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Intrapartal Ultrasound to Assess Fetal Head Position and Station in the Second Stage of Labor: State of the Art

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Intrapartum Ultrasonography for Labor Management

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Abstract

When there is failure to progress in the second stage of labor, an operative delivery may become necessary. Fetal position and station indicate which operative intervention is required, a primary Cesarean section or an instrumental delivery. Digital pelvic examination is not accurate for the determination of fetal head position and station during labor. Sonographic evaluations have recently been performed in the second stage of labor to improve assessments of labor progression and outcome. Several sonographic approaches have been described for determining the station and rotation of the fetal head. These include linear measurements (distance between the fetal head and the maternal perineum), subjective assessment of the fetal head direction and angular measurements. The studies performed to test the validity of transperineal intrapartal ultrasound in the labor ward aim to establish a simple ultrasound method that will be applicable to the clinical setting and obstetrically relevant by reflecting fetal head engagement. The bottom line will be to demonstrate whether the use of ultrasound can improve outcomes.

This chapter gives an overview about the use of intrapartal ultrasound in the second stage of labor. The role of ultrasonographic assessment of the fetal head in the management of labor and delivery is discussed.

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Authors and Affiliations

  1. Department of Obstetrics, Charité - University Hospital, Campus Charité Virchow Klinikum, Berlin, Germany

    Anna M. Dückelmann

  2. Division of Maternal-Fetal Medicine, Obstetrics and Gynecology Department, Weill Cornell Medical College—Qatar, Sidra Medical and Research Center, Doha, Qatar

    Karim D. Kalache

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  1. Anna M. Dückelmann
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  2. Karim D. Kalache
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Correspondence to Anna M. Dückelmann .

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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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Dückelmann, A.M., Kalache, K.D. (2021). Intrapartal Ultrasound to Assess Fetal Head Position and Station in the Second Stage of Labor: State of the Art. In: Malvasi, A. (eds) Intrapartum Ultrasonography for Labor Management. Springer, Cham. https://doi.org/10.1007/978-3-030-57595-3_36

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