Can ultrasound on admission in active labor predict labor duration and a spontaneous delivery?

• Published in: American Journal of Obstetrics & Gynecology MFM
• Main Authors: Hjartardóttir, Hulda, Lund, Sigrún H, Benediktsdóttir, Sigurlaug, Geirsson, Reynir T, Eggebø, Torbjørn M
• Other Authors: 1Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson); Faculty of Medicine, University of Iceland, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson). Electronic address: [e-mail]. 2deCODE genetics, Reykjavík, Iceland (Dr Lund). 3Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson); Faculty of Medicine, University of Iceland, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson). 4National Center for Fetal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Dr Eggebø); Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway (Dr Eggebø); Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (Dr Eggebø).
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2022
• Subjects: angle of progression; delivery time; fetal head station; head-perineum distance; labor; transperineal ultrasound; Ómskoðun; Fæðing; Ultrasonography; Prenatal; Labor Presentation; Meier; Reykjavík; Iceland
• Online Access: http://hdl.handle.net/2336/622006; https://doi.org/10.1016/j.ajogmf.2021.100383

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Download Background: Identifying predictive factors for a normal outcome at admission in the labor ward would be of value for planning labor care, timing interventions, and preventing labor dystocia. Clinical assessments of fetal head station and position at the start of labor have some predictive value, but the value of ultrasound methods for this purpose has not been investigated. Studies using transperineal ultrasound before labor onset show possibilities of using these methods to predict outcomes. Objective: This study aimed to investigate whether ultrasound measurements during the first examination in the active phase of labor were associated with the duration of labor phases and the need for operative delivery. Study design: This was a secondary analysis of a prospective cohort study at Landspitali University Hospital, Reykjavík, Iceland. Nulliparous women at ≥37 weeks' gestation with a single fetus in cephalic presentation and in active spontaneous labor were eligible for the study. The recruitment period was from January 2016 to April 2018. Women were examined by a midwife on admission and included in the study if they were in active labor, which was defined as regular contractions with a fully effaced cervix, dilatation of ≥4 cm. An ultrasound examination was performed by a separate examiner within 15 minutes; both examiners were blinded to the other's results. Transabdominal and transperineal ultrasound examinations were used to assess fetal head position, cervical dilatation, and fetal head station, expressed as head-perineum distance and angle of progression. Duration of labor was estimated as the hazard ratio for spontaneous delivery using Kaplan-Meier curves and Cox regression analysis. The hazard ratios were adjusted for maternal age and body mass index. The associations between study parameters and mode of delivery were ...