opt for an earlier cesarean route.

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Acknowledgments

The author wants to express his gratitude to Helen Macfarlane for the extensive and superb work in the production of the graphic representations.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, University of Colorado Denver, Aurora, CO, USA

    Antonino F. Barbera

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  1. Antonino F. Barbera
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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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Barbera, A.F. (2021). The Angle of Progression: An Objective Assessment of Fetal Head Descent in the Birth Canal. In: Malvasi, A. (eds) Intrapartum Ultrasonography for Labor Management. Springer, Cham. https://doi.org/10.1007/978-3-030-57595-3_24

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  • DOI: https://doi.org/10.1007/978-3-030-57595-3_24

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  • Publisher Name: Springer, Cham

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