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Subject Area

Community Medicine

Article Type

Original Study

Abstract

Objectives To evaluate head–perineum distance (HPD) and angle of progression (AOP) as predictors of successful vaginal delivery in the active phase of first stage of labor in primigravida. Background Intrapartum ultrasonography has enabled further understanding of the complex physiology of childbirth. It has been shown to provide objective information on the dynamics of different stages of labor and may also be used to assess the mode of delivery. Patients and methods This prospective cohort study was conducted at obstetrics departments of Om El-Masryeen General Hospital, Giza, Egypt, from November 2018 to March 2019. This study included 80 pregnant women in the active phase of first stage of labor who fulfilled inclusion and exclusion criteria. Full history taking, physical and local examination, and obstetric ultrasound were done, and transperineal ultrasound was done to measure HPD and AOP. Results Women who delivered vaginally showed a statistically significant higher mean of the AOP (120.3 ± 11.9°) versus who delivered by cesarean section (89.1 ± 10.7°), with aP value of 0.001. At a cutoff of more than 104°, AOP predicted successful vaginal labor, with a sensitivity of ~90% and a specificity of 86%. At cutoff less than 4.5 cm, HPD predicted successful vaginal labor with a sensitivity of ~88% and a specificity of 91%. Conclusion Transperineal ultrasound measurement of HPD and AOP in the first stage of labor accurately predicts the mode of delivery.

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