Ultrasound assessment of fetal head position during labor and delivery

Prikhodko A.M., Romanov A.Yu., Baev O.R.

1 National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia, Moscow 2 Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute for Postgraduate Training of Physicians, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation, Moscow, Russia
The paper presents a systems analysis of the data of modern Russian and foreign literature on ultrasound in labor and delivery. It assesses whether ultrasonography can be used during childbirth to diagnose the correct and incorrect positions of the fetal head. The authors describe the technique of ultrasonography and the ultrasound signs of anterior and posterior occipital presentations, the transverse position of the arrow-shaped suture, and extensor and asynclitic insertions of the fetal head. Ultrasound allows a more accurate diagnosis of the type and position of a fetus in labor and delivery. Ultrasound used during labor is an additional tool to diagnose complications associated with the incorrect position of the fetal head and permits the timely and correct determination of delivery tactics.

Keywords

ultrasound in labor
fetus
labor management
posterior occipital presentation
transabdominal ultrasound scanning
transperineal ultrasound scanning

References

  1. Erlik U., Wolman I. Intrapartum sonographic assessment of labor. J. Obstet. Gynaecol. India. 2013; 63(5): 297-300.
  2. Sherer D.M., Miodovnik M., Bradley K.S., Langer O. Intrapartum fetal head position I: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the active stage of labor. Ultrasound Obstet. Gynecol. 2002; 19(3): 258-63.
  3. Sherer D.M., Miodovnik M., Bradley K.S., Langer O. Intrapartum fetal head position II: comparison between transvaginal digital examination and transabdominal ultrasound assessment during the second stage of labor. Ultrasound Obstet. Gynecol. 2002; 19(3): 264-8.
  4. Ghi T., Bellussi F., Azzarone C., Krsmanovic J., Franchi L., Youssef A. et al. The «occiput-spine angle»: a new sonographic index of fetal head deflexion during the first stage of labor. Am. J. Obstet. Gynecol. 2016; 215(1): 84. e1-7.
  5. Ghi T., Farina A., Pedrazzi A., Rizzo N., Pelusi G., Pilu G. Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound. Ultrasound Obstet. Gynecol. 2009; 33(3): 331-6.
  6. Gizzo S., Andrisani A., Noventa M., Burul G., Di Gangi S., Anis O. et al. Intrapartum ultrasound assessment of fetal spine position. Biomed. Res. Int. 2014; 2014: 783598.
  7. Blasi I., D’Amico R., Fenu V., Volpe A., Fuchs I., Henrich W. et al. Sonographic assessment of fetal spine and head position during the first and second stages of labor for the diagnosis of persistent occiput posterior position: a pilot study. Ultrasound Obstet. Gynecol. 2010; 35(2): 210-5.
  8. Akmal S., Tsoi E., Howard R., Osei E., Nicolaides K.H. Investigation of occiput posterior delivery by intrapartum sonography. Ultrasound Obstet. Gynecol. 2004; 24(4): 425-8.
  9. de la Torre L., González-Quintero V.H., Mayor-Lynn K., Smarkusky L., Hoffman M.C., Saab A. et al. Significance of accidental extensions in the lower uterine segment during cesarean delivery. Am. J. Obstet. Gynecol. 2006; 194(5): e4-6.
  10. Wu J.M., Williams K.S., Hundley A.F., Connolly A., Visco A.G. Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries. Am. J. Obstet. Gynecol. 2005; 193(2): 525-8; discussion 528-9.
  11. Benavides L., Wu J.M., Hundley A.F., Ivester T.S., Visco A.G. The impact of occiput posterior fetal head position on the risk of anal sphincter injury in forceps-assisted vaginal deliveries. Am. J. Obstet. Gynecol. 2005; 192(5): 1702-6.
  12. Ben-Haroush A., Melamed N., Kaplan B., Yogev Y. Predictors of failed operative vaginal delivery: a single-center experience. Am. J. Obstet. Gynecol. 2007; 197(3): 308. e1-5.
  13. Badawi N., Kurinczuk J.J., Keogh J.M., Alessandri L.M., O’Sullivan F., Burton P.R. et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ. 1998; 317(7172):1554-8.
  14. Kahrs B.H., Usman S., Ghi T., Youssef A., Torkildsen E.A., Lindtjørn E. et al. Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study. Am. J. Obstet. Gynecol. 2017; 217(1): 69. e1-69. e10.
