A Clinical Study on Progress of Labor using Ultra Sound during Parturition: Analysis of 71 Patients

Introduction: The progress of active labor by transvaginal examination is a subjective evaluation of the obstetrician with many limitations. The current trend in obstetrics is to avoid vaginal deliveries. There are many scientific proposals to monitor the progress of the active labor using ultrasound in laboring patients. Aim: To clinically assess the active labor and compare with ultrasound to accurately and objectively monitor the progress of normal labor as well as to predict successful vaginal birth. Materials and Methods: In total, 71 patients with full-term primigravida attending the Department of Obstetrics and Gynecology in active first stage labor were included. Patients with cephalic presentation with occipitoanterior were included. Initial per vaginal (PV) examination followed by transabdominal ultrasound and later trans-vaginal ultrasound were used to visualize the infrapubic plane. At rest and at peak uterine contractions, the parameters of ultrasound were used to for the ability to detect the engagement of fetal head and for the occurrence of vaginal delivery. Results: About 68.40% of the patients felt ultrasound examination more convenient than PV examination. The dynamic progression distance with a cutoff of 23.21 mm recognized patients who will deliver virginally. The sensitivity of the ultrasound examination during intrapartum was 70.6%, and the specificity was 79.9%. The sensitivity of dynamic angle of progression was 81.2% and a specificity of 84.30%. There was a statistical correlation between cervical diameter assessed using PV examination and using ultrasound during labor with P = 0.041 (P significant at <0.05). Conclusion: Ultrasound examination during active labor provided an accurate scientific assessment of birth progress. The study could identify the group of patients in active labor at high risk of surgical delivery.