Correlation Between the Head Progression Distance Using Intrapartum Transperineal Ultrasound and the Bishop Score Using Digital Examination in Assessment of Labor Progress

Abstract

Aim: Evaluation of the role of head progression distance (PD) using the transperineal ultrasound (TPUS) in assessment of progress of labor. Materials and Methods: This study conducted on 60 cases admitted to El-Shatby Maternity University Hospital in active phase of labor, at full term with singleton pregnancy presented by vertex. We measured the head progression distance (PD) in each case on admission, after 1 hour and after 2 hours (using transperineal ultrasound) and correlated it with the Bishop score by digital examination. We documented also the mode of delivery in all cases. Results: The mean head progression distance (PD) had a statistically significant association with the fetal head station on admission, after 1 hour and after 2 hours. HPD will get longer with the progress of labor with the fetal head descent. The sensitivity of Bishop score on admission to predict the mode of delivery was 58.33% at cut-off 7, after 1 hour it was 75% at cut-off 9 and after 2 hours it was 91.67% at cut-off 10. The sensitivity of head progression distance (PD) on admission to predict the mode of delivery was 66.67% at cut-off 44mm, after 1 hour it was 75% at cut-off 51mm and after 2 hours it was 91.67% at cut-off 63mm. Conclusion: Head progression distance (PD) measurement using intrapartum transperineal ultrasound (TPUS) is correlated with Bishop score using digital examination. The increasing PD with progress of labor is associated with more likelihood of vaginal delivery. PD can be used for objective assessment of progress of labor.