Role of intrapartum sonography in labour

Objective: We aimed to investigate the role of intrapartum ultrasonography, which is objective, easy to apply and learn, non-invasive and highly tolerable by the patient, in predicting the mode and duration of delivery in pregnant women in the active phase of labor. Materials and Methods: In the study, which included a total of 81 pregnant women (36 nullipara and 45 multiparous women in term, singleton, head presentation, active phase of the first stage of labor with ruptured amniotic membranes), we evaluated the pregnant women who were evaluated by digital vaginal examination and recorded their examinations simultaneously with the help of transperineal ultrasonography. We evaluate the angle of progression (AoP) in the sagittal plane and measuring the midline angle (MLA) and head perineum distance (HPD) parameters in the transverse plane. On the other hand, we recorded maternal characteristics, delivery mode, time between examination to delivery and postpartum neonatal findings. We compared all these data statistically with correlation and regression analysis. Result: In correlation analysis, positive correlation was found between progression angle and head station (p <0.001, r = 0.404), cervical effacement (p <0.001, r = 0.410), cervical dilatation (p = 0.002, r = 0.339), and negative correlation between head perineum distance ( p <0.001, r = -0.615). It was observed that the angle of progression was statistically significant higher in the group who had spontaneous vaginal delivery compared to the group that delivered by obstetric intervention (130,96 ± 13,14 vs. 117,78 ± 20,80, p=0,010).While a negative correlation was found between the delivery time and progression angle (p<0,001, r=-0,455), it was observed that it showed a positive correlation with the head-perineum distance (p<0,001, r=0,546). In the ROC curve analysis, the cut-off value for the angle of progression was found to be 125.5 ° significant for the prediction of spontaneous vaginal delivery.Conclusion: Among the transperineal ultrasonography parameters applied in the method and management decision in the follow-up of labor in the delivery room, the angle of progression was statistically significant enough to be used in the prediction of the delivery mode.