Asynclitism and Its Ultrasonographic Rediscovery in Labor Room to Date: A Systematic Review

Autor: Antonio Malvasi, Marina Vinciguerra, Bruno Lamanna, Eliano Cascardi, Gianluca Raffaello Damiani, Giuseppe Muzzupapa, Ioannis Kosmas, Renata Beck, Maddalena Falagario, Antonella Vimercati, Ettore Cicinelli, Giuseppe Trojano, Andrea Tinelli, Gerardo Cazzato, Miriam Dellino
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Diagnostics, Vol 12, Iss 12, p 2998 (2022)
Druh dokumentu: article
ISSN: 12122998
2075-4418
DOI: 10.3390/diagnostics12122998
Popis: Asynclitism, the most feared malposition of the fetal head during labor, still represents to date an unresolved field of interest, remaining one of the most common causes of prolonged or obstructed labor, dystocia, assisted delivery, and cesarean section. Traditionally asynclitism is diagnosed by vaginal examination, which is, however, burdened by a high grade of bias. On the contrary, the recent scientific evidence highly suggests the use of intrapartum ultrasonography, which would be more accurate and reliable when compared to the vaginal examination for malposition assessment. The early detection and characterization of asynclitism by intrapartum ultrasound would become a valid tool for intrapartum evaluation. In this way, it will be possible for physicians to opt for the safest way of delivery according to an accurate definition of the fetal head position and station, avoiding unnecessary operative procedures and medication while improving fetal and maternal outcomes. This review re-evaluated the literature of the last 30 years on asynclitism, focusing on the progressive imposition of ultrasound as an intrapartum diagnostic tool. All the evidence emerging from the literature is presented and evaluated from our point of view, describing the most employed technique and considering the future implication of the progressive worldwide consolidation of asynclitism and ultrasound.
Databáze: Directory of Open Access Journals
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