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Prediction of spontaneous vaginal delivery by transperineal ultrasound performed just after full cervical dilatation is determined

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Abstract

Purpose

To investigate whether transperineal ultrasound examination just after full cervical dilatation is determined can predict the mode of delivery.

Methods

This was a prospective observational study of pregnant women. After full cervical dilatation was determined by vaginal examination during labor, transperineal ultrasound was immediately performed, and the head direction (HD), progression distance (PD), and angle of progression (AoP) were measured. The cases were divided into two groups: spontaneous vaginal delivery and operative delivery due to failure of progression. Differences between the groups were statistically analyzed using Student’s t test and Fisher’s exact test.

Results

Of the 50 women, 42 had spontaneous vaginal deliveries and 8 had vacuum extractions. The spontaneous delivery group had significantly higher HD, PD, and AoP values than the vacuum extraction group. The areas under the receiver-operating characteristic curves for the prediction of spontaneous vaginal delivery were 0.850 for HD, 0.827 for PD, and 0.783 for AoP. The optimum cut-off points and positive predictive values were 83° and 92.9 % for HD, 56 mm and 94.9 % for PD, and 146° and 94.3 % for AoP, respectively.

Conclusion

Transperineal ultrasound examination just after full cervical dilatation was determined was useful in predicting spontaneous vaginal delivery.

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References

  1. Sherer DM, Miodovnik M, Bradley KS, et al. Intrapartum fetal head position I: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the active stage of labor. Ultrasound Obstet Gynecol. 2002;19:258–63.

    Article  CAS  PubMed  Google Scholar 

  2. Sherer DM, Miodovnik M, Bradley KS, et al. Intrapartum fetal head position II: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the active stage of labor. Ultrasound Obstet Gynecol. 2002;19:264–8.

    Article  CAS  PubMed  Google Scholar 

  3. Dupuis O, Ruimark S, Corinne D, et al. 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.

    Article  PubMed  Google Scholar 

  4. Dupuis O, Silveira R, Zentner A, et al. 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.

    Article  PubMed  Google Scholar 

  5. Buchmann E, Libhaber E. Interobserver agreement in intrapartum estimation of fetal head station. Int J Gynecol Obstet. 2008;101:285–9.

    Article  Google Scholar 

  6. Dietz HP, Lanzarone V. Measuring engagement of the fetal head: validity and reproducibility of a new ultrasound technique. Ultrasound Obstet Gynecol. 2005;25:165–8.

    Article  CAS  PubMed  Google Scholar 

  7. Barbera AF, Pombar X, Peruginoj G, et al. A new method to assess fetal head descent in labor with transperineal ultrasound. Ultrasound Obstet Gynecol. 2009;33:313–9.

    Article  CAS  PubMed  Google Scholar 

  8. Ghi T, Farina A, Pedrazzi A, et al. 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.

    Article  CAS  PubMed  Google Scholar 

  9. Dückelmann AM, Bamberg C, Michaelis SA, et al. Measurement of fetal head descent using the “angle of progression” on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise. Ultrasound Obstet Gynecol. 2010;35:216–22.

    Article  PubMed  Google Scholar 

  10. Ghi T, Contro E, Farina A, et al. Three-dimensional ultrasound in monitoring progression of labor: a reproducibility study. Ultrasound Obstet Gynecol. 2010;36:500–6.

    Article  CAS  PubMed  Google Scholar 

  11. Molina FS, Terra R, Carrillo MP, et al. What is the most reliable ultrasound parameter for assessment of fetal head descent? Ultrasound Obstet Gynecol. 2010;36:493–9.

    Article  CAS  PubMed  Google Scholar 

  12. Torkildsen EA, Salvesen KÅ, Eggeboø TM. Agreement between two- and three-dimensional transperineal ultrasound methods in assessing fetal head descent in the first stage of labor. Ultrasound Obstet Gynecol. 2012;39:310–5.

    Article  CAS  PubMed  Google Scholar 

  13. Kalache KD, Dückelmann AM, Michaelis SA, et al. 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.

    Article  CAS  PubMed  Google Scholar 

  14. Torkildsen EA, Salvesen KÅ, Eggebø TM. Prediction of delivery mode with transperineal ultrasound in women with prolonged first stage of labor. Ultrasound Obstet Gynecol. 2011;37:702–8.

