Sonographic pattern of fetal head descent: Relationship with duration of active second stage of labor and occiput position at delivery
| Autor: | Gianluigi Pilu, Elisa Maroni, Tullio Ghi, Antonio Maria Morselli-Labate, Elisa Montaguti, Aly Youssef, Nicola Rizzo, Alexandro Paccapelo |
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| Přispěvatelé: | Ghi, T, Maroni, E, Youssef, A, Morselli-Labate, Am, Paccapelo, A, Montaguti, E, Rizzo, N, Pilu, G. |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors Vacuum Extraction Obstetrical Birth weight Kaplan-Meier Estimate labor persistent occiput posterior Ultrasonography Prenatal Labor Presentation Labor Stage Second Pregnancy intrapartum ultrasound medicine Humans second stage three-dimensional Radiology Nuclear Medicine and imaging Fetal head Mass index Prospective Studies Stage (cooking) Fetus Radiological and Ultrasound Technology business.industry Obstetrics Cesarean Section Ultrasound Obstetrics and Gynecology Occiput General Medicine Surgery medicine.anatomical_structure Logistic Models Reproductive Medicine Oxytocin Female business Head medicine.drug |
| Popis: | Objectives The objectives of this study were firstly to assess the longitudinal changes of various sonographic parameters of fetal head progression in relation to length of active second stage of labor, and secondly to compare ultrasound findings obtained longitudinally among fetuses with persistent occiput posterior (OP) vs those with persistent occiput anterior (OA) position. Methods From a series of nulliparous low-risk women at term attending the labor ward of our university hospital, transperineal ultrasound volumes were prospectively acquired at the beginning of the active second stage (T1) and at 40-min intervals thereafter until delivery (T2, T3). Sonographic parameters were derived from offline analysis of each volume, including the angle of progression (AoP), progression distance (PD), head–symphysis distance (HSD), head direction (HD) and midline angle. These parameters were compared between patients who delivered within 60 min from the beginning of the active second stage of labor (early delivery) and those who remained undelivered by that time (late delivery). Fetal head position was determined from stored digital images of transabdominal examinations performed at the beginning of the active second stage. Comparison was performed between fetuses with OA and those with persistent OP position at delivery. Results Spontaneous vaginal delivery was achieved in 58 (81.7%) cases, whereas vacuum extraction and Cesarean section were performed in eight (11.3%) and five (7.0%) cases, respectively. Delivery was achieved within 60 min from the beginning of the active second stage in 44 (62.0%) patients. In the early vs late delivery groups, measurements of AoP, HSD and PD at T1 were significantly different (AoP, 143.9 ± 20.5° vs 125.3 ± 15.0°, P |
| Databáze: | OpenAIRE |
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