  15. Bellussi F., Ghi T., Youssef A., Cataneo I., Salsi G., Simonazzi G. et al. Intrapartum ultrasound to differentiate flexion and deflexion in occipitoposterior rotation. Fetal Diagn. Ther. 2017; 42(4): 249-56.
  16. Malvasi A., Giacci F., Gustapane S., Sparic R., Barbera A., Tinelli A. Intrapartum sonographic signs: new diagnostic tools in malposition and malrotation. J. Matern. Fetal Neonatal Med. 2016; 29(15): 2408-13.
  17. Bashiri A., Burstein E., Bar-David J., Levy A., Mazor M. Face and brow presentation: independent risk factors. J. Matern. Fetal Neonatal Med. 2008; 21(6): 357-60.
  18. Gardberg M., Leonova Y., Laakkonen E. Malpresentations--impact on mode of delivery. Acta Obstet. Gynecol. Scand. 2011; 90(5): 540-2.
  19. Ghi T., Maroni E., Youssef A., Cariello L., Salsi G., Arcangeli T. et al. Intrapartum three-dimensional ultrasonographic imaging of face presentations: report of two cases. Ultrasound Obstet. Gynecol. 2012; 40(1): 117-8.
  20. Ghi T., Dall’Asta A., Kiener A., Volpe N., Suprani A., Frusca T. Intrapartum diagnosis of posterior asynclitism using two-dimensional transperineal ultrasound. Ultrasound Obstet. Gynecol. 2017; 49(6): 803-4.
  21. Malvasi A., Stark M., Ghi T., Farine D., Guido M., Tinelli A. Intrapartum sonography for fetal head asynclitism and transverse position: sonographic signs and comparison of diagnostic performance between transvaginal and digital examination. J Matern. Fetal Neonatal Med. 2012; 25(5): 508-12.
  22. Ghi T., Youssef A., Pilu G., Malvasi A., Ragusa A. Intrapartum sonographic imaging of fetal head asynclitism. Ultrasound Obstet. Gynecol. 2012; 39(2): 238-40.
  23. Malvasi A., Tinelli A. Intrapartum sonography asynclitism diagnosis by transperineal ultrasonography. J. Matern. Fetal Neonatal Med. 2018; 31(11): 1530-1.
  24. Malvasi A., Barbera A., Ghi T., Tinelli A. Lateral asynclitism: introduction of a new terminolgy associated to specific fetal position of the fetal head diagnosed by ultrasound in the second stage of labor. J. Matern. Fetal Neonatal Med. 2015; 28(15): 1839-41.
  25. Ghi T., Bellussi F., Pilu G. Sonographic diagnosis of lateral asynclitism: a new subtype of fetal head malposition as a main determinant of early labor arrest. Ultrasound Obstet. Gynecol. 2015; 45(2): 229-31.
  26. Bellussi F., Ghi T., Youssef A., Salsi G., Giorgetta F., Parma D. et al. The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations. Am. J. Obstet. Gynecol. 2017; 217(6): 633-41.
  27. Rozenberg P., Porcher R., Salomon L.J., Boirot F., Morin C., Ville Y. Comparison of the learning curves of digital examination and transabdominal sonography for the determination of fetal head position during labor. Ultrasound Obstet. Gynecol. 2008; 31(3): 332-7.
  28. Malvasi A., Montanari Vergallo G., Tinelli A., Marinelli E. “Can the intrapartum ultrasonography reduce the legal liability in distocic labor and delivery?” J. Matern. Fetal Neonatal Med. 2018; 31(8): 1108-9.
  29. Popowski T., Porcher R., Fort J., Javoise S., Rozenberg P. Influence of ultrasound determination of fetal head position on mode of delivery: a pragmatic randomized trial. Ultrasound Obstet. Gynecol. 2015; 46(5): 520-5.

Received 18.04.2018

Accepted 20.04.2018

About the Authors

Prikhodko, Andrey M., PhD, physician of the Maternity Department, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health
of Russian Federation. 117997, Russia, Moscow, Ac. Oparina str. 4
Tel.: +74954383047. E-mail: a_prikhodko@oparina4.ru
Romanov, Andrey Yu., clinical resident, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russian Federation.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79031589400. E-mail: romanov1553@yandex.ru
Baev, Oleg R., MD, head of Maternity Department, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation, professor of the Department of Obstetrics, Gynecology, Perinatology, and Reproductology of I.N. Sechenov First Moscow State Medical University of Ministry
of Health of Russian Federation. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381188. E-mail: o_baev@oparina4.ru

For citation: Prikhodko A.M., Romanov A.Yu., Baev O.R. Ultrasound assessment of fetal head position during labor and delivery. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (3): 5-9. (in Russian)
https://dx.doi.org/10.18565/aig.2019.3.5-9

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.