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Malvasi A, Damiani GR, DI Naro E, Vitagliano A, Dellino M, Achiron R, Ioannis K, Vimercati A, Gaetani M, Cicinelli E, Vinciguerra M, Ricci I, Tinelli A, Baldini GM, Silvestris E, Trojano G. Intrapartum ultrasound and mother acceptance: A study with informed consent and questionnaire. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100246. [PMID: 37876768 PMCID: PMC10590726 DOI: 10.1016/j.eurox.2023.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Intrapartum ultrasound (IU) is used in the delivery ward; even if IU monitors the labouring women, it could be perceived as a discomfort and even as an" obstetric violence", because it is a young technique, not often well "accepted". A group of clinicians aimed at obtain an informed consent from patients, prior to perform a translabial ultrasound (TU). The aim of this study was to evaluate the acceptance of both translabial and transabdominal IU. Methods In this study, performed at the University Hospital of Bari (Unit of Obstetrics and Gynecology), were enrolled 103 patients in the first or second stage of labor in singleton cephalic presentation. A statistical frequency and an association analysis were performed. As a significant result, we consider the peace of mind/satisfaction and the" obstetric violence". IU was performed both transabdominal and translabial to determine the presentation, head positions, angle of progression and head perineum distance. During the first and second stage of labor, the ASIUG questionnaires (Apulia study intrapartum ultrasonography group) were administered. Results 74 (71, 84%) patients underwent IU and 29 had a vaginal examination (28, 15%). Significant less "violence" has been experienced with a IU (73 out 74/98, 65%) and only one person (1 /1, 35%) recorded that. On the contrary, 10 patients (10/29) perceived that "violence" (34, 48%) while 19 (65, 52%) did not respond on a similar way, after a vaginal examination (VE). More patients felt satisfaction (71 out 74/95, 95%) with the use of IU and only 3 (3/4, 05%) felt unease. A different picture was evident in the vaginal examination group. Only 17 patients (17 out 29/58, 62%) felt comfort while 12 (41, 38%) felt unease. Conclusions In our study, IU use is well accepted by most of patients, because it could reassure women about their fetal condition. Moreover, they can see the fetus on the screen, while the obstetrician is performing the US and this is important for a visual feedback, in comparison with the classical VE.
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Affiliation(s)
- Antonio Malvasi
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), 141701 Moscow, Russia
| | - Gianluca Raffaello Damiani
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Edoardo DI Naro
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Amerigo Vitagliano
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Miriam Dellino
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Reuven Achiron
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Kosmas Ioannis
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Antonella Vimercati
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Maria Gaetani
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Ettore Cicinelli
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Marina Vinciguerra
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Ilaria Ricci
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Andrea Tinelli
- Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), 141701 Moscow, Russia
- Department of Obstetrics and Gynecology, "Veris delli Ponti" Hospital, Scorrano, 73020 Lecce, Italy
- Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, 73100 Lecce, Italy
| | | | - Erica Silvestris
- Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy
| | - Giuseppe Trojano
- Department of Maternal and Child Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, ItalyHealth, "Madonna delle Grazie" Hospital ASM, 75100 Matera, Italy
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Youssef A, Brunelli E, Montaguti E, Di Donna G, Dodaro MG, Bianchini L, Pilu G. Transperineal ultrasound assessment of maternal pelvic floor at term and fetal head engagement. