Ultrasound in labour & delivery


131 111 3MB

English Pages [45]

Report DMCA / Copyright

DOWNLOAD PDF FILE

Table of contents :
Ultrasound in monitoring the progress of labour
Slide Number 2
Slide Number 3
Slide Number 4
Why ultrasound in labor?
To start with
Intracranial hemorrage in singleton term fetuses and mode of delivery California 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 depressed skull fractures Dupuis et al: AJOG (2005) 192, 165e70
Cranial trauma and intra-partum deaths: Confidential enquiry BJOG (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 morbidity Ponkey 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 morbidity Cheng et al: Obstet Gynecol 2006;107:837–44
Encephalopathy in term infants Badawi: BMJ 1998; 317:1154
Errors in the clinical prediction of posterior occiput Akmal et al: Ultrasound Obstet Gynecol 2003; 21: 437–440
Frequency of occiput posterior Akmal et al: Ultrasound Obstet Gynecol 2004; 24: 425
Probability of persistent occiput posterior at delivery Akmal et al: Ultrasound Obstet Gynecol 2004; 24: 425
ACOG classification of operative delivery
Birth simulator: Reliability of clinical assessment Dupuis et al: AJOG:(2005) 192, 868–74
Translabial (infrapubic) ultrasound: the sagittal view
Slide Number 25
3D ultrasound in second stage of labor
Slide Number 27
Slide Number 28
Normal head descent
Slide Number 30
Progression angle Barbera: ACOG DVD, 2004
Angle of progression: probability of spontaneous delivery and successful vacuum extraction
Slide Number 33
Head direction Henrich: 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: 753–760 Ghi et al: Ultrasound Obstet Gynecol 2009; 33: 331–336
Ghi et al: Ultrasound Obstet Gynecol 2009; 33: 331–336
Progression distance Dietz & Lanzarone, UOG 2005; 25: 165–168
Slide Number 39
Slide Number 40
Correlation between sonography of fetal head rotation and digital examinations (occiput anterior only)
Caveat: the posterior occiput
Slide Number 43
Labor is a dynamic process
Ultrasound in labor?
Recommend Papers

Ultrasound in labour & delivery

  • Author / Uploaded
  • ISUOG
  • 0 0 0
  • Like this paper and download? You can publish your own PDF file online for free in a few minutes! Sign Up
File loading please wait...
Citation preview

Ultrasound in monitoring the progress of labour

Background •Clinical evaluation of fetal head station and position in stage 2 of labour requires much expertise and is highly subjective •Critical findings to suspect obstructed labour or to decide how to expedite delivery when indicated •Ultrasound in labour may assist obstetrician

Background Right

Pelvic Inlet

Station=0

Left

Angle ≥45°

Background Right

Midpelvis

Left

Ischiatic spines

Station >+2 0/+2 cm cm