Intrapartum sonographic assessment of the fetal head flexion in protracted active phase of labor and association with labor outcome: a multicenter, prospective study.
TL;DR: In this article, the authors evaluated the relationship between the transabdominal sonographic indices of fetal head flexion and the mode of delivery in women with protracted active phase of labor.
About: This article is published in American Journal of Obstetrics and Gynecology.The article was published on 2021-03-04. It has received 14 citations till now. The article focuses on the topics: Fetal head & Vaginal delivery.
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TL;DR: This recommendation document follows the mission of the World Association of Perinatal Medicine and aims to bring together groups and individuals throughout the world for standardization to implement the ultrasound evaluation in labor ward and improve the clinical management of labor.
Abstract: Abstract This recommendation document follows the mission of the World Association of Perinatal Medicine in collaboration with the Perinatal Medicine Foundation. We aim to bring together groups and individuals throughout the world for standardization to implement the ultrasound evaluation in labor ward and improve the clinical management of labor. Ultrasound in labor can be performed using a transabdominal or a transperineal approach depending upon which parameters are being assessed. During transabdominal imaging, fetal anatomy, presentation, liquor volume, and placental localization can be determined. The transperineal images depict images of the fetal head in which calculations to determine a proposed fetal head station can be made.
10 citations
22 Jul 2021
TL;DR: In this article, the use of intrapartum ultrasound to assess fetal position and presentation, in addition to fetal attitude, to predict and aid in decision making regarding delivery can help in improving management decision making.
Abstract: Fetuses with malpresentation and malposition during labor represent important clinical challenges. Women with fetuses presenting with malpresentation or malposition are at risk of increased perinatal complications, such as cesarean delivery, failure of operative vaginal delivery, neonatal acidemia, and neonatal intensive care admission. Intrapartum ultrasound has been found to be more reliable than digital examination in assessing malpresentation and malposition. The use of intrapartum ultrasound to assess fetal position and presentation, in addition to fetal attitude, to predict and aid in decision making regarding delivery can help in improving management decision making. Cephalic malpresentation and malposition is a unique subset of fetal orientation and can benefit from intrapartum ultrasound identification and assessment for delivery.
5 citations
15 Jul 2021
TL;DR: The first stage of labor is from the start of active labor until the cervix is fully dilatated as discussed by the authors, and a clinical examination has traditionally been done to assess labor progress during this stage, to assess cervical dilatation, fetal head position, and fetal head station.
Abstract: The first stage of labor is from the start of active labor until the cervix is fully dilatated. To assess labor progress during this stage, a clinical examination has traditionally been done. The cervical dilatation, fetal head position, and fetal head station are evaluated. Moreover, these observations can be made with an ultrasound examination. Studies have shown that traditional clinical examinations are subjective, have poor reproducibility, and are unreliable. Ultrasound examinations of the fetal head station and fetal head position in the first stage of labor might predict labor outcome and mode of delivery and can help in decision making when prolonged first stage of labor is diagnosed.
4 citations
TL;DR: An overview of fetal descent examined with ultrasound can be found in this article, where a transperineal scan of the proximal part of the fetal head above the pelvic inlet is performed.
4 citations
22 Jul 2021
3 citations
References
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TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
Abstract: Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
15,454 citations
TL;DR: Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of the most common indications, including labor dystocia, abnormal or indeterminate fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia.
1,033 citations
National Institutes of Health1, Georgetown University2, University of Utah3, Baystate Medical Center4, Maimonides Medical Center5, Cedars-Sinai Medical Center6, Summa Health System7, University of Texas Health Science Center at Houston8, MetroHealth9, University of Miami10, University of Illinois at Chicago11, Christiana Care Health System12
TL;DR: In a large, contemporary population, the rate of cervical dilation accelerated after 6 cm, and progress from 4 cm to 6 cm was far slower than previously described.
617 citations
TL;DR: Key points were identified to assist with reduction in cesarean delivery rates including that labor induction should be performed primarily for medical indication; if done for nonmedical indications, the gestational age should be at least 39 weeks or more and the cervix should be favorable, especially in the nulliparous patient.
569 citations
TL;DR: Among primary cesarean deliveries, more subjective indications (nonreassuring fetal status and arrest of dilation) contributed larger proportions than more objective indications (malpresentation, maternal-fetal, and obstetric conditions).
564 citations