Search

Ultrasonography represents an important diagnostic tool used nowadays to better understand the complex process of delivery and its perturbations in order to ensure delivering a healthy baby to a healthy mother. Intrapartum ultrasound (IPU) offers a greater precision in evaluating fetal head position, station and descent than digital vaginal examination. Thus, IPU can become a reliable instrument in the hands of trained medical personnel for the management of normal and abnormal labor. We reviewed all current data and we present the experience of our unit in the County Emergency Hospital of Craiova with IPU. The goal of this paper is not meant to change the classic algorithm of labor monitoring, but to provide objective additional evaluations of the traditional labor parameters of crucial importance. Sonographic measurements reviewed and used include both linear methods of measurement such as fetal head-perineum distance (HPD), progression distance (PD) and fetal head-symphysis distance (HSD) and angular methods such as the angle of progression (AOP), the angle of direction (AOD) and rotation. A HPD less than 40 mm, an AOP of more than 110–120°, PD more than 35 mm, and an AOD of more than 105° represent good predictors in achieving an uncomplicated vaginal delivery. These cut-offs proved to be helpful in selecting those patients with such a high risk for Caesarean delivery that they should avoid a trial of labor. IPU has become a highly useful risk tool with the potential to greatly improve planning hospital service needs and minimizing patient risk. IPU can be considered a significant part of the point-of-care-ultrasound (POCUS) and should be available in most delivery rooms, even just for verifying the correctness of clinical examination when assessing fetal presentation, position and station in labor. This 'bedside' examination with no additional requirement for advanced equipment or special training provides an immediate diagnosis of obstetrical complications that can lead to critical outcomes for the mother and the fetus. Ultrasound in labor should become standard of care. [ABSTRACT FROM AUTHOR]