Ultrasound in labour & delivery

Table of contents :
Ultrasound in monitoring the progress of labour
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Why ultrasound in labor?
To start with
Intracranial hemorrage in singleton term fetuses and mode of deliveryCalifornia database of 583,340 nulliparous singletons deliveries 2500-4000 grms: NEJM341:1709, 1999
Fetal lesions during C-section (multicentric study of 37110 CS)Alexander et al: Obstet Gynecol 2006;108:885–90
Obstetric depressedskull fracturesDupuis et al: AJOG (2005) 192, 165e70
Cranial trauma and intra-partum deaths: Confidential enquiryBJOG (2005) 112, 619–626
Fetal head position
Persistent posterior occiput
Frequency of posterior occiput Ponkey et al: Obstet Gynecol 2003;101:915
Probability of spontaneous vaginal delivery with persistent occiput posterior
Posterior occiput:maternal morbidityPonkey et al: Obstet Gynecol 2003;101:915
Risk factors for anal sphyncter laceration with forceps Benavides et al:Am J Obstet Gynecol (2005) 192, 1702
Posterior occiput: fetal morbidityCheng et al: Obstet Gynecol 2006;107:837–44
Encephalopathy in term infantsBadawi: BMJ 1998; 317:1154
Errors in the clinical prediction of posterior occiputAkmal et al: Ultrasound Obstet Gynecol 2003; 21: 437–440
Frequency of occiput posteriorAkmal et al: Ultrasound Obstet Gynecol 2004; 24: 425
Probability of persistent occiput posterior at deliveryAkmal et al: Ultrasound Obstet Gynecol 2004; 24: 425
ACOG classification of operative delivery
Birth simulator:Reliability of clinical assessmentDupuis et al: AJOG:(2005) 192, 868–74
Translabial (infrapubic) ultrasound:the sagittal view
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3D ultrasound in second stage of labor
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Normal head descent
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Progression angleBarbera: ACOG DVD, 2004
Angle of progression:probability of spontaneous delivery and successful vacuum extraction
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Head directionHenrich: UOG 2006; 28: 753–760
Correlation between sonography of fetal head direction and digital examinations(Ghi et al: Ultrasound Obstet Gynecol 2009; 33: 331–336)
Head direction and vacuum Henrich et al: Ultrasound Obstet Gynecol 2006; 28: 753–760Ghi et al: Ultrasound Obstet Gynecol 2009; 33: 331–336
Ghi et al: Ultrasound Obstet Gynecol 2009; 33: 331–336
Progression distanceDietz & Lanzarone, UOG 2005; 25: 165–168
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Correlation between sonography of fetal head rotation and digital examinations (occiput anterior only)
Caveat:the posterior occiput
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Labor is a dynamic process
Ultrasound in labor?