Abstract
The role of Intrapartum Translabial Ultrasound to Predict Successful Vaginal Birth In Ladies With Previous Caesarean Section
Highlights
By PV digital examination, the mean cervical dilatation was 4.56 ± 0.87 cm, 19% of cases had their membranes spontaneously ruptured at time of examination. 5.5% of patients had trial of VBAC under epidural analgesia. 49 cases had vaginal delivery, 3 of them delivered by vacuum to shorten the 2nd stage TOLAC ended by CS delivery in 75.5% of cases, 72.84% of them had a CS for nonprogressive labor
The identification of the fetal head position by PV was not possible in 16% of cases, no significant agreement was found between the ultrasound and PV examination findings (r=0.123)
In a study by Usman et al., Fetal head position was recorded in 99.7% of US and 51.5% on vaginal examination (p < .0001)(10)
Summary
Witnessing a dramatically increasing rates of CS deliveries mainly due to the practice of defensive medicine[1], repeat CS is central to that practice. Being the „gold standard‟ in obstetric practice, the digital transvaginal examination is a subjective evaluation and has several limitations[2]. A growing body of knowledge is accumulating regarding intrapartum ultrasound as a relatively new application of ultrasound. Intrapartum ultrasonography can provide objective infor-mation on the dynamics of different stages of labor [3], and may be used to assess labor progression, predict labor outcome and to predict the prognosis for operative vaginal delivery [4]. Translabial ultrasound was used to demonstrate pelvic floor structures, it was shown to be fast, safe, reliable, easy to learn and readily available tool [5]
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