Vaginal versus ultrasound examination of fetal occiput position during the second stage of labor

• Published in: American journal of obstetrics and gynecology Vol. 191; no. 2; pp. 521 - 524
• Main Authors: Chou, Margaret R., Kreiser, Doron, Taslimi, M.Mark, Druzin, Maurice L., El-Sayed, Yasser Y.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.08.2004; Elsevier
• Subjects: Adult; Biological and medical sciences; Delivery, Obstetric; Delivery. Postpartum. Lactation; Female; Fetal occiput position; Gynecology. Andrology. Obstetrics; Humans; Labor Presentation; Labor Stage, Second; Medical sciences; Occipital Bone; Occiput posterior; Physical Examination; Pregnancy; Second stage of labor; Ultrasonography, Prenatal; Ultrasound examination; Ultrasound examination; Fetal occiput position; Second stage of labor; Occiput posterior; Sonography; Pregnancy; Fetal occiput position Occiput positerior Ultrasound examination Second stage of labor; Gynecology; Vagina; Fetus; Delivery; Labor; Obstetrics; Ultrasound; Comparative study
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.01.029

The purpose of this study was to determine whether ultrasonography is more accurate than vaginal examination in the determination of fetal occiput position in the second stage of labor. Eighty-eight patients in the second stage of labor were evaluated by vaginal examination and by combined transabdominal and transperineal ultrasound examination to determine occiput position. These predictions of position were compared with the actual delivery position at vaginal delivery after spontaneous restitution or at cesarean delivery. Different examiners performed the vaginal examinations and the ultrasound examinations. Each examiner was blinded to the determination of the other examiner. Vaginal examination determined fetal occiput position correctly 71.6% of the time; ultrasound examination determined fetal occiput position correctly 92.0% of the time (P=.018). Ultrasound examination is more accurate than vaginal examination in the diagnosis of fetal occiput position in the second stage of labor.