Saeko Kameyama1, Akira Sato2, Hiroshi Miura1, Jin Kumagai1, Naoki Sato1, Dai Shimizu1, Kenichi Makino1, Yukihiro Terada1. 1. Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. 2. Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. satoa@doc.med.akita-u.ac.jp.
Abstract
PURPOSE: To investigate whether transperineal ultrasound examination just after full cervical dilatation is determined can predict the mode of delivery. METHODS: This was a prospective observational study of pregnant women. After full cervical dilatation was determined by vaginal examination during labor, transperineal ultrasound was immediately performed, and the head direction (HD), progression distance (PD), and angle of progression (AoP) were measured. The cases were divided into two groups: spontaneous vaginal delivery and operative delivery due to failure of progression. Differences between the groups were statistically analyzed using Student's t test and Fisher's exact test. RESULTS: Of the 50 women, 42 had spontaneous vaginal deliveries and 8 had vacuum extractions. The spontaneous delivery group had significantly higher HD, PD, and AoP values than the vacuum extraction group. The areas under the receiver-operating characteristic curves for the prediction of spontaneous vaginal delivery were 0.850 for HD, 0.827 for PD, and 0.783 for AoP. The optimum cut-off points and positive predictive values were 83° and 92.9 % for HD, 56 mm and 94.9 % for PD, and 146° and 94.3 % for AoP, respectively. CONCLUSION: Transperineal ultrasound examination just after full cervical dilatation was determined was useful in predicting spontaneous vaginal delivery.
PURPOSE: To investigate whether transperineal ultrasound examination just after full cervical dilatation is determined can predict the mode of delivery. METHODS: This was a prospective observational study of pregnant women. After full cervical dilatation was determined by vaginal examination during labor, transperineal ultrasound was immediately performed, and the head direction (HD), progression distance (PD), and angle of progression (AoP) were measured. The cases were divided into two groups: spontaneous vaginal delivery and operative delivery due to failure of progression. Differences between the groups were statistically analyzed using Student's t test and Fisher's exact test. RESULTS: Of the 50 women, 42 had spontaneous vaginal deliveries and 8 had vacuum extractions. The spontaneous delivery group had significantly higher HD, PD, and AoP values than the vacuum extraction group. The areas under the receiver-operating characteristic curves for the prediction of spontaneous vaginal delivery were 0.850 for HD, 0.827 for PD, and 0.783 for AoP. The optimum cut-off points and positive predictive values were 83° and 92.9 % for HD, 56 mm and 94.9 % for PD, and 146° and 94.3 % for AoP, respectively. CONCLUSION: Transperineal ultrasound examination just after full cervical dilatation was determined was useful in predicting spontaneous vaginal delivery.
Entities:
Keywords:
Angle of progression; Head direction; Labor; Progression distance; Transperineal ultrasound
Authors: Y Gilboa; Z Kivilevitch; M Spira; A Kedem; E Katorza; O Moran; R Achiron Journal: Ultrasound Obstet Gynecol Date: 2013-03-13 Impact factor: 7.299