The Usefulness of Intrapartum Transperineal Ultrasonography for the Prediction of Mode of Delivery

E. Sarıdoğan, O. Moraloğlu Tekin
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Abstract

OBJECTIVE: We aimed to assess the accuracy of intrapartum transperineal ultrasonography that is non-invasive, easy to learn, rapid to perform, comfortable for pregnant women, and low-cost method to evaluate the progress of labor objectively.STUDY DESIGN: We evaluated two hundred-ten singleton pregnant women at term with cephalic presentation who went into active labor via intrapartum transperineal ultrasonography using the angle of progression and head-perineum distance. Maternal characteristics, conventional vaginal examination findings, mode of delivery, and neonatal results were noted. The data were compared using correlation and regression analysis.RESULTS: The relationships between the descent of clinical fetal head station, the increase of angle of progression (p=0.001), and the decrease of head-perineum distance (p=0.001) were statistically significant. The receiver operating characteristics curve showed that measurement of angle of progression with <110.5 degrees (p=0.001) and measurement of head-perineum distance with >52.5 millimeters (p=0.001) were associated with emergent cesarean delivery. For the prediction of delivery mode, both angle of progression and head-perineum distance had high sensitivity and specificity.CONCLUSIONS: Intrapartum transperineal ultrasonography parameters were in agreement with each other and conventional vaginal examination for determination of delivery mode. Head-perineum distance was a parity-dependent measurement whilst angle of progression was parity-independent.
产时经会阴超声对预测分娩方式的作用
目的:探讨一种无创、易学、快速、孕妇舒适、低成本的产时经会阴超声检查客观评价产程的准确性。研究设计:我们通过产时经会阴超声检查,利用进展角和头-会阴距离,评估了210例头侧表现的足月单胎孕妇。记录了产妇特征、常规阴道检查结果、分娩方式和新生儿结果。采用相关分析和回归分析对数据进行比较。结果:临床胎头位下降、进展角增大(p=0.001)与头会阴距离减小(p=0.001)之间的关系均有统计学意义。受试者工作特征曲线显示,52.5 mm的进位角与剖宫产相关(p=0.001)。对于分娩方式的预测,推进角度和头-会阴距离均具有较高的敏感性和特异性。结论:产时经会阴超声参数与常规阴道检查确定分娩方式基本一致。头会阴距离与奇偶相关,而前进角度与奇偶无关。
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