Fetal head descent assessed by transabdominal ultrasound: a prospective observational study.

Background: Determining fetal head descent, expressed as fetal head station and engagement is an essential part of monitoring progression in labor. Assessing fetal head station is based on the distal part of the fetal skull, whereas assessing engagement is based on the proximal part. Prerequisites for assisted vaginal birth are that the fetal head should be engaged and its lowermost part at or below the level of the ischial spines.

Intrapartum ultrasound in women with prolonged first stage of labor.

The first stage of labor is from the start of active labor until the cervix is fully dilatated. To assess labor progress during this stage, a clinical examination has traditionally been done. The cervical dilatation, fetal head position, and fetal head station are evaluated.

There are 4, not 7, cardinal movements in labor.

The mechanics of labor describe the forces required for fetal descent, and the movements that the fetus must perform to overcome the resistance met by the maternal bony pelvis and soft tissue. The fetus negotiates the birth canal and rotational movements are necessary for descent. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

Ultrasound before operative vaginal delivery: why and how.

Safe management of the second stage of labor is important. Wait for spontaneous delivery, operative vaginal deliveries and second stage cesarean sections are all options when prolonged second stage occurs. The important question is which option to choose.

Fetal molding examined with transperineal ultrasound and associations with position and delivery mode.

Background: To accommodate passage through the birth canal, the fetal skull is compressed and reshaped, a phenomenon known as molding. The fetal skull bones are separated by membranous sutures that facilitate compression and overlap, resulting in a reduced diameter. This increases the probability of a successful vaginal delivery.

Live born recipient of twin-twin transfusion syndrome with anomalous mitral arcade.

We present a case report of anomalous mitral arcade in a live born former recipient of twin-twin transfusion syndrome. At 33+0 week of gestation fetal ultrasound demonstrated that she had a large mitral insufficiency, decreased movement of the lateral cusp of the mitral valve and dilated left atrium. The twins were delivered by caesarean section at week 33+1 due to fetal distress.

Time to delivery based on sonographic assessment prior to forceps and vacuum.

Introduction: To compare the duration of vacuum and forceps delivery in relation to ultrasound assessment of fetal head position and station.

Methods: A prospective single-centre cohort study in nulliparous women at term with prolonged second stage of labour. Fetal head position was determined using transabdominal ultrasound and station as head-perineum distance (HPD) from transperineal ultrasound prior to an instrument.

Fetal rotation during vacuum extractions for prolonged labor: a prospective cohort study.

Introduction: The aim of the study was to investigate fetal head rotation during vacuum extraction.

Material And Methods: We conducted a prospective cohort study from November 2013 to July 2016 in seven European hospitals. Fetal head position was determined with transabdominal or transperineal ultrasound and categorized as occiput anterior (OA), occiput transverse (OT) or occiput posterior (OP) position.

Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study.

Background: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions should be focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors.