Caterina Pizzicaroli1,2, Carlotta Montagnoli3, Ilaria Simonelli4, Maria Grazia Frigo5, Herbert Valensise6, Mario Filippo Segatore7, Giovanni Larciprete7. 1. Department of Obstetrics and Gynaecology, Fatebenefratelli Isola Tiberina Hospital, Rome, Italy. caterina.pizzicaroli@gmail.com. 2. Fatebenefratelli Isola tiberina Hospital, Via di Ponte Quattro capi, 39, 00186, Rome, Italy. caterina.pizzicaroli@gmail.com. 3. Department of Obstetrics and Gynaecology, San Matteo degli infermi Hospital, Spoleto, Italy. 4. Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, AFaR Division, Rome, Italy. 5. Department of Anaesthesiology, Fatebenefratelli Isola Tiberina Hospital, Rome, Italy. 6. Department of Obstetrics and Gynaecology, Tor Vergata University, Policlinico Casilino, Rome, Italy. 7. Department of Obstetrics and Gynaecology, Fatebenefratelli Isola Tiberina Hospital, Rome, Italy.
Abstract
PURPOSE: The aim of the study was to evaluate the progression and rotation of the fetal head during the second stage of labor using translabial ultrasound and to compare ultrasonographic data obtained in nulliparous women both receiving and not receiving neuraxial analgesia. METHODS: The 49 patients enrolled in the study were divided into two groups according to receiving or not receiving neuraxial analgesia. Every half hour from full dilation to delivery, the ultrasonographic translabial parameters of Angle of Progression, Head Symphysis Distance, and Midline Angle were obtained and recorded by a single operator. Then, these records were compared between the two groups of patients. RESULTS: Patients that underwent neuraxial analgesia presented with increased duration of the second stage of labor, with mean values of Angle of Progression significantly higher and of Midline Angle significantly lower for each time interval studied compared to patients without analgesia. A borderline significant relationship was found between administration of neuraxial analgesia and Head Symphysis Distance. CONCLUSIONS: In this study, we demonstrated that combined spinal-epidural analgesia influences the duration of the second stage of labor and the initial progression and rotation of the fetal head through the birth canal, but not the kind of delivery. A correlation between Angle of Progression values and success in the application of a vacuum has been reported by other authors and confirmed in our study.
PURPOSE: The aim of the study was to evaluate the progression and rotation of the fetal head during the second stage of labor using translabial ultrasound and to compare ultrasonographic data obtained in nulliparous women both receiving and not receiving neuraxial analgesia. METHODS: The 49 patients enrolled in the study were divided into two groups according to receiving or not receiving neuraxial analgesia. Every half hour from full dilation to delivery, the ultrasonographic translabial parameters of Angle of Progression, Head Symphysis Distance, and Midline Angle were obtained and recorded by a single operator. Then, these records were compared between the two groups of patients. RESULTS:Patients that underwent neuraxial analgesia presented with increased duration of the second stage of labor, with mean values of Angle of Progression significantly higher and of Midline Angle significantly lower for each time interval studied compared to patients without analgesia. A borderline significant relationship was found between administration of neuraxial analgesia and Head Symphysis Distance. CONCLUSIONS: In this study, we demonstrated that combined spinal-epidural analgesia influences the duration of the second stage of labor and the initial progression and rotation of the fetal head through the birth canal, but not the kind of delivery. A correlation between Angle of Progression values and success in the application of a vacuum has been reported by other authors and confirmed in our study.
Entities:
Keywords:
Fetal head rotation; Neuraxial analgesia; Nulliparous woman; Operative delivery; Second stage of labor; Translabial ultrasound
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