Intrapartum Translabial Ultrasound (ITU) to Assess Birth Progress
For many years, diagnostic ultrasound has had a place in the labor ward. Recently, it has also been applied to assess birth progress. Initially, the position of the fetal spine and occiput was assessed by transabdominal ultrasound and correlated with vaginal palpation to improve detection of OP presentation. From 2005, translabial ultrasound was used, initially before [3, 4] but then also during labor [5–10] to measure head station objectively. Studies of accuracy of vaginal palpation, measured using a phantom, showed that obstetric vaginal palpation is very operator dependent and, overall, not accurate; this applies to palpated head stations expressed in centimeters above or below the mid-pelvis (Fig. 9.1) and simply as “high,” “mid,” and “low,” according to the ACOG classification .
- 10.Kalache KD, Duckelmann AM, Michaelis SA, Lange J, Cichon G, Dudenhausen JW (2009) 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 33:326–330. doi: 10.1002/uog.6294 PubMedCrossRefGoogle Scholar
- 11.Dupuis O, Ruimark S, Corinne D, Simone T, Andre D, Rene-Charles R (2005) Fetal head position during the second stage of labor: comparison of digital vaginal examination and transabdominal ultrasonographic examination. Eur J Obstet Gynecol Reprod Biol 123:193–197. doi: 10.1016/j.ejogrb.2005.04.009 PubMedCrossRefGoogle Scholar
- 12.Tutschek B (2012). Intrapartaler translabialer Ultraschall (ITU) zur Bestimmung des Geburtsfortschritts. CME Praktische Fortbildung: Gynakol, Geburtsmed Gynakol Endokrinol; (1):26Google Scholar
- 13.Barbera AF, Imani F, Becker T, Lezotte DC, Hobbins JC (2009) Anatomic relationship between the pubic symphysis and ischial spines and its clinical significance in the assessment of fetal head engagement and station during labor. Ultrasound Obstet Gynecol 33:320–325. doi: 10.1002/uog.6322 PubMedCrossRefGoogle Scholar