Intrapartum Sonography and Clinical Risk Management

  • Andrea TinelliEmail author
  • Sarah Gustapane
  • Francesco Giacci
  • Domenico Dell’Edera
  • Antonio Malvasi


Dystocia is the leading cause of caesarean section in nulliparae. In 1998, Gregory et al. reported that the main indication for performing a caesarean section is dystocia [1].


Caesarean Section Operative Delivery HELLP Syndrome Fetal Head Lower Uterine Segment 
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  1. 1.
    Gregory KD, Curtin SC, Taffel SM, Notzon FC (1998) Changes in indications for cesarean delivery: United States, 1985 and 1994. Am J Public Health 88:1384–1387PubMedCrossRefGoogle Scholar
  2. 2.
    Gifford DS, Morton SC, Fiske M, Keesey J, Keeler E, Kahn KL (2000) Lack of progress in labor as a reason for cesarean. Obstet Gynecol 95:589–595PubMedCrossRefGoogle Scholar
  3. 3.
    Tampakoudis P, Assimakopoulos E, Grimbizis G, Zafrakas M, Tampakoudis G, Mantalenakis S, Bontis J (2004) Cesarean section rates and indications in Greece: data from a 24-year period in a teaching hospital. Clin Exp Obstet Gynecol 31:289–292PubMedGoogle Scholar
  4. 4.
    Lowe NK (2007) A review of factors associated with dystocia and cesarean section in nulliparous women. J Midwifery Womens Health 52:216–228PubMedCrossRefGoogle Scholar
  5. 5.
    Kjaergaard H, Olsen J, Ottesen B, Dykes AK (2009) Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset. Acta Obstet Gynecol Scand 88:402–407PubMedCrossRefGoogle Scholar
  6. 6.
    Ojiyi EC, Dike EI, Idrissa AU (2008) Primary caeserean section in grandmultiparae at Mater Misericordiae Hosptial Afikpo: a 5 year retrospective study. Niger J Clin Pract 11:368–371PubMedGoogle Scholar
  7. 7.
    Tan WC, Devendra K, Tan AS (2003) Changing trends in indications for caesarean sections in a tertiary hospital. Ann Acad Med Singapore 32:299–304PubMedGoogle Scholar
  8. 8.
    Najmi RS, Rehan N (2000) Prevalence and determinants of caesarean section in a teaching hospital of Pakistan. J Obstet Gynecol 20:479–483CrossRefGoogle Scholar
  9. 9.
    Leeman L, Leeman RA (2003) Native American community with a 7% cesarean delivery rate: does case mix, ethnicity, or labor management explain the low rate? Ann Fam Med 1:36–43PubMedCrossRefGoogle Scholar
  10. 10.
    Olagundoye V, Mac Kenzie IZ (2007) The impact of a trial of instrumental delivery in theatre on neonatal outcome. BJOG 114:603–608PubMedCrossRefGoogle Scholar
  11. 11.
    Rosenberg K, Trevathan W (2002) Birth, obstetrics and human evolution. BJOG 109:1199–1206PubMedCrossRefGoogle Scholar
  12. 12.
    Rosenberg KR, Trevathan WR (2001) The evolution of human birth. Sci Am 285:72–77PubMedCrossRefGoogle Scholar
  13. 13.
    National Health Service, Italian Health Ministry: Statistical data of (2008) SDOGoogle Scholar
  14. 14.
    Scheller JM, Nelson KB (1994) Does cesarean delivery prevent cerebral palsy or other neurologic problems of childhood? Obstet Gynecol 83:624–630PubMedCrossRefGoogle Scholar
  15. 15.
    Malvasi A, Tinelli A, Guido M, Zizza A, Cotrino G, Vergari U (2009) The increasing trend in cesarean sections in south eastern Italy: medical and biopolitical analysis of causes and possible mechanisms for its reduction. Curr Womens Health Rev 5:176–183CrossRefGoogle Scholar
  16. 16.
    Croughan-Minihane MS, Petitti DB, Gordis L (1990) Morbidity among breech infants according to method of delivery. Obsted Gynecol 75:821–825Google Scholar
  17. 17.
    Marra A (2003) Il ginecologo e l’ostetrico. Diritti, Doveri e responsabilità. Passoni Editore Milan, Italy.Google Scholar
  18. 18.
    Vimercati A, Greco P, Kardashi A, Rossi C, Loizzi V, Scioscia M, Loverro G (2000) Choice of caesarean section and perception of legale pressure. J Perinat Med 28:111–117PubMedGoogle Scholar
  19. 19.
    Zhang J, Troendle J, Reddy UM, Laughon SK, Branch DW, Burkman R, Landy HJ, Hibbard JU, Haberman S, Ramirez MM, Bailit JL, Hoffman MK, Gregory KD, Gonzalez-Quintero VH, Kominiarek M, Learman LA, Hatjis CG, van Veldhuisen P (2010) Consortium on safe labor. Contemporary cesarean delivery practice in the United States. Am J Obstet Gynecol 203:326.e1–326.e10CrossRefGoogle Scholar
  20. 20.
