Abstract
Aims: Intrapartum translabial ultrasound [ITU] can be an objective, reproducible and more reliable method than digital vaginal examination when evaluating fetal head position and station in prolonged second stage of labor. However, two-dimensional (2D) ultrasound is not sufficient to demonstrate the ischial spines and other important “landmarks” of the female pelvis. Therefore, the purpose of this study was to evaluate the distance of the interspinous plane as a parallel line to the infrapubic line in 2D ITU with the help of 3D computed tomography and digital reconstruction.
Results: Mean distance between the infrapubic plane and the tip of the ischiadic spine was 32.35 (±4.46) mm. The mean height was 166 (±7) cm; the mean weight was 67.5 (±18.4) kg. Body height and the measured distance were significantly correlated (P=0.025; correlation coefficient of 0.5), whereas body weight was not (P=0.37; correlation coefficient of –0.214).
Conclusions: With the present results, clinicians were enabled to transfer the reproducible measurements of the “head station” by ITU to the widespread but observer-depending vaginal examination. Furthermore, ITU can be verified as an objective method in comparison to subjective palpation with the ability to optimize the evaluation of the head station according to bony structures as landmarks in a standardized application.
References
[1] DeLee JB. Principles and practice of obstetrics. 6th ed. Philadelphia, PA, USA: WB Saunders, 1933.Search in Google Scholar
[2] Maternal anatomy. In: Cunningham FG, Leveno KJ, Bloom SL, Haut JC, Gilstrap LC III, Wenstrom KD, editors. Williams obstetrics. 22nd ed. Columbus, OH, USA: McGraw-Hill, 2005. p. 15–38.Search in Google Scholar
[3] Greenhill JP, Friedman EA. Biological principles and modern practice of obstetrics. Philadelphia, PA, USA: WB Saunders, 1974.Search in Google Scholar
[4] Dupuis O, Ruimark S, Corinne D, Simone T, Andre D, Rene-Charles R. Fetal head position during the second stage of labor: comparison of digital vaginal examination and transabdominal ultrasonographic examination. Eur J Obstet Gynecol Reprod Biol. 2005;123:193–7.10.1016/j.ejogrb.2005.04.009Search in Google Scholar PubMed
[5] Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P, Cucherat M, et al. Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification. Am J Obstet Gynecol. 2005;192:868–74.10.1016/j.ajog.2004.09.028Search in Google Scholar PubMed
[6] Akmal S, Kametas N, Tsoi E, Hargreaves C, Nicolaides KH. Comparison of transvaginal digital examination with intrapartum sonography to determine fetal head position before instrumental delivery. Ultrasound Obstet Gynecol. 2003;21:437–40.10.1002/uog.103Search in Google Scholar PubMed
[7] Akmal S, Tsoi E, Nicolaides KH. Intrapartum sonography to determine fetal occipital position: interobserver agreement. Ultrasound Obstet Gynecol. 2004;24:421–4.10.1002/uog.1065Search in Google Scholar PubMed
[8] Dietz HP, Lanzarone V. Measuring engagement of the fetal head: validity and reproducibility of a new ultrasound technique. Ultrasound Obstet Gynecol. 2005;25:165–8.10.1002/uog.1765Search in Google Scholar PubMed
[9] Barbera AF, Imani F, Becker T, Lezotte DC, Hobbins JC. Anatomic relationship between the pubic symphysis and ischial spines and its clinical significance in the assessment of fetal head engagement and station during labor. Ultrasound Obstet Gynecol. 2009;33:320–5.10.1002/uog.6322Search in Google Scholar PubMed
[10] Barbera AF, Pombar X, Perugino G, Lezotte DC, Hobbins JC. A new method to assess fetal head descent in labor with transperineal ultrasound. Ultrasound Obstet Gynecol. 2009;33:313–9.10.1002/uog.6329Search in Google Scholar PubMed
[11] Ghi T, Farina A, Pedrazzi A, Rizzo N, Pelusi G, Pilu G. Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound. Ultrasound Obstet Gynecol. 2009;33:331–6.10.1002/uog.6313Search in Google Scholar PubMed
[12] Henrich W, Dudenhausen J, Fuchs I, Kamena A, Tutschek B. Intrapartum translabial ultrasound [ITU]: sonographic landmarks and correlation with successful vacuum extraction. Ultrasound Obstet Gynecol. 2006;28:753–60.10.1002/uog.3848Search in Google Scholar PubMed
[13] Eggebo TM, Gjessing LK, Heien C, Smedvig E, Okland I, Romundstad P, et al. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultrasound Obstet Gynecol. 2006;27:387–91.10.1002/uog.2744Search in Google Scholar PubMed
[14] Molina FS, Terra R, Carrillo MP, Puertas A, Nicolaides KH. What is the most reliable ultrasound parameter for assessment of fetal head descent? Ultrasound Obstet Gynecol. 2010;36:493–9.10.1002/uog.7709Search in Google Scholar
[15] Torkildsen EA, Salvesen KA, Eggebo TM. Agreement between 2D and 3D transperineal ultrasound methods in assessing fetal head descent in the first stage of labor. Ultrasound Obstet Gynecol. 2012;39:310–5.10.1002/uog.9065Search in Google Scholar
[16] Tutschek B, Braun T, Chantraine F, Henrich W. A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent. Br J Obstet Gynaecol. 2011;118:62–9.10.1111/j.1471-0528.2010.02775.xSearch in Google Scholar
[17] Kalache KD, Duckelmann AM, Michaelis SA, Lange J, Cichon G, Dudenhausen JW. Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the ‘angle of progression’ predict the mode of delivery? Ultrasound Obstet Gynecol. 2009;33:326–30.10.1002/uog.6294Search in Google Scholar
[18] Fasubaa OB, Ezechi OC, Orji EO, Ogunniyi SO, Akindele ST, Loto OM, et al. Delivery of the impacted head of the fetus at caesarean section after prolonged obstructed labour: a randomised comparative study of two methods. J Obstet Gynaecol. 2002;22:375–8.10.1080/01443610220141290Search in Google Scholar
[19] Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet. 2001;358:1203–7.10.1016/S0140-6736(01)06341-3Search in Google Scholar
[20] Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med. 1999;341:1709–14.10.1056/NEJM199912023412301Search in Google Scholar PubMed
[21] Yeo L, Romero R. Sonographic evaluation in the second stage of labor to improve the assessment of labor progress and its outcome. Ultrasound Obstet Gynecol. 2009;33:253–8.10.1002/uog.6336Search in Google Scholar PubMed PubMed Central
[22] Bamberg C, Dückelmann AM, Teichgräber U, Henrich W, Dudenhausen JW, Kalache KD, et al. Angle of progression measurements of fetal head at term: a systematic comparison between open magnetic resonance imaging and transperineal ultrasound. Am J Obstet Gynecol. 2012;206:161.e1–5.10.1016/j.ajog.2011.10.867Search in Google Scholar PubMed
[23] Extract of Statistical Yearbook, Berlin, Germany, 2012.Search in Google Scholar
The authors stated that there are no conflicts of interest regarding the publication of this article.
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