A deep learning approach to identify the fetal head position using transperineal ultrasound during labor.

Objectives: To develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor.

Material And Methods: Prospective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings.

Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation.

This recommendation document follows the mission of the World Association of Perinatal Medicine in collaboration with the Perinatal Medicine Foundation. We aim to bring together groups and individuals throughout the world for standardization to implement the ultrasound evaluation in labor ward and improve the clinical management of labor. Ultrasound in labor can be performed using a transabdominal or a transperineal approach depending upon which parameters are being assessed.

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.

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.

Use of second-line therapies for management of massive primary postpartum hemorrhage.

Objective: To determine rates of use and success of second-line therapies for massive primary postpartum hemorrhage (PPH).

Methods: A retrospective cohort study was conducted among 91 women who gave birth at Kwong Wah Hospital, Hong Kong, between January 1, 2006, and December 31, 2011. Inclusion criteria were gestational age of at least 24 weeks and massive PPH (defined as blood loss ≥1500 mL within 24 hours after birth).

Intrapartum translabial ultrasound demonstration of face presentation during first stage of labor.

We report an unusual case in which sonographic diagnosis of face presentation was made by translabial ultrasound examination during the first stage of labor. In a multigravida, induction of labor was performed at 39 weeks' gestation for suspected small-for-gestational age. The diagnosis of face presentation was confirmed by the use of intrapartum translabial ultrasound examination.

Pregnancy outcome of a patient with atypical polypoid adenomyoma.

Objective: Detailed description and follow-up of a patient with atypical polypoid adenomyoma and infertility, from investigation until delivery of a healthy baby.

Design: Case report.

Setting: Tertiary infertility center.