Role Of Transperineal Ultrasound In Assessment Of Fetal Head Engagement As Indication Of Caesarean Section Taking Mode Of Delivery As Gold Standard
Role of transperineal ultrasound in assessment of fetal head engagement
DOI:
https://doi.org/10.54393/pbmj.v5i4.379Keywords:
Transperineal ultrasound, cesarean section, fetal head engagement, head perineal distance, mode of deliveryAbstract
The frequency of caesarean sections has been gradually increasing in the past several decades. The usage of transperineal ultrasound (TPU) has been increasing. Many studies have demonstrated that TPU can provide valuable information for the clinician. Objective: To assess the role of transperineal ultrasound in fetal head engagement as indication of caesarean section taking mode of delivery as gold standard. Methods: A cross-sectional study was carried out in Radiology Department of Nawaz Medicare and DHQ hospital, Faisalabad. Written consent was taken from all patients before the ultrasound examination. Patients were assessed for eligibility in inclusion criteria. Confirmation of intrauterine living pregnancy, placenta site, fetal presentation, liquor amount and gestational age was done with routine obstetric ultrasound. Enrolled pregnant patients at term were assessed for the fetal head-perineal distance and cervical length by TPU examination. Results: One hundred and twenty-four (124) women participated in the investigation. Maternal age and gestational age were not determinants of outcomes of labor. Fetal head-perineal distance measured by TPU had a test sensitivity of 88.31 %, specificity of 78.72 %, the positive predictive value is 87.18%, the negative predictive value is 80.43% and diagnostic accuracy is 84.68%. Conclusions: The findings of this study shows that head perineal distance measured by TPU have higher sensitivity and is a non-invasive method which provides valuable objective measurements for fetal head engagement in primigravida at term and can be easily accepted and tolerated by women. Also, unnecessary caesarean section rate can be reduced by timely decision.
References
Tarimo CS, Mahande MJ, Obure J. Prevalence and risk factors for cesarean delivery following labor induction at a tertiary hospital in North Tanzania: a retrospective cohort study (2000–2015). BMC Pregnancy and Childbirth. 2020,20(1): 1-8.doi.org/10.1186/s12884-020-02861-8
Klemetti R, Che X, Gao Y, Raven J, Wu Z, et al. Cesarean section delivery among primiparous women in rural China: an emerging epidemic. American journal of obstetrics and gynecology. 2010 ,202(1): 65-e1.doi.org/10.1016/j.ajog.2009.08.032
Kanji Z, Simonovich SD, Najmi N, Bishop-Royse J. Examining clinical indications for cesarean section in a university hospital in Karachi, Pakistan. Journal of Asian Midwives (JAM). 2019,6(1):14-25.
Kazandjian VA, Chaulk CP, Ogunbo S, Wicker K. Does a Cesarean section delivery always cost more than a vaginal delivery? Journal of evaluation in clinical practice. 2007,13(1):16-20. doi.org/10.1111/j.1365-2753.2006. 00690.x
Antoine C, Young BK. Cesarean section one hundred years 1920–2020: The Good, the Bad and the Ugly. Journal of Perinatal Medicine. 2020, 1.doi.org/10.1515/jpm-2020-0305
Minajagi PS, Srinivas SB, Hebbar S. Predicting the mode of delivery by angle of progression (AOP) before the onset of labor by transperineal ultrasound in nulliparous women. Current Women's Health Reviews. 2020,16(1):39-45. doi.org/10.2174/1573404815666191113153204
Torkildsen EA, Salvesen KÅ, Eggebø TM. Prediction of delivery mode with transperineal ultrasound in women with prolonged first stage of labor. Ultrasound in obstetrics & gynecology. 2011,37(6):702-8. doi.org/10.1002/uog.8951
Kalache KD, Dückelmann AM, Michaelis SA, Lange J, Cichon G, et al. Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the ‘angle of progression’predict the mode of delivery? Ultrasound in Obstetrics and Gynecology. 2009,33(3): 326-30.doi.org/10.1002/uog.6294
Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J. Transvaginal sonographic measurement of cervical length vs. Bishop score in labor induction at term: tolerability and prediction of Cesarean delivery. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2007,29(5): 568-73.doi.org/10.1002/uog.4018
Eggebø TM, Gjessing LK, Heien C, Smedvig E, Økland I, et a. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2006,27(4): 387-91.doi.org/10.1002/uog.2744
Bartha JL, Romero‐Carmona R, Martínez‐del‐Fresno P, Comino‐Delgado R. Bishop score and transvaginal ultrasound for preinduction cervical assessment: a randomized clinical trial. Ultrasound in obstetrics & gynecology. 2005,25(2): 155-9.doi.org/10.1002/uog.1813
Rane SM, Guirgis RR, Higgins B, Nicolaides KH. The value of ultrasound in the prediction of successful induction of labor. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2004, 24(5):538-49. doi.org/10.1002/uog.1100
Pandis G, Papageorghiou AT, Ramanathan VG, Thompson MO, Nicolaides KH. Preinduction sonographic measurement of cervical length in the prediction of successful induction of labor. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2001,18(6): 623-8.doi.org/10.1046/j.0960-7692.2001. 00580.x
Ghi T, Eggebø T, Lees C, Kalache K, Rozenberg P, et al. ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound in Obstetrics & Gynecology. 2018,52(1):128-39. doi.org/10.1002/uog.19072
Khazardoost S, Vahdani FG, Latifi S, Borna S, Tahani M, et al. Pre-induction translabial ultrasound measurements in predicting mode of delivery compared to bishop score: a cross-sectional study. BMC pregnancy and childbirth. 2016,16(1):1-7. doi.org/10.1186/s12884-016-1090-x
Dimassi K, Amor AB, Belghith C, Khedija MA, Triki A, et al. Ultrasound diagnosis of fetal head engagement. International Journal of Gynecology & Obstetrics. 2014,127(1):6-9. doi.org/10.1016/j.ijgo.2014.04.008
Eggebø TM, Heien C, Økland I, Gjessing LK, Romundstad P, et al. Ultrasound assessment of fetal head–perineum distance before induction of labor. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008,32(2): 199-204.doi.org/10.1002/uog.5360
El-Bishry GA, El Kholy AL, Sweed MS, Hassan N. The accuracy of fetal head to perineum distance and cervical length in predicting the outcomes of labor induction. Evidence Based Women's Health Journal. 2020,10(1): 16-26.doi.org/10.21608/ebwhj.2019.17674.1034
Dietz HP, Lanzarone V. Measuring engagement of the fetal head: validity and reproducibility of a new ultrasound technique. Ultrasound in obstetrics & gynecology. 2005, 25(2):165-8. doi.org/10.1002/uog.1765
Maticot-Baptista D, Ramanah R, Collin A, Martin A, Maillet R, et al. Ultrasound in the diagnosis of fetal head engagement. A preliminary French prospective study. J Gynecol Obstet Biol Reprod 2009,38(6):474–80. doi.org/10.1016/j.jgyn.2009.04.001
Rivaux G, Dedet B, Delarue E, Depret S, Closset E, et al.The diagnosis of fetal head engagement: transperineal ultrasound, a new useful tool? Gynecol Obstet Fertil 2012,40(3):148–52. doi.org/10.1016/j.gyobfe.2011.07.012
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