Evaluation of the labour process with serial transperineal ultrasonography and prediction of the type of birth

Abstract

Abstract Objectives The purpose of this study is to follow the birth process with transperineal ultrasonography (TPU) and predict the delivery method using angle of progression (AOP). Methods The study included 134 patients. The AOP was examined with TPU in the lithotomy position applied at 4-h intervals, not at a time of straining or contractions. The relationship was examined between AOP and those who continued with vaginal delivery, and those who underwent caesarean section delivery. Results A total of 122 (91%) patients had vaginal delivery and 12 (9%) patients had cesarean delivery. In patients giving vaginal delivery, progress in AOP was observed in every 4-h measurement, but not in patients with cesarean section. In the ROC analysis, if 70% sensitivity and 75% specificity with AOP degree >132.5°, the patient was expected to have vaginal delivery with a probability of 77.5% (95% CI 0.62–0.93; p=0.002). Conclusions Rather than repeating digital examinations, the labour process can be monitored with serial TPU and the type of delivery can be predicted. There is a need for further studies for the measurement of AOP with TPU to become a part of clinical practice in the monitoring of the whole labour process.