    Hanley GE, Janssen PA, Greyson D (2010) Regional variation in the cesarean delivery and assisted vaginal delivery rates. Obstet Gynecol 115:1201–1208PubMedCrossRefGoogle Scholar
  21. 21.
    Kale A, Chong YS, Biswas A (2008) Effect of availability of fetal ECG monitoring on operative deliveries. Acta Obstet Gynecol Scand 87:1189–1193PubMedCrossRefGoogle Scholar
  22. 22.
    Mola GD, Amoa AB, Edilyong J (2002) Factors associated with success or failure in trials of vacuum extraction. Aust N Z J Obstet Gynecol 42:35–39CrossRefGoogle Scholar
  23. 23.
    Wong GY, Mok YM, Wong SF (2007) Transabdominal ultrasound assessment of the fetal head and the accuracy of vacuum cup application. Int J Gynaecol Obstet 98:120–123PubMedCrossRefGoogle Scholar
  24. 24.
    Weerasekera DS, Premaratne S (2002) A randomised prospective trial of the obstetric forceps versus vacuum extraction using defined criteria. J Obstet Gynecol 22:344–345CrossRefGoogle Scholar
  25. 25.
    Lieberman E, O’donoghue C (2002) Unintended effects of epidural analgesia during labor: a systematic review. Am J Obstet Gynecol 186((5 Suppl Nature)):S31–S68PubMedGoogle Scholar
  26. 26.
    Molina FS, Nicolaides KH (2010) Ultrasound in labor and delivery. Fetal Diagnosis Therapy 27:61–67CrossRefGoogle Scholar
  27. 27.
    Sentilhes LJ, Gillard P, Deshamps P, Fourniè A (2008) Indications and prerequisites for operative vaginal delivery: when how and where? J Gynecol Obstet Biol Reprod 37(Suppl 8):S188–S201CrossRefGoogle Scholar
  28. 28.
    Lau WL, Leung WC, Chin R (2009) Intrapartum translabial ultrasound demonstrating brow presentation during the second stage of labor. Int J Gynecol Obstet 107:62–63CrossRefGoogle Scholar
  29. 29.
    Malvasi A, Tinelli A, Guido M, Zizza A, Farine D, Stark M (2010) Should the visceral peritoneum at the bladder flap closed at cesarean sections? A post-­partum sonographic and clinical assessment. J Matern Fetal Neonatal Med 23:662–669PubMedCrossRefGoogle Scholar
  30. 30.
    Malvasi A, Tinelli A, Pacella E (2010) Mass closure of visceral peritoneum at cesarean section. A proposal method. J Matern Fetal Neonatal Med 23:345–346PubMedCrossRefGoogle Scholar
  31. 31.
    Malvasi A, Tinelli A, Farine D, Rahimi S, Cavallotti C, Vergara D, Martignago R, Stark M (2009) Effects of visceral peritoneal closure on scar formation at cesarean delivery. Int J Gynaecol Obstet 105:131–135PubMedCrossRefGoogle Scholar
  32. 32.
    Malvasi A, Tinelli A, Tinelli R, Serio G, Pellegrino M, Mettler L (2008) Subfascial hematomas and hemoperitoneum after cesarean section: prevalence according to closure and non-closure of the parietal peritoneum. Gynecol Obstet Invest 66:162–168PubMedCrossRefGoogle Scholar
  33. 33.
    Malvasi A, Tinelli A, Tinelli R, Cavallotti C, Farine D (2008) The diagnosis and management of post-cesarean section hemorrhagic shock. J Matern Fetal Neonatal Med 21:487–491PubMedCrossRefGoogle Scholar
  34. 34.
    Malvasi A, Tinelli A, Hudelist G, Vergara D, Martignago R, Tinelli R (2009) Closure versus non-closure of the visceral peritoneum (VP) in patients with gestational hypertension–an observational analysis. Hypertens Pregnancy 28:290–299PubMedCrossRefGoogle Scholar
  35. 35.
    Malvasi A, Tinelli A, Tinelli R, Rahimi S, Resta L, Tinelli FG (2007) The post-cesarean section symptomatic bladder flap hematoma: a modern reappraisal. J Matern Fetal Neonatal Med 20:709–714PubMedCrossRefGoogle Scholar
  36. 36.
    Tinelli A, Malvasi A, Vittori G (2009) Laparoscopic treatment of post-cesarean section bladder flap hematoma: a feasible and safe approach. Minim Invasive Ther Allied Technol 18:356–360PubMedCrossRefGoogle Scholar
  37. 37.
    Malvasi A, Tinelli A, Stark M, Pontrelli G, Brizzi A, Wetzl RG, Benhamou D (2010) Low-dose sequential combined spinal-epidural anaesthesia in elective Stark caesarean section: a preliminary cohort study. Eur Rev Med Pharmacol Sci 14:215–221PubMedGoogle Scholar
  38. 38.
