ArticleMedical science monitor : international medical journal of experimental and clinical research2024
Predicting Vaginal Delivery Success: Role of Intrapartum Transperineal Ultrasound Angle of Descent at a Single Center.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND Assessment of labor progress via digital vaginal examination is subjective, while intrapartum transperineal ultrasonography is deemed more objective and effective. The angle of descent (AoD) is a reliable intrapartum transperineal ultrasound parameter with minimal inter-observer and intra-observer errors. This study compared intrapartum transperineal ultrasonography with digital vaginal examination in evaluating the angle of descent for vaginal delivery selection in 70 women. MATERIAL AND METHODS This cross-sectional study was conducted at Dr. Mohammad Hoesin Hospital Palembang in Indonesia, using a consecutive sampling method to measure AoD of 70 patients at admission and every 2 h during labor progression. Patients were monitored until childbirth, and outcomes of successful vaginal or cesarean delivery were reported. A diagnostic test determined the optimal AoD for predicting successful vaginal delivery and its predictive value. RESULTS The study included 70 patients with a mean age of 28.29±6.09 years and a body mass index of 30.59±3.49 kg/m². Among them, 29 (41%) had successful vaginal deliveries. Adequate contraction frequency at admission was strongly associated with successful vaginal delivery (P<0.001). The optimal AoD for predicting successful vaginal delivery was 94.5°, with an area under the curve of 0.567 (95% CI 0.425-0.710), sensitivity of 84.2%, specificity of 45.7%, and accuracy of 54.3%. CONCLUSIONS Intrapartum transperineal ultrasonography for measuring AoD can be a valuable adjunct in labor management. Further investigations are needed to validate the optimal AoD in Indonesian pregnant women.
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