Role of transperineal ultrasound measurements in women with prolonged second stage of labor as predictors of the mode of delivery

Abstract

Aim of the work: To assess the clinical significance of transperineal ultrasound measurements, the angle of progression and the head progression distance in prediction of the mode of delivery in women with prolonged second stage of labor. Subjects and methods: 60 women with a live singleton fetus at full term who presented with prolonged second stage of labor were enrolled in our study. Transperineal ultrasound was used for determination of both angle of progression and head progression distance. We statistically analyzed the relationship between the ultrasound measurements and the different modes of delivery. Results: 32 women had spontaneous vaginal delivery, 13 women had assisted vaginal delivery using vacuum extraction and the remaining 15 women had a cesarean section. A statistically significant difference was found between the angle of progression and the mode of delivery, however there was no statistically significant difference between head progressive distance and different modes of delivery. The angle of head progression correlated with the mode of delivery using logistic regression analysis with a probability of 85.5% for an angle of 120°. Conclusion: Angle of progression measured by transperineal ultrasound, is an easy, simple, reliable, and noninvasive method for prediction of mode of delivery in women with prolonged second stage of labor rather than head progression distance.

Keywords

• Transperineal
• Ultrasound
• Prolonged
• Labor
• Progression