    Brizzi A, Greco F, Malvasi A, Valerio A, Martino V (2005) Comparison of sequential combined spinal-epidural anesthesia and spinal anesthesia for cesarean section. Minerva Anestesiol 71:701–709PubMedGoogle Scholar
  39. 39.
    Malvasi A, Tinelli A, Cavallotti C, Bettocchi S, Di Renzo GC, Stark M (2010) Substance P (SP) and vasoactive intestinal polypeptide (VIP) in the lower uterine segment in first and repeated cesarean sections. Peptides 31:2052–2059PubMedCrossRefGoogle Scholar
  40. 40.
    Malvasi A, Tinelli A, Stark M (2009) Il taglio cesareo:confronto tra tecniche chirurgiche. In: Di Renzo GC (ed) Trattato di Ginecologia ed Ostetricia. Verduci Edit, Roma, Cap.112, pp 1453–1475. ISBN: 88–7620–812–7 – 978–88–7620–812–6Google Scholar
  41. 41.
    Dückelmann AM, Michaelis SA, Bamberg C, Dudenhausen JW, Kalache KD (2012) Impact of intrapartal ultrasound to assess fetal head position and station on the type of obstetrical interventions at full cervical dilatation. J Matern Fetal Neonatal Med 25(5):484–488, Epub ahead of printPubMedCrossRefGoogle Scholar
  42. 42.
    Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, Harper A, Hulbert D, Lucas S, McClure J, Millward-Sadler H, Neilson J, Nelson-Piercy C, Norman J, O’Herlihy C, Oates M, Shakespeare J, de Swiet M, Williamson C, Beale V, Knight M, Lennox C, Miller A, Parmar D, Rogers J, Springett A (2011) Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG 118(Suppl 1):1–203. doi: 10.1111/j.1471-0528.2010.02847.x PubMedGoogle Scholar
  43. 43.
    Martinelli I (2001) Risk factors in venous thromboembolism. Thromb Haemost 86:395–403PubMedGoogle Scholar
  44. 44.
    Greer IA (1999) Thrombosis in pregnancy: maternal and fetal issues. Lancet 353:1258–1265PubMedCrossRefGoogle Scholar
  45. 45.
    Lane DA, Mannucci PM, Bauer KA, Bertina RM, Bochkov NP, Boulyjenkov V, Chandy M, Dahlbäck B, Ginter EK, Miletich JP, Rosendaal FR, Seligsohn U (1996) Inherited thrombophilia: part 1. Thromb Haemost 76(5):651–662PubMedGoogle Scholar
  46. 46.
    Gates S, Brocklehurst P, Davis LJ (2002) Prophylaxis for venous trhomboebolic disease in pregnancy and the early postnatal period. Cochrane Database Syst Rev. (2): CD001689Google Scholar
  47. 47.
    Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J, American College of Chest Physicians Chest (2008) Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of chest physicians evidence-based clinical practice guidelines (8th edition). Chest 133(6 Suppl):844S–886SPubMedCrossRefGoogle Scholar
  48. 48.
    Lussana F, Dentali F, Abbate R, d’Aloja E, D’Angelo A, De Stefano V, Faioni EM, Grandone E, Legnani C, Martinelli I, Simioni P, Tormene D (2009) Screening for thrombophilia and antithrombotic prophylaxis in pregnancy: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 124:e19–e25PubMedCrossRefGoogle Scholar
  49. 49.
    Dell’ Edera D, Guanciali Franchi P, Lioi MB, Epifania AA, Tinelli A, Monti Condesnitt V, Brizzi A, Malvasi A (2011) Biochemical and molecular characterization of von Willebrand disease type 2N in a pregnant patient who gave birth under analgesia with remifentanil. J Biol Regul Homeost Agents 25:469–475Google Scholar
  50. 50.
    Trigg DE, Stergiotou I, Peitsidis P, Kadir RA (2012) A systematic review: the use of desmopressin for treatment and prophylaxis of bleeding disorders in pregnancy. Haemophilia 18(1):25–33PubMedCrossRefGoogle Scholar
  51. 51.
    McLintock C, James AH (2011) Obstetric hemorrhage. J Thromb Haemost 9(8):1441–1451PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Andrea Tinelli
    • 1
    Email author
  • Sarah Gustapane
    • 2
  • Francesco Giacci
    • 2
  • Domenico Dell’Edera
    • 3
  • Antonio Malvasi
    • 4
  1. 1.Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Department of Obstetric and GynecologyVito Fazzi HospitalLecceItaly
  2. 2.Department of Obstetric and GynecologySS. Annunziata HospitalChietiItaly
  3. 3.Unit of Cytogenetic and Molecular Genetics“Madonna delle Grazie” HospitalMateraItaly
  4. 4.Department of Obstetric and GynecologySanta Maria HospitalBariItaly

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