Predictive Value of Intrapartum Transperineal Ultrasonography in Determining Delivery Mode: A Prospective Study

Abstract

Objective: This study aimed to evaluate the usefulness of intrapartum transperineal ultrasonographic (ITU) parameters in predicting delivery mode. Methods: This prospective study included 104 pregnant women in active labor with ruptured membranes at Düzce University Health Application and Research Center from April 2023 to April 2024. ITU measured the angle of progression (AoP), head-perineum distance (HPD), and midline angle (MLA). These parameters were compared with digital vaginal examinations and delivery outcomes. Results: Of the participants, 93 (89.4%) had spontaneous vaginal deliveries (SVD), 6 (5.7%) had operative vaginal deliveries (OVD), and 5 (4.8%) had cesarean sections (C/S). AoP1 and AoP2 were significantly higher in the SVD group compared to OVD and C/S groups (p<0.001). The ΔAoP was significantly lower in the OVD group (p=0.044). HPD1 and HPD2 were significantly higher in the C/S group (p=0.031 and p=0.041, respectively). MLA1 and MLA2 were significantly lower in the SVD group (p=0.002 and p=0.001, respectively). Conclusion: ITU is a valuable tool in predicting delivery mode. AoP, HPD, and MLA measurements provide objective and reliable data to assist clinicians in labor management. Further research with larger sample sizes is needed to validate these findings and establish standardized protocols for clinical use.

Keywords

• Intrapartum transperineal ultrasound
• Predicting delivery mode
• Angle of progression
• Head-perineum distance

Doğum Şeklini Belirlemede İntrapartum Transperineal Ultrasonografinin Tahmin Değeri: Prospektif Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı, intrapartum transperineal ultrasonografi (ITU) parametrelerinin doğum şeklini öngörmedeki etkinliğini değerlendirmektir. Yöntem: Bu prospektif çalışmaya, Nisan 2023 ile Nisan 2024 tarihleri arasında Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezi'nde, aktif doğum eylemi içinde ve membranları rüptüre olmuş 104 gebe dahil edilmiştir. ITU ile ilerleme açısı (AoP), baş-perine mesafesi (HPD) ve orta hat açısı (MLA) ölçümleri yapıldı. Bu parametreler, dijital vajinal muayene bulguları ve doğum sonuçları ile karşılaştırıldı. Bulgular: Katılımcıların 93’ü (%89,4) spontan vajinal doğum (SVD), 6’sı (%5,7) operatif vajinal doğum (OVD) ve 5’i (%4,8) sezaryen (C/S) ile doğum yaptı. AoP1 ve AoP2 değerleri, SVD grubunda OVD ve C/S gruplarına kıyasla anlamlı derecede yüksekti (p<0,001). ΔAoP değeri OVD grubunda anlamlı derecede düşük bulundu (p=0,044). HPD1 ve HPD2 ölçümleri C/S grubunda anlamlı olarak daha yüksekti (sırasıyla p=0,031 ve p=0,041). MLA1 ve MLA2 değerleri ise SVD grubunda anlamlı derecede daha düşüktü (sırasıyla p=0,002 ve p=0,001). Sonuç: ITU, doğum şeklini öngörmede değerli bir araçtır. AoP, HPD ve MLA ölçümleri, doğum yönetiminde klinisyenlere yardımcı olabilecek objektif ve güvenilir veriler sağlamaktadır. Bu bulguların doğrulanması ve klinik kullanıma yönelik standart protokollerin oluşturulması için daha büyük örneklem gruplarıyla ek çalışmalara ihtiyaç vardır.

Keywords

• İntrapartum transperineal ultrasonografi
• doğum şeklini tahmin
• ilerleme açısı
• baş-perine mesafesi

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