Asynclitism in the second stage of labor: prevalence, associations, and outcome.

Background: Fetal head asynclitism may affect labor progress, increase the need for obstetrical intervention, and even be associated with difficult or failed instrumental delivery. However, there is limited evidence on the true prevalence and associations of asynclitism when diagnosed by transperineal ultrasound in the second stage of labor.

Objective: This study aimed to examine the prevalence and outcome of asynclitism in the second stage of labor in a regional hospital in Hong Kong.

Intrapartum ultrasound and the choice between assisted vaginal and cesarean delivery.

Inaccurate assessment of the fetal head position and station might increase the risk for difficult or failed assisted vaginal delivery. Compared with digital vaginal examination, an ultrasound examination is objective and more accurate. The International Society of Ultrasound in Obstetrics and Gynecology has issued practical guidelines on intrapartum ultrasound in 2018 and recommended that an ultrasound assessment should be conducted when there is suspected delay or arrest of the first or second stage of labor or before considering assisted vaginal delivery.

Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor.

Objective: To compare the angle of progression (AoP) measured by transperineal ultrasonography before indicating an instrumental delivery or cesarean delivery.

Methods: A prospective observational study was conducted among women with singleton term pregnancies with prolonged second stage of labor at Kwong Wah Hospital, Hong Kong, China, between May 16, 2011, and May 25, 2016. Transabdominal and transperineal ultrasonography were performed to determine fetal head position and AoP, respectively, both at rest and during uterine contraction with pushing.

Prevention of early onset group B streptococcal disease by universal antenatal culture-based screening in all public hospitals in Hong Kong.

Objectives: To determine the prevalence of maternal colonization with group B streptococcus (GBS), and early onset GBS disease (EOGBSD) after implementation of universal screening.

Methods: This was a three-year retrospective cohort study on universal antenatal rectovaginal culture-based screening and intrapartum antimicrobial prophylaxis (IAP) to colonized women in the public sector in Hong Kong. Routinely collected data including maternal colonization and EOGBSD were retrieved.