Skip to main content

Ultrasound Examination Before Vacuum Extraction

  • Chapter
  • First Online:
Intrapartum Ultrasonography for Labor Management

Abstract

The cesarean section rates are rising and much higher than medical indicated [1]. Cesarean section is associated with risks of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth in subsequent pregnancies [2]. Avoiding the first cesarean influences delivery mode in subsequent deliveries. WHO recommends that every effort should be made to provide cesarean sections to women in need, rather than striving to achieve a specific rate. The risk for complications is highest when performed at low stations, and a vacuum extraction may be a safe alternative. Levine et al. has shown a sixfold increase in preterm birth in subsequent deliveries following a second-stage cesarean section [3]. In many countries there is an underuse of operative vaginal deliveries [4]. More use of vacuum extractions has the potential to reduce the rate of cesarean sections, and both pediatric and maternal benefits may be achieved.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 19902014. PLoS One. 2016;11:e0148343.

    PubMed  PubMed Central  Google Scholar 

  2. Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, Gibbons D, Kelly NM, Kennedy HP, Kidanto H, Taylor P, Temmerman M. Short-term and longterm effects of caesarean section on the health of women and children. Lancet. 2018;392:1349–57.

    PubMed  Google Scholar 

  3. Levine LD, Sammel MD, Hirshberg A, Elovitz MA, Srinivas SK. Does stage of labor at time of cesarean delivery affect risk of subsequent preterm birth? Am J Obstet Gynecol. 2015;212:360.e1–7.

    Google Scholar 

  4. Bailey PE, van Roosmalen J, Mola G, Evans C, de Bernis L, Dao B. Assisted vaginal delivery in low and middle income countries: an overview. BJOG. 2017;124:13351344.

    Google Scholar 

  5. Cunningham FG, Williams JW. Williams obstetrics. London, New York: McGraw-Hill Medical; 2010.

    Google Scholar 

  6. Eggebo TM. Ultrasound is the future diagnostic tool in active labor. Ultrasound Obstet Gynecol. 2013;41:361–3.

    CAS  PubMed  Google Scholar 

  7. Aiken CE, Aiken AR, Brockelsby JC, Scott JG. Factors influencing the likelihood of instrumental delivery success. Obstet Gynecol. 2014;123:796–803.

    PubMed  PubMed Central  Google Scholar 

  8. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med. 1999;341:17091714.

    Google Scholar 

  9. Sheiner E, Shoham-Vardi I, Silberstein T, Hallak M, Katz M, Mazor M. Failed vacuum extraction. Maternal risk factors and pregnancy outcome. J Reprod Med. 2001;46:819–24.

    CAS  PubMed  Google Scholar 

  10. Bultez T, Quibel T, Bouhanna P, Popowski T, Resche-Rigon M, Rozenberg P. Angle of fetal head progression measured using transperineal ultrasound as a predictive factor of vacuum extraction failure. Ultrasound Obstet Gynecol. 2016;48:86–91.

    CAS  PubMed  Google Scholar 

  11. Ali UA, Norwitz ER. Vacuum-assisted vaginal delivery. Rev Obstet Gynecol. 2009;2:5–17.

    PubMed  PubMed Central  Google Scholar 

  12. Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P, Cucherat M, Redarce T, Rudigoz RC. Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification. Am J Obstet Gynecol. 2005;192:868–74.

    PubMed  Google Scholar 

  13. Dupuis O, Ruimark S, Corinne D, Simone T, Andre D, Rene-Charles R. Fetal head position during the second stage of labor: comparison of digital vaginal examination and transabdominal ultrasonographic examination. Eur J Obstet Gynecol Reprod Biol. 2005;123:193–7.

    PubMed  Google Scholar 

  14. Akmal S, Kametas N, Tsoi E, Hargreaves C, Nicolaides KH. Comparison of transvaginal digital examination with intrapartum sonography to determine fetal head position before instrumental delivery. Ultrasound Obstet Gynecol. 2003;21:437–40.

    CAS  PubMed  Google Scholar 

  15. Ramphul M, Ooi PV, Burke G, Kennelly MM, Said SA, Montgomery AA, Murphy DJ. Instrumental delivery and ultrasound: a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery. BJOG. 2014;121:1029–38.

    CAS  PubMed  Google Scholar 

  16. Ghi T, Eggebo T, Lees C, Kalache K, Rozenberg P, Youssef A, Salomon LJ, Tutschek B. ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound Obstet Gynecol. 2018;52:128–39.

    CAS  PubMed  Google Scholar 

  17. Barbera AF, Pombar X, Perugino G, Lezotte DC, Hobbins JC. A new method to assess fetal head descent in labor with transperineal ultrasound. Ultrasound Obstet Gynecol. 2009;33:313–9.

    CAS  PubMed  Google Scholar 

  18. Eggebo TM, Gjessing LK, Heien C, Smedvig E, Okland I, Romundstad P, Salvesen KA. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultrasound Obstet Gynecol. 2006;27:387–91.

    CAS  PubMed  Google Scholar 

  19. Ghi T, Farina A, Pedrazzi A, Rizzo N, Pelusi G, Pilu G. Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound. Ultrasound Obstet Gynecol. 2009;33:331–6.

    CAS  PubMed  Google Scholar 

  20. Iversen JK, Jacobsen AF, Mikkelsen TF, Eggebo TM. Structured clinical examinations in labor: rekindling the craft of obstetrics. J Matern Fetal Neonatal Med. 2019:1–7.

    Google Scholar 

  21. Ghi T, Dall’Asta A, Masturzo B, Tassis B, Martinelli M, Volpe N, Prefumo F, Rizzo G, Pilu G, Cariello L, Sabbioni L, Morselli-Labate AM, Todros T, Frusca T. Randomised Italian sonography for occiput POSition trial ante vacuum (R.I.S.POS.T.A.). Ultrasound Obstet Gynecol. 2018;52:699–705.

    CAS  PubMed  Google Scholar 

  22. Sizer AR, Nirmal DM. Occipitoposterior position: associated factors and obstetric outcome in nulliparas. Obstet Gynecol. 2000;96:749–52.

    CAS  PubMed  Google Scholar 

  23. Youssef A, Ghi T, Pilu G. How to perform ultrasound in labor: assessment of fetal occiput position. Ultrasound Obstet Gynecol. 2013;41:476–8.

    CAS  PubMed  Google Scholar 

  24. Akmal S, Tsoi E, Howard R, Osei E, Nicolaides KH. Investigation of occiput posterior delivery by intrapartum sonography. Ultrasound Obstet Gynecol. 2004;24:425–8.

    CAS  PubMed  Google Scholar 

  25. Fitzgerald MP, Weber AM, Howden N, Cundiff GW, Brown MB, Pelvic N. Floor disorders. Risk factors for anal sphincter tear during vaginal delivery. Obstet Gynecol. 2007;109:29–34.

    PubMed  Google Scholar 

  26. Kahrs BH, Usman S, Ghi T, Youssef A, Torkildsen EA, Lindtjorn E, Ostborg TB, Benediktsdottir S, Brooks L, Harmsen L, Salvesen KA, Lees CC, Eggebo TM. Fetal rotation during vacuum extractions for prolonged labor: a prospective cohort study. Acta Obstet Gynecol Scand. 2018;97:998.

    PubMed  Google Scholar 

  27. Tutschek B, Torkildsen EA, Eggebo TM. Comparison between ultrasound parameters and clinical examination to assess fetal head station in labor. Ultrasound Obstet Gynecol. 2013;41:425–9.

    CAS  PubMed  Google Scholar 

  28. Kalache KD, Duckelmann AM, Michaelis SA, Lange J, Cichon G, Dudenhausen JW. Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the ‘angle of progression’ predict the mode of delivery? Ultrasound Obstet Gynecol. 2009;33:326–30.

    CAS  PubMed  Google Scholar 

  29. Sainz JA, Garcia-Mejido JA, Aquise A, Bonomi MJ, Borrero C, De La Fuente P, Fernandez-Palacin A. Intrapartum transperineal ultrasound used to predict cases of complicated operative (vacuum and forceps) deliveries in nulliparous women. Acta Obstet Gynecol Scand. 2017;96:1490–7.

    PubMed  Google Scholar 

  30. Ghi T, Youssef A, Maroni E, Arcangeli T, De Musso F, Bellussi F, Nanni M, Giorgetta F, Morselli-Labate AM, Iammarino MT, Paccapelo A, Cariello L, Rizzo N, Pilu G. Intrapartum transperineal ultrasound assessment of fetal head progression in active second stage of labor and mode of delivery. Ultrasound Obstet Gynecol. 2013;41:430–5.

    CAS  PubMed  Google Scholar 

  31. Eggebo TM, Wilhelm-Benartzi C, Hassan WA, Usman S, Salvesen KA, Lees CC. A model to predict vaginal delivery in nulliparous women based on maternal characteristics and intrapartum ultrasound. Am J Obstet Gynecol. 2015;213:362.e1–6.

    Google Scholar 

  32. Maticot-Baptista D, Ramanah R, Collin A, Martin A, Maillet R, Riethmuller D. Ultrasound in the diagnosis of fetal head engagement. A preliminary French prospective study. J Gynecol Obstet Biol Reprod (Paris). 2009;38:474–80.

    CAS  Google Scholar 

  33. Kahrs BH, Usman S, Ghi T, Youssef A, Torkildsen EA, Lindtjorn E, Ostborg TB, Benediktsdottir S, Brooks L, Harmsen L, Romundstad PR, Salvesen KA, Lees CC, Eggebo TM. Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study. Am J Obstet Gynecol. 2017;217:69.e1–69.e10.

    Google Scholar 

  34. Kasbaoui S, Severac F, Aissi G, Gaudineau A, Lecointre L, Akladios C, Favre R, Langer B, Sananes N. Predicting the difficulty of operative vaginal delivery by ultrasound measurement of fetal head station. Am J Obstet Gynecol. 2017;216:507.e501–9.

    Google Scholar 

  35. Benediktsdottir S, Salvesen KA, Hjartardottir H, Eggebo TM. Reproducibility and acceptability of ultrasound measurements of head-perineum distance. Acta Obstet Gynecol Scand. 2018;97:97–103.

    PubMed  Google Scholar 

  36. Henrich W, Dudenhausen J, Fuchs I, Kamena A, Tutschek B. Intrapartum translabial ultrasound (ITU): sonographic landmarks and correlation with successful vacuum extraction. Ultrasound Obstet Gynecol. 2006;28:753–60.

    CAS  PubMed  Google Scholar 

  37. Chan VYT, Lau WL, So MKP, Leung WC. Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor. Int J Gynaecol Obstet. 2019;144:192–8.

    PubMed  Google Scholar 

  38. Sainz JA, Garcia-Mejido JA, Aquise A, Borrero C, Bonomi MJ, Fernandez-Palacin A. A simple model to predict the complicated operative vaginal deliveries using vacuum or forceps. Am J Obstet Gynecol. 2019;220:193.e191–12.

    Google Scholar 

  39. Kahrs BH, Usman S, Ghi T, Youssef A, Torkildsen EA, Lindtjorn E, Ostborg TB, Benediktsdottir S, Brooks L, Harmsen L, Salvesen KA, Lees CC, Eggebo TM. Descent of the fetal head during active pushing: a secondary analysis of a prospective cohort study investigating ultrasound examinations before an operative vaginal delivery. Ultrasound Obstet Gynecol. 2019;54:524.

    CAS  PubMed  Google Scholar 

  40. Youssef A, Montaguti E, Dodaro MG, Kamel R, Rizzo N, Pilu G. Levator ani muscle coactivation at term is associated with longer second stage of labor in nulliparous women. Ultrasound Obstet Gynecol. 2019;53:686–92.

    CAS  PubMed  Google Scholar 

  41. Kamel R, Montaguti E, Nicolaides KH, Soliman M, Dodaro MG, Negm S, Pilu G, Momtaz M, Youssef A. Contraction of the levator ani muscle during Valsalva maneuver (coactivation) is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor. Am J Obstet Gynecol. 2019;220:189.e181–8.

    Google Scholar 

  42. Gilboa Y, Frenkel TI, Schlesinger Y, Rousseau S, Hamiel D, Achiron R, Perlman S. Visual biofeedback using transperineal ultrasound in second stage of labor. Ultrasound Obstet Gynecol. 2018;52:91–6.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kahrs, B.H., Eggebø, T.M. (2021). Ultrasound Examination Before Vacuum Extraction. In: Malvasi, A. (eds) Intrapartum Ultrasonography for Labor Management. Springer, Cham. https://doi.org/10.1007/978-3-030-57595-3_31

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-57595-3_31

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-57594-6

  • Online ISBN: 978-3-030-57595-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics