Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor

2018 ◽  
Vol 144 (2) ◽  
pp. 192-198 ◽  
Author(s):  
Viola Y.T. Chan ◽  
Wai-lam Lau ◽  
Mike K.P. So ◽  
Wing-cheong Leung
Keyword(s):  
Second Stage Of Labor ◽  
Second Stage ◽  
Cesarean Deliveries ◽  
Angle Of Progression

303: Reversed breech extraction maneuver for cesarean deliveries performed in the second stage of labor

2007 ◽  
Vol 197 (6) ◽  
pp. S94
Author(s):  
Aharon Tevet ◽  
Faiz Khatib ◽  
Shahar Finci ◽  
Matan J. Cohen ◽  
Boris Zuckerman ◽  
...  
Keyword(s):  
Second Stage Of Labor ◽  
Second Stage ◽  
Cesarean Deliveries ◽  
Breech Extraction

scholarly journals McRoberts' maneuver increases fetal head angle of progression in second stage of labor

2018 ◽  
Vol 52 (4) ◽  
pp. 545-547 ◽  
Author(s):  
A. L. Zimerman ◽  
M. Moskovich ◽  
E. B. Levi ◽  
R. Maymon ◽  
J. Tobvin ◽  
...  
Keyword(s):  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Angle Of Progression

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Transperineal Ultrasound ◽  
Survival Models ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Angle Of Progression

Objective The objective of this study was to assess the association between the angle of progression (AoP) measured by transperineal ultrasound and mode of delivery and duration of the second stage. Study Design This is a prospective observational study of nulliparous women with a singleton gestation at term in which serial transperineal ultrasound examinations were obtained during the second stage of labor. Multivariable logistic regression and adjusted survival models were used for the analysis. Results A total of 137 patients were included in the analysis and median AoP for the study group was 153 degrees. The adjusted odds ratio (aOR) of requiring an operative delivery was 2.6 times higher for those patients who had an AoP < 153 degrees and the aOR of requiring a cesarean delivery was almost six times higher when compared with those patients who had an AoP ≥ 153 degrees (95% confidence interval [CI]: 1.0, 6.2; p = 0.04; aOR: 5.8, 95% CI: 1.2–28.3; p = 0.03, respectively). Those patients with an AoP < 153 degrees were at a higher hazard of staying pregnant longer (adjusted hazard ratio: 1.8, 95% CI: 1.2–2.8, p = 0.005). Conclusion The AoP has the potential to predict spontaneous vaginal delivery and the duration of the second stage of labor which may be useful in counseling patients and managing their labor.

scholarly journals Mueller-Hillis maneuver and angle of progression: Are they correlated?

2017 ◽  
Vol 63 (6) ◽  
pp. 527-531
Author(s):  
Sofia Mendes ◽  
Rita Silva ◽  
Inês Martins ◽  
Susana Santo ◽  
Nuno Clode
Keyword(s):  
Roc Curve ◽  
Area Under The Curve ◽  
P Value ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Singleton Pregnancy ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Angle Of Progression

Summary Objective: Mueller-Hillis maneuver (MHM) and angle of progression (AOP) measured by transperineal ultrasound have been used to assess fetal head descent during the second stage of labor. We aimed to assess whether AOP correlates with MHM in the second stage of labor. Method: A prospective observational study including women with singleton pregnancy in the second stage of labor was performed. The AOP was measured immediately after the Mueller-Hillis maneuver. A receiver-operating characteristics (ROC) curve analysis was performed to determine the best discriminatory AOP cut-off for the identification of a positive MHM. A p-value less than 0.05 was considered statistically significant. Results: One hundred and sixty-six (166) women were enrolled in the study and 81.3% (n=135) had a positive MHM. The median AOP was 143º (106º to 210º). The area under the curve for the prediction of a positive maneuver was 0.619 (p=0.040). Derived from the ROC curve, an AOP of 138.5º had the best diagnostic performance for the identification of a positive MHM (specificity of 65% and a sensitivity of 67%). Conclusion: An AOP of 138º seems to be associated with a positive MHM in the second stage of labor.

Correlation between clinical fetal head station and sonographic angle of progression during the second stage of labor

2017 ◽  
Vol 31 (21) ◽  
pp. 2905-2910 ◽  
Author(s):  
Sharon Perlman ◽  
Zvi Kivilevitch ◽  
Orit Moran ◽  
Eldad Katorza ◽  
Salim Kees ◽  
...  
Keyword(s):  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Angle Of Progression

scholarly journals Angle of progression with trans-perineal ultrasound and delivery type in labor’s second stage; a cross-sectional study in Isfahan, Iran

2021 ◽  
Vol 7 (1) ◽  
pp. e05-e05
Author(s):  
Elaheh Zarean ◽  
Ferdos Mehrabian ◽  
Mahsa Sadat Miri
Keyword(s):  
Vaginal Delivery ◽  
Induction Time ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Apgar Scores ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Angle Of Progression

Introduction: Numerous studies have shown that clinical evaluation in labor is not very accurate, therefore ultrasound is one of the instruments that can give us a more objective assessment than the clinical evaluation. Objectives: In this study, we investigate the magnitude of the angle of progression (AoP) at the second stage of labor in fetuses with cephalic presentation and its relation to spontaneous vaginal delivery. Patients and Methods: In this cross-sectional study, we measured the AoP using trans-perineal sonography in the 2nd stage of the labor and compared AoP in normal vaginal delivery (NVD), cesarean and NVD with vacuum groups on 80 pregnant women. We also investigated the correlation between AoP and induction time and duration of the second stage of labor. Results: In 80 study patients, 54 (67.5 %) had normal vaginal deliveries, 21 (26.2 %) had cesarean section and 5 (6.2%) had NVD with a vacuum. There was a statistically significant difference between NVD, cesarean section, and NVD with vacuum in terms of the AoP (P<0.01). There was a statistically significant correlation between AoP and induction time, duration of 2nd stage of labor and Apgar scores (P<0.05). Conclusion: Higher progression angle is associated with shorter induction time and 2nd stage of labor, higher neonatal Apgar scores and a higher chance of spontaneous vaginal delivery which makes it an appropriate index for predicting pregnancy outcomes.

Intrapartum ultrasound prior to Kristeller maneuver: an observational study

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Marcos Javier Cuerva ◽  
Pablo Tobias ◽  
Jose Angel Espinosa ◽  
Jose Luis Bartha
Keyword(s):  
Observational Study ◽  
Apgar Score ◽  
Umbilical Artery ◽  
Ph Value ◽  
Delivery Mode ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Digital Palpation ◽  
Angle Of Progression

AbstractTo evaluate the accuracy of criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor.In this prospective observational study, the station of the fetal head was measured using the angle of progression (intrapartum ultrasound) just prior to the intervention of the managing obstetrician in 52 women with prolonged second stage of labor. The managing obstetricians were blinded to the sonographic results. The decision of performing a Kristeller maneuver was taken by the obstetricians based on digital palpation and their experience. Delivery mode, Apgar score, umbilical artery pH value, episiotomy, perineal tears, bleeding, and time to delivery were recorded.Kristeller maneuver was performed in 36/52 (69.2%) cases. There were no significant differences between the Kristeller and the non-Kristeller group regarding the angle of progression. There were no significant differences between both groups with respect to delivery mode, perineal tears, episiotomy, bleeding, Apgar score, and umbilical artery pH value.Our study failed to define any criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor. There was no relation between the angle of progression and the decision to perform a Kristeller maneuver.

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