Abstract
Objectives: To evaluate, the clinical significance of the head progression distance (HPD), measured by trans-perineal ultrasound, during prolonged second stage of labor. Methods: A prospective study of women, above 37 weeks of gestation, with failure to progress in the second stage of labor was conducted. A TPU approach in a sagital plane, was performed in order to assess the HPD. It’s correlation with fetomaternal characteristics, mode of delivery, and perinatal outcome were evaluated. Results: Sixty six women in prolonged second stage were enrolled in the study. Sixteen (25.8%), delivered by spontaneous vaginal delivery (SVD), twelve (19.4%) delivered by Cesarean delivery, thirty (48.4%) by vacuum extraction, and four (6.5%), by forceps. The mean HPD in cm measured in SVD, vacuum extraction, forceps and Cesarean delivery was 6.6 ± 0.9, 6.5 ± 1.2, 7.7 ± 1.1 and 5.8 ± 1.5 respectively, did not differ between modes of delivery. The only parameter that correlated with HPD was fetal head circumference measured after delivery R = 0.381 P < 0.04 Conclusions: Our study indicate that head progression distance do not predict the mode of delivery at prolonged 2nd stage.
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