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:921-927. [PMID: 31975450 DOI: 10.1002/uog.21982] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/17/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate the association between pelvic floor dimensions in nulliparous women at term and fetal head engagement, as assessed by transperineal ultrasound. METHODS This was a prospective observational study of nulliparous women at term. Before the onset of labor, transperineal ultrasound was used to measure the anteroposterior diameter (APD) of the levator hiatus and the angle of progression (AoP) at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva maneuver (before and after visual feedback). We assessed the correlation between pelvic floor static and dynamic dimensions (levator hiatal APD and levator ani muscle coactivation) and AoP, which is an objective index of fetal head engagement. RESULTS In total, 282 women were included in the analysis. Among these, 211 (74.8%) women had a vaginal delivery while 71 (25.2%) had a Cesarean delivery. AoP was narrower in the Cesarean-delivery group at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva, whereas no differences in levator hiatal APD were found between the two groups. We found a negative correlation between levator hiatal APD at rest, on maximum pelvic floor muscle contraction and on maximum Valsalva and the duration of the second stage of labor. There was a positive correlation between AoP and levator hiatal APD on maximum Valsalva maneuver after visual feedback (r = 0.15, P = 0.01). Women with levator ani muscle contraction on Valsalva maneuver (i.e. coactivation), both pre and post visual feedback, had a narrower AoP at rest and on maximum Valsalva. After visual feedback, women with levator ani muscle coactivation had a longer second stage of labor than did those without (80.8 ± 61.4 min vs 62.9 ± 43.4 min (P = 0.04)). CONCLUSIONS Smaller pelvic floor dimensions and levator ani muscle coactivation are associated with higher fetal head station and with a longer second stage of labor in nulliparous women at term. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Youssef
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - E Brunelli
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - E Montaguti
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - G Di Donna
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - M G Dodaro
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - L Bianchini
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - G Pilu
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
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Sainz JA, Fernández-Palacín A, Borrero C, Aquise A, Ramos Z, García-Mejido JA. Intra and interobserver variability of intrapartum transperineal ultrasound measurements with contraction and pushing. J OBSTET GYNAECOL 2017; 38:333-338. [DOI: 10.1080/01443615.2017.1354179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- José A. Sainz
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynaecology, University of Seville, Seville, Spain
| | - Ana Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - Carlota Borrero
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain
| | - Adriana Aquise
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain
- Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, UK
| | - Zenaida Ramos
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain
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Tutschek B, Braun T, Chantraine F, Henrich W. Re: Prediction of delivery time in second stage of labor using transperineal ultrasound. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:663-664. [PMID: 28471029 DOI: 10.1002/uog.17424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/20/2016] [Indexed: 06/07/2023]
Affiliation(s)
- B Tutschek
- Center for Fetal Medicine, Gladbachstrasse 95, 8044, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - T Braun
- Charité, Campus Virchow, University Hospital, Berlin, Germany
| | - F Chantraine
- Obstetrics and Gynecology, University Hospital, Liège, Belgium
| | - W Henrich
- Charité, Campus Virchow, University Hospital, Berlin, Germany
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Tutschek B, Braun T, Chantraine F, Henrich W. Computed tomography and ultrasound to determine fetal head station. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:279-280. [PMID: 28169500 DOI: 10.1002/uog.17291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/15/2016] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Fetal Medicine and Gynecological Ultrasound, Gladbachstrasse 95, 8044, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - T Braun
- Charité, Universitätsmedizin Berlin, Department of Obstetrics, Berlin, Germany
| | - F Chantraine
- Obstetrics and Gynecology, University Hospital, Liège, Belgium
| | - W Henrich
- Charité, Universitätsmedizin Berlin, Department of Obstetrics, Berlin, Germany
