Angle of progression in pregnant women before onset of labor in predicting the mode of delivery

Abstract

Objective The aim of this study was to assess the efficacy of measuring angle of progress in the prediction of the mode of delivery in primigravida between 37 and 40 weeks of gestation. Background Prediction of mode of delivery, particularly identification of pregnant women at risk for cesarean delivery, has the potential to improve pregnancy outcome. Transperineal ultrasound has been suggested to be useful for predicting the mode of delivery. Patients and methods The study included 150 nulliparous women with a gestational age of 37–40 weeks, singleton fetus, and cephalic presentation with intact membranes. None of the women were in labor. We excluded women scheduled for elective cesarean section (CS) for a variety of indications. After history taking and physical examination, patients were subjected to transperineal ultrasound imaging to measure the angle of progression, and the mode of delivery was followed up to test the ability of the measured angle to predict the mode of delivery. Results At a cutoff angle of 93.5°, angle of progression correctly identified cases planned to deliver vaginally with a sensitivity of about 83.6% and a specificity of 88.9%. A statistically significant correlation was found between the angle of progression measured in the antenatal period and the mode of delivery (P Conclusion Translabial ultrasound-converted images to measure the angle of progression in antenatal period accurately predicted the mode of delivery, providing a more scientific basis for assessing labor.