    Article  CAS  PubMed  Google Scholar 

  15. Eggebø TM, Hassan WA, Salvesen KA, et al. Sonographic prediction of vaginal delivery in prolonged labor: a two-center study. Ultrasound Obstet Gynecol. 2014;43:195–201.

    Article  PubMed  Google Scholar 

  16. American College of Obstetrics and Gynecology. Dystocia and augmentation of labor. ACOG practice bulletin no. 49. Obstet Gynecol. 2003;102:1445–54.

    Google Scholar 

  17. American College of Obstetrics and Gynecology. Operative vaginal delivery. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2001;74:69–76.

    Article  Google Scholar 

  18. Japan Society of Obstetrics and Gynecology. Guideline for obstetrical practice in Japan 2014. Tokyo: Japan Society of Obstetrics and Gynecology; 2014. p. 225–31.

    Google Scholar 

  19. Rane SM, Guirgis RR, Higgins B, et al. The value of ultrasound in the prediction of successful induction of labor. Ultrasound Obstet Gynecol. 2004;24:538–49.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  21. Gilboa Y, Kivilevitch Z, Spira M, et al. Head progression distance in prolonged second stage of labor: relationship with mode of delivery and fetal head station. Ultrasound Obstet Gynecol. 2013;41:436–41.

    Article  CAS  PubMed  Google Scholar 

  22. Ghi T, Youssef A, Maroni E, et al. 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.

    Article  CAS  PubMed  Google Scholar 

  23. Hassan SJ, Sundby J, Husseini A, et al. The paradox of vaginal examination practice during normal childbirth: palestinian women’s feelings, opinions, knowledge and experiences. Reprod Health. 2012;9:16.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Westover T, Knuppel RA. Modern management of clinical chorioamnionitis. Infect Dis Obstet Gynecol. 1995;3:123–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Barbera AF, Imani F, Becker T, et al. 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. 2009;33:320–5.

    Article  CAS  PubMed  Google Scholar 

  26. Bamberg C, Scheuermann S, Slowinski T, et al. Relationship between fetal head station established using an open magnetic resonance imaging scanner and the angle of progression determined by transperineal ultrasound. Ultrasound Obstet Gynecol. 2011;37:712–6.

    Article  CAS  PubMed  Google Scholar 

  27. Eggebø TM, Økland I, Heien C, et al. Can ultrasound measurements replace digitally assessed elements of the Bishop score? Acta Obstet Gynecol Scand. 2009;88:325–31.

    Article  PubMed  Google Scholar 

  28. Hassan WA, Eggebø T, Ferguson M, et al. The sonopartogram: a novel method for recording progress of labor by ultrasound. Ultrasound Obstet Gynecol. 2014;43:189–94.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We wish to thank Kaoru Goto, Kakunodate General Hospital; Hiromitsu Tsubaki, Ogachi Chuo Hospital; and the obstetric doctors and midwives for their assistance. In addition, we would like to thank Kouichi Kobayashi and Ken Sakamaki, Japan Community Health Care Organization, Tokyo Yamate Medical Center.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Saeko Kameyama, Akira Sato, Hiroshi Miura, Jin Kumagai, Naoki Sato, Dai Shimizu, Kenichi Makino & Yukihiro Terada

Authors
  1. Saeko Kameyama
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  2. Akira Sato
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  3. Hiroshi Miura
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  4. Jin Kumagai
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  6. Dai Shimizu
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  8. Yukihiro Terada
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Corresponding author

Correspondence to Akira Sato.

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Conflict of interest

Saeko Kameyama, Akira Sato, Hiroshi Miura, Jin Kumagai, Naoki Sato, Dai Shimizu, Kenichi Makino, and Yukihiro Terada declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

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Kameyama, S., Sato, A., Miura, H. et al. Prediction of spontaneous vaginal delivery by transperineal ultrasound performed just after full cervical dilatation is determined. J Med Ultrasonics 43, 243–248 (2016). https://doi.org/10.1007/s10396-015-0681-x

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  • DOI: https://doi.org/10.1007/s10396-015-0681-x

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