Assessing the difficulty of forceps delivery using a transperineal ultrasonographic station: a prospective cohort study.

IF 1.9 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Ultrasonics Pub Date : 2025-04-09 DOI:10.1007/s10396-025-01536-1

Hiroko Takita, Ryu Matsuoka, Bunbu Sekiya, Yuki Mukai, Takeshi Nakamura, Mayumi Kaneko, Akihiko Sekizawa

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引用次数: 0

Abstract

Purpose: To investigate the clinical utility of a novel transperineal ultrasonographic (TUS) parameter, the TUS station, for assessing labour progression and predicting forceps delivery difficulty.

Methods: In this prospective cohort study, 384 TUS images from 144 participants who delivered vaginally between January 2019 and December 2021 were assessed for labour progression in a single tertiary perinatal center in Japan. Singleton cephalic pregnancies ≥ 37 weeks were included. The digital vaginal examination (DVE) findings, TUS station, and angle of progression (AoP), an ultrasound parameter commonly used for assessing labour progression, were obtained by individual obstetricians who were blinded to the results in all cases. The TUS station and DVE findings and AoP and DVE findings of the participants were compared. A second cohort requiring forceps delivery was analyzed to explore the relationship between TUS station and delivery difficulty.

Results: In the quantitative assessment of fetal head descent, the TUS station correlated with DVE findings. During the resting phase of labour, the TUS cut-off value for an easy forceps delivery was 2 cm, with a sensitivity of 85%; the maximum AUC value was 0.9 (95% confidence interval [CI]: 0.73-0.96). At the time of labour, the TUS cut-off value for an easy forceps delivery was 2.9 cm, with a sensitivity of 85%; the maximum AUC value was 0.8 (95% CI 0.65-0.96).

Conclusion: The TUS station may serve as a valuable and objective parameter for consideration in decisions regarding forceps delivery.

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使用经会阴超声站评估产钳分娩困难：一项前瞻性队列研究。

目的：探讨一种新型的经会阴超声（TUS）参数，即TUS站，在评估产程和预测产钳分娩困难中的临床应用。方法：在这项前瞻性队列研究中，在日本的一个三级围产期中心，对144名在2019年1月至2021年12月期间顺产的参与者的384张TUS图像进行了评估。包括单胎头位妊娠≥37周。阴道数字检查（DVE）的结果，TUS站和进展角（AoP），通常用于评估产程的超声参数，是由个别产科医生获得的，他们对所有病例的结果都是盲目的。比较受试者的TUS站和DVE结果以及AoP和DVE结果。分析第二组需要产钳分娩的队列，探讨us位与分娩困难的关系。结果：在胎儿头部下降的定量评估中，TUS站位与DVE表现相关。在分娩静息期，轻松产钳分娩的TUS临界值为2 cm，灵敏度为85%；最大AUC值为0.9（95%置信区间[CI]: 0.73-0.96）。分娩时，易产钳的TUS临界值为2.9 cm，灵敏度为85%；最大AUC值为0.8 （95% CI 0.65 ~ 0.96）。结论：在决定是否使用产钳时，TUS位置可作为一个有价值的客观参数。

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

Journal of Medical Ultrasonics 医学-核医学

CiteScore

3.30

自引率

11.10%

发文量

102

审稿时长

>12 weeks

期刊介绍： The Journal of Medical Ultrasonics is the official journal of the Japan Society of Ultrasonics in Medicine. The main purpose of the journal is to provide forum for the publication of papers documenting recent advances and new developments in the entire field of ultrasound in medicine and biology, encompassing both the medical and the engineering aspects of the science.The journal welcomes original articles, review articles, images, and letters to the editor.The journal also provides state-of-the-art information such as announcements from the boards and the committees of the society.