Effect of the "shoulder-up" bundle on the incidence of spontaneous perineal injury after vaginal delivery: comparison of 2 historic cohorts after propensity score matching.

Background: Perineal injury following vaginal delivery represents a major cause of long-term maternal morbidity, and its prevention is among the priorities of modern obstetrical practice.

Objective: This study aimed to investigate whether the systematic implementation of a bundle of maneuvers to prevent perineal injury (ie, the "shoulder-up" bundle) may reduce the rate of spontaneous perineal tears in women delivering at a single tertiary maternity unit.

Study Design: This was a single-center retrospective intervention study including all vaginal deliveries between April 1, 2020 and March 31, 2022.

Usefulness of an Intrapartum Ultrasound Simulator (IUSim™) for Midwife Training: Results from an RCT.

Introduction: We conducted a randomized study to determine whether a training session on a dedicated simulator (IUSim™) would facilitate the midwives in learning the technique of transperineal intrapartum ultrasound.

Methods: Following a 30-min multimedia presentation including images and videos on how to obtain and measure the angle of progression (AoP) and the head-perineum distance (HPD), 6 midwives with no prior experience in intrapartum ultrasound were randomly split into 2 groups: 3 of them were assigned to the "training group" and 3 to the "control group." The midwives belonging to the former group were taught to measure the 2 sonographic parameters during a 3-h practical session conducted on IUSim™ under the supervision of an expert obstetrician.

Evaluation of the uterine scar stiffness in women with previous Cesarean section by ultrasound elastography: A cohort study.

Purpose: To evaluate by means of elastography if the quantitative assessment of the cesarean scar elasticity is feasible using as reference the surrounding intact myometrium and to investigate if the cesarean scar stiffness is influenced by the clinical characteristics of the previous cesarean delivery.

Methods: Prospective study including women with a previous Cesarean Section (CS) ≥ 37 weeks' gestation performed 12-15 months before. By transvaginal ultrasound two regions of interest (ROI) were selected: uterine scar (Region 1) and surrounding myometrium (Region 2).

Prediction of fetal macrosomia using two-dimensional and three-dimensional ultrasound.

Objective: The estimation of the fetal weight by three-dimensional (3D) ultrasound (US) with fractional thigh volume (TVol) has been suggested to be more accurate than two-dimensional (2D) US particularly within the context of fetuses at risk of macrosomia. The objective of this study was to compare the accuracy of 2D US and 3D US with two different methods of projection for the identification of fetal macrosomia at term.

Study Design: Prospective study which included women at risk for fetal macrosomia referred for fetal biometry between 34-36 weeks.