Benefits and pitfalls of the use of intrapartum ultrasound
نویسندگان
چکیده
Introduction Ultrasound in labour (intrapartum ultrasound) has come to the fore in the last decade stemming from both an increased desire for a reliable method of labour assessment coupled with increased availability of ultrasound on the delivery suite. The use of ultrasound in the delivery suite currently is predominantly for presentation, amniotic fluid and fetal heart assessment, but there is a growing acknowledgement that ultrasound parameters could be used in assessing the progress of labour, and potentially in predicting labour outcome.1 The need for an objective method of assessing labour was first recognised as early as 1977 with the first known publication on intrapartum scanning.2 A more comprehensive review of intrapartum ultrasound, incorporating some concepts that are standard in contemporary practice was described in a Russian PhD thesis from the mid-1990s.3 There is the need, if not an alternative, then at least an adjunctive to digital vaginal examinations (VE). Digital VEs are associated with ascending infection to the fetus,4 chorioamnionitis5 and endometritis as well as reduced time to delivery in preterm labour.5 The examination itself may also be an uncomfortable experience for the labouring woman.6 In some circumstances, digital vaginal examinations (VEs) are contraindicated, such as Placenta Praevia or Preterm Prelabour Rupture Of Membranes (PPROM). For some women with a fear of childbirth, previous sexual trauma or vaginismus, digital VEs are especially traumatic and for these women special arrangements are usually made to avoid examination except where absolutely necessary. Irrespective of these concerns, digital VE is a notoriously subjective technique and agreement between observers is frequently poor.7,8 Benefits and pitfalls of the use of intrapartum ultrasound
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