Process of fetal head descent as recorded by ultrasonography: How does this compare with the conventional first stage of labor? 2022

Huirong Tang, and Wenwen Wang, and Yunyun Pan, and Mo Liu, and Fang Shao, and Biyun Xu, and Yu Su, and Yali Hu, and Yimin Dai, and Mingming Zheng
Department of Obstetrics and Gynecology, The Affiliated Drum and Tower Hospital of Medical School of Nanjing University, Nanjing, China.

OBJECTIVE To construct an ultrasound partogram using serial transperineal sonographic measurements of the angle of fetal head progression during the first stage of labor, and to compare it with a conventional partogram based on digital vaginal examinations. METHODS Between 2017 and 2018, a prospective cohort study at Drum Tower Hospital, Nanjing, China, recruited 375 nulliparous women with singleton pregnancy and spontaneous onset of labor at 37 or more gestational weeks. Transperineal ultrasound scans were performed to measure the angle of progression (AoP) every 0.5-1 h until the second stage. Vaginal examinations were also used to measure cervical dilatation. Repeated-measures analysis was used to generate labor curves. RESULTS The labor curve generated by AoP had a pattern similar to that based on cervical dilatation. There was an initial slow period lasting approximately 5.5 h until the cervical dilatation or AoP reached the inflection point (4 cm and 119°, respectively), followed by a second, more rapid period, lasting approximately 2.5 h. CONCLUSIONS Based on ultrasound data, it was feasible to construct an "angle of progression partogram" of the first stage of labor, which was similar in pattern to the partogram based on cervical dilatation measured in the same cohort.

UI MeSH Term Description Entries
D007746 Labor Presentation The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK. Fetal Presentation,Presentation, Fetal,Fetal Malpresentation,Fetal Malpresentations,Malpresentation, Fetal,Presentation, Labor
D007747 Labor Stage, First Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI. Labor, First Stage,Cervical Dilatation,Cervical Dilatations,Dilatation, Cervical,Dilatations, Cervical,First Labor Stage,First Stage Labor
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006257 Head The upper part of the human body, or the front or upper part of the body of an animal, typically separated from the rest of the body by a neck, and containing the brain, mouth, and sense organs. Heads
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014463 Ultrasonography The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. Echography,Echotomography,Echotomography, Computer,Sonography, Medical,Tomography, Ultrasonic,Ultrasonic Diagnosis,Ultrasonic Imaging,Ultrasonographic Imaging,Computer Echotomography,Diagnosis, Ultrasonic,Diagnostic Ultrasound,Ultrasonic Tomography,Ultrasound Imaging,Diagnoses, Ultrasonic,Diagnostic Ultrasounds,Imaging, Ultrasonic,Imaging, Ultrasonographic,Imaging, Ultrasound,Imagings, Ultrasonographic,Imagings, Ultrasound,Medical Sonography,Ultrasonic Diagnoses,Ultrasonographic Imagings,Ultrasound, Diagnostic,Ultrasounds, Diagnostic
D016216 Ultrasonography, Prenatal The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease. Fetal Ultrasonography,Prenatal Diagnosis, Ultrasonic,Ultrasonography, Fetal,Diagnosis, Prenatal Ultrasonic,Diagnosis, Ultrasonic Prenatal,Prenatal Ultrasonic Diagnosis,Prenatal Ultrasonography,Ultrasonic Diagnosis, Prenatal,Ultrasonic Prenatal Diagnosis,Diagnoses, Prenatal Ultrasonic,Diagnoses, Ultrasonic Prenatal,Prenatal Diagnoses, Ultrasonic,Prenatal Ultrasonic Diagnoses,Ultrasonic Diagnoses, Prenatal,Ultrasonic Prenatal Diagnoses

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