Miyuki Muramoto1, Kiyotake Ichizuka2, Junichi Hasegawa3, Masamitsu Nakamura3, Satoshi Dohi2, Hiroshi Saito2, Masaaki Nagatsuka2. 1. Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuduki-ku, Yokohama-shi, Kanagawa, 224-8503, Japan. miyukin347525@hotmail.co.jp. 2. Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuduki-ku, Yokohama-shi, Kanagawa, 224-8503, Japan. 3. Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: To clarify whether intrapartum transperineal ultrasound (ITU) can be used to evaluate uterine contraction intensity, and whether the intensity is associated with the duration of the second stage. METHODS: A prospective observational study was performed involving 86 women with a normal singleton term fetus and more than three contractions every 10 min. ITU was performed for contractile and non-contractile periods of labor at the beginning of the second stage, and one representative "angle of progression (AoP)" image was selected for each period. The Mann-Whitney U test was used to compare ∆AoP, the difference between the two angles, depending on the duration of the second stage. Receiver operating characteristic curves were used to evaluate the probability of duration of the second stage ≤50 min in nulliparous women. RESULTS: Among nulliparous women, ΔAoP differed significantly according to the duration of the second stage (52.5° ± 5.0° for ≤50 min vs. 30.9° ± 2.1° for >50 min; P < 0.001). Receiver operating characteristic curve analysis showed that approximately 85% of nulliparous women with ΔAoP greater than 40° delivered within 50 min. CONCLUSION: These findings could be utilized in the evaluation of uterine contraction intensity, and ∆AoP measurement could be used to predict the duration of the second stage of labor in nulliparous women.
PURPOSE: To clarify whether intrapartum transperineal ultrasound (ITU) can be used to evaluate uterine contraction intensity, and whether the intensity is associated with the duration of the second stage. METHODS: A prospective observational study was performed involving 86 women with a normal singleton term fetus and more than three contractions every 10 min. ITU was performed for contractile and non-contractile periods of labor at the beginning of the second stage, and one representative "angle of progression (AoP)" image was selected for each period. The Mann-Whitney U test was used to compare ∆AoP, the difference between the two angles, depending on the duration of the second stage. Receiver operating characteristic curves were used to evaluate the probability of duration of the second stage ≤50 min in nulliparous women. RESULTS: Among nulliparous women, ΔAoP differed significantly according to the duration of the second stage (52.5° ± 5.0° for ≤50 min vs. 30.9° ± 2.1° for >50 min; P < 0.001). Receiver operating characteristic curve analysis showed that approximately 85% of nulliparous women with ΔAoP greater than 40° delivered within 50 min. CONCLUSION: These findings could be utilized in the evaluation of uterine contraction intensity, and ∆AoP measurement could be used to predict the duration of the second stage of labor in nulliparous women.
Entities:
Keywords:
Angle of progression; Intrapartum transperineal ultrasound; Nulliparous women; Second stage of labor; Uterine contraction intensity
Authors: A Youssef; F Bellussi; E Montaguti; E Maroni; G Salsi; A M Morselli-Labate; A Paccapelo; N Rizzo; G Pilu; T Ghi Journal: Ultrasound Obstet Gynecol Date: 2014-01-13 Impact factor: 7.299
Authors: T Ghi; E Maroni; A Youssef; A M Morselli-Labate; A Paccapelo; E Montaguti; N Rizzo; G Pilu Journal: Ultrasound Obstet Gynecol Date: 2014-05-28 Impact factor: 7.299