Automated Approach for Enhancing Fetal Head Station Assessment in Labor with Transperineal Ultrasound

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2024-10-22 DOI:10.1016/j.ultrasmedbio.2024.09.022

Francesco Conversano , Maria Giovanna Di Trani , Rocco Morello , Alberto Bottino , Paola Pisani , Antonella Vimercati , Marco Di Paola , Sergio Casciaro

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引用次数: 0

Abstract

Rationale and Objectives

Accurate assessment of fetal head station (FHS) is crucial during labor management to reduce the risk of complications and plan the mode of delivery. Although digital vaginal examination (DVE) has been associated with inaccuracies in FHS assessment, ultrasound (US) evaluation remains dependent on sonographer expertise. This study aimed at investigating the reliability and accuracy of an automatic approach to assess the FHS during labor with transperineal US (TPU).

Materials and Methods

In this prospective observational study, 27 pregnant women in the second stage of labor, with fetuses in cephalic presentation, underwent conventional labor management with additional TPU examination. A total of 45 2D B-mode TPU acquisitions were performed at different FHS, before performing DVE. The FHS was assessed by the algorithm (FHS_aut) on TPU images and by DVE (FHS_dig). The sonographic assessment of FHS by expert sonographer (FHS_exp) on the same TPU acquisition used for the automatic measurement served as gold standard. The performance and accuracy were assessed through Spearman's ρ, the coefficient of determination (R²), root mean square error (RMSE), and Bland–Altman analysis.

Results

A strong correlation between FHS_aut and FHS_exp (ρ = 0.97, p < 0.001) and a high coefficient of determination (R² = 0.95) were found. A lower correlation with FHS_exp (ρ = 0.66, p < 0.001) and coefficient of determination (R² = 0.52) was found for DVE. Moreover, the RMSE reported higher accuracy of FHS_aut (RMSE = 0.32 cm) compared to FHS_dig (RMSE = 0.97 cm). Bland–Altman analysis showed that the algorithm performed with smaller bias and narrower limits of agreement compared to DVE.

Conclusion

The proposed algorithm can evaluate FHS with high accuracy and low RMSE. This approach could facilitate the use of US in labor, supporting the clinical staff in labor management.

查看原文本刊更多论文

利用经会阴超声增强分娩时胎儿头部位置评估的自动化方法

理由和目标：在产程管理中，准确评估胎头着床（FHS）对降低并发症风险和计划分娩方式至关重要。尽管数字阴道检查（DVE）与胎头站位评估的不准确性有关，但超声（US）评估仍依赖于超声技师的专业知识。本研究旨在探讨经会阴超声（TPU）自动评估分娩期 FHS 的可靠性和准确性：在这项前瞻性观察研究中，27 名处于第二产程、胎儿呈头位的孕妇在接受常规产程管理的同时接受了额外的 TPU 检查。在进行 DVE 之前，共在不同的 FHS 下进行了 45 次二维 B 型 TPU 采集。通过TPU图像上的算法（FHSaut）和DVE（FHSdig）对FHS进行评估。作为金标准，专家超声技师在用于自动测量的同一 TPU 采集图像上对 FHS 进行了超声评估（FHSexp）。通过Spearman's ρ、判定系数（R2）、均方根误差（RMSE）和Bland-Altman分析评估其性能和准确性：结果发现，FHSaut 和 FHSexp 之间具有很强的相关性（ρ = 0.97，p < 0.001），并且具有很高的决定系数（R2 = 0.95）。DVE 与 FHSexp 的相关性较低（ρ = 0.66，p < 0.001），判定系数也较低（R2 = 0.52）。此外，RMSE 显示 FHSaut（RMSE = 0.32 厘米）比 FHSdig（RMSE = 0.97 厘米）更准确。Bland-Altman分析表明，与DVE相比，该算法的偏差更小，一致性范围更窄：结论：所提出的算法能以较高的准确度和较低的 RMSE 评估 FHS。结论：所提出的算法能以较高的准确性和较低的均方误差对 FHS 进行评估，这种方法有助于在分娩过程中使用 US，为临床人员的分娩管理提供支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.