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Youssef A, Salsi G, Cataneo I, Martelli F, Azzarone C, Bellussi F, Ghi T, Pilu G, Rizzo N. Agreement between two 3D ultrasound techniques for the assessment of the subpubic arch angle. J Matern Fetal Neonatal Med 2016; 30:1-5. [PMID: 27050886 DOI: 10.1080/14767058.2016.1175000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess the reliability of a new three-dimensional (3D) ultrasound technique for the measurement of the subpubic arch angle (SPA) and the agreement between two contrast-enhancing 3D ultrasound techniques. METHODS We acquired two static 3D transperineal volumes from 72 nulliparous women using two ultrasound machines equipped with two different 3D contrast enhancement and linear reconstruction softwares: 1. Oblique View Extended Imaging with HD-Volume Imaging (OVIX-HDVI™), Samsung; 2. Omniview with Volume Contrast Imaging (Omniview-VCI™), GE Healthcare. An operator measured SPA once by OVIX-HDVI, and twice by Omniview-VCI, while another operator measured SPA once by Omniview-VCI. We evaluated intra- and inter-observer reproducibility of Omniview-VCI and intermethod agreement. Reproducibility and intermethod agreement were studied by means of intraclass correlation coefficient (ICC) and Bland-Altman method. RESULTS Omniview-VCI SPA measurements showed excellent intraobserver and interobserver reproducibility (ICC 0.970; 95% C.I. 0.952 to 0.981, 0.932; 95% C.I. 0.893 to 0.957, respectively). Furthermore, Omniview VCI SPA measurements demonstrated excellent agreement with those performed by OVIX-HDVI technique (ICC 0.943; 95 C.I. 0.911 to 0.964). No systematic difference was found in any of the reliability studies. CONCLUSIONS OmniView-VCI is a reliable method for SPA assessment. Both OmniView-VCI and OVIX-HDVI can be used interchangeably for SPA measurement.
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Affiliation(s)
- Aly Youssef
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Ginevra Salsi
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Ilaria Cataneo
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Federica Martelli
- b Department of Obstetrics and Gynecology , Tor Vergata University , Rome , Italy , and
| | - Carlotta Azzarone
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Federica Bellussi
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Tullio Ghi
- c Department of Obstetrics and Gynecology , University of Parma , Parma , Italy
| | - Gianluigi Pilu
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Nicola Rizzo
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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Sainz JA, Borrero C, Fernández-Palacín A, Aquise A, Valdivieso P, Pastor L, Garrido R. Intrapartum transperineal ultrasound as a predictor of instrumentation difficulty with vacuum-assisted delivery in primiparous women. J Matern Fetal Neonatal Med 2014; 28:2041-7. [DOI: 10.3109/14767058.2014.976547] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- José A. Sainz
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
- Department of Obstetrics and Gynaecology, University of Seville, Spain, and
| | - Carlota Borrero
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
| | - Ana Fernández-Palacín
- Department of Preventive Medicine and Public Health, Biostatistics Unit, University of Seville, Spain
| | - Adriana Aquise
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
| | - Pamela Valdivieso
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
| | - Luis Pastor
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
| | - Rogelio Garrido
- Department of Obstetrics and Gynaecology, Valme University Hospital, Seville, Spain,
- Department of Obstetrics and Gynaecology, University of Seville, Spain, and
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Youssef A, Maroni E, Cariello L, Bellussi F, Montaguti E, Salsi G, Morselli-Labate AM, Paccapelo A, Rizzo N, Pilu G, Ghi T. Fetal head-symphysis distance and mode of delivery in the second stage of labor. Acta Obstet Gynecol Scand 2014; 93:1011-7. [DOI: 10.1111/aogs.12454] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 07/02/2014] [Indexed: 01/14/2023]
Affiliation(s)
- Aly Youssef
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Elisa Maroni
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Luisa Cariello
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Federica Bellussi
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Elisa Montaguti
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Ginevra Salsi
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | | | - Alexandro Paccapelo
- Department of Medical and Surgical Sciences; Alma Mater - University of Bologna; Bologna Italy
| | - Nicola Rizzo
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Gianluigi Pilu
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Tullio Ghi
- Department of Obstetrics and Gynecology; Sant'Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
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Tutschek B, Torkildsen EA, Eggebø TM. Comparison between ultrasound parameters and clinical examination to assess fetal head station in labor. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 41:425-429. [PMID: 23371409 DOI: 10.1002/uog.12422] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Several ultrasound parameters, including intrapartum transperineal ultrasound (ITU) head station, angle of progression (AