Assessment of the angle of progression and distance perineum-head in the prediction of type of delivery and duration of labor using intrapartum ultrasonography.
| Autor: | Carvalho Neto RH; Maternal Fetal Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza, Brazil., Viana Junior AB; Maternal Fetal Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza, Brazil., Moron AF; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil., Araujo Júnior E; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil., Carvalho FHC; Maternal Fetal Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza, Brazil., Feitosa HN; Maternal Fetal Medicine Service, Assis Chateaubriand Maternity, Federal University of Ceará (UFC), Fortaleza, Brazil.; Department of Obstetrics and Gynecology, University of Fortaleza (UNIFOR), Fortaleza, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2021 Jul; Vol. 34 (14), pp. 2340-2348. Date of Electronic Publication: 2019 Sep 18. |
| DOI: | 10.1080/14767058.2019.1666818 |
| Abstrakt: | Objective: To evaluate the relevance of the angle of progression (AOP) and head-perineum distance (HPD) for predicting the type of delivery and duration of the second stage of labor using intrapartum ultrasonography. Methods: In total, 221 women in labor with a single gestational sac at ≥37 weeks of gestation and fetuses in cephalic presentation underwent two-dimensional ultrasonography by transperineal route for measurements of AOP and HPD. Correlations between the type of delivery (vaginal or surgical (cesarean section and forceps)), duration of the second stage of labor, and fetal and maternal characteristics were assessed. AOP and HPD variables were separately studied in the first and second stages of labor. Multivariate logistic regression was followed in stages to identify the predictors for the surgical delivery outcome - stepwise forward method. Results: In total, 153 (69.2%) women underwent vaginal deliveries, 7 (3.2%) underwent forceps deliveries, and 61 (27.6%) underwent cesarean deliveries. AOP was a statistically significant parameter in first and second stages of labor (107.8 ± 12.1° versus 100.8 ± 13.7°; p = .017), with an inverse correlation with the occurrence of vaginal delivery. HPD was a statistically significant parameter in the second stage of labor (3.42 ± 0.84 cm versus 4.17 ± 0.54 cm; p < .003), with a direct correlation with the occurrence of surgical delivery. The value of AOP that optimized the curve was 129.9° with 85% specificity and 63% sensitivity for the vaginal delivery endpoint. The value of HPD that optimized the curve was 4.3 cm with 69% specificity and 89% sensitivity for the surgical delivery endpoint. In the first phase, the variables defining the type of delivery were the following: height, body mass index, and AOP. In the second phase, the variables defining were the following: height, labor analgesia, HPD, and position of the fetal occiput. Conclusion: AOP and HPD determined by intrapartum ultrasonography were associated with duration of labor, which may aid in predicting the type of delivery in association with clinical parameters. |
| Databáze: | MEDLINE |
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