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Intrapartum transperineal ultrasound for evaluating uterine contraction intensity in the second stage of labor

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Abstract

Purpose

To clarify whether intrapartum transperineal ultrasound (ITU) can be used to evaluate uterine contraction intensity, and whether the intensity is associated with the duration of the second stage.

Methods

A prospective observational study was performed involving 86 women with a normal singleton term fetus and more than three contractions every 10 min. ITU was performed for contractile and non-contractile periods of labor at the beginning of the second stage, and one representative “angle of progression (AoP)” image was selected for each period. The Mann–Whitney U test was used to compare ∆AoP, the difference between the two angles, depending on the duration of the second stage. Receiver operating characteristic curves were used to evaluate the probability of duration of the second stage ≤50 min in nulliparous women.

Results

Among nulliparous women, ΔAoP differed significantly according to the duration of the second stage (52.5° ± 5.0° for ≤50 min vs. 30.9° ± 2.1° for >50 min; P < 0.001). Receiver operating characteristic curve analysis showed that approximately 85% of nulliparous women with ΔAoP greater than 40° delivered within 50 min.

Conclusion

These findings could be utilized in the evaluation of uterine contraction intensity, and ∆AoP measurement could be used to predict the duration of the second stage of labor in nulliparous women.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuduki-ku, Yokohama-shi, Kanagawa, 224-8503, Japan

    Miyuki Muramoto, Kiyotake Ichizuka, Satoshi Dohi, Hiroshi Saito & Masaaki Nagatsuka

  2. Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan

    Junichi Hasegawa & Masamitsu Nakamura

Authors
  1. Miyuki Muramoto
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  2. Kiyotake Ichizuka
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  3. Junichi Hasegawa
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  4. Masamitsu Nakamura
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  5. Satoshi Dohi
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  6. Hiroshi Saito
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  7. Masaaki Nagatsuka
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Corresponding author

Correspondence to Miyuki Muramoto.

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Ethical statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

Miyuki Muramoto, Kiyotake Ichizuka, Junichi Hasegawa, Masamitsu Nakamura, Satoshi Dohi, Hiroshi Saito, and Masaaki Nagatsuka declare that they have no conflict of interest.

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Muramoto, M., Ichizuka, K., Hasegawa, J. et al. Intrapartum transperineal ultrasound for evaluating uterine contraction intensity in the second stage of labor. J Med Ultrasonics 44, 117–122 (2017). https://doi.org/10.1007/s10396-016-0752-7

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  • DOI: https://doi.org/10.1007/s10396-016-0752-7

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