The Role and Place of Intranatal Ultrasonography in Modern Obstetrics

Abstract

Intranatal ultrasonography is considered an auxiliary method, but its use may be of some importance in assessing the clinical situation and in making decisions on the tactics of patient management. This method is recommended for determining the position and presentation of the fetus, in case of difficulty with palpation, to determine the fetal heartbeat, if it is impossible or difficult to do it in another way, in the presence of bloody discharge from the genital tract to determine the previa or premature placental abruption. Intranatal ultrasonography is important to determine the tactics of further labor management after the birth of the first fetus in multiple pregnancies. However, there are also conflicting positions. It is believed that intrapartum ultrasonography is inappropriate and uninformative for determining the fetal body weight in labor, although it can be used to control the fetal movement through the birth canal; to determine the functional state of the fetus in childbirth using Doppler, although in some cases this is the only way to find out about the state of the fetus; to detect collisions and entanglement with the umbilical cord, although this is an important point in twins or in fetal distress. However, the informativeness of intrapartum ultrasound has not been sufficiently studied and can be used in clinical practice only after conducting scientific research, especially in cases of assessing the state of the scar on the uterus, to predict the results of induction of labor by measuring the length of the cervix before labor induction; to assess the progress of the head in the second stage of labor in order to choose the method of delivery (through the vaginal birth canal or cesarean section), as well as to predict the estimated time of completion of the second stage of labor. The introduction of the principles of evidence-based medicine in ultrasound diagnostics in obstetric and gynecological practice allows developing modern differentiated approaches to antenatal monitoring in the presence of high perinatal risk factors, however, there is extremely insufficient data for the use of intrapartum ultrasound diagnostics. Currently, the use of ultrasonography in childbirth is presented by the International Society for Ultrasound in Obstetrics and Gynecology in the form of guidelines. Conclusion. The use of intrapartum ultrasonography requires additional equipment of maternity wards with equipment, as well as training of specialists to obtain the necessary qualifications. However, the introduction of ultrasound monitoring of the course of labor in clinical practice can be an effective way to reduce the level of perinatal pathology and the financial costs associated with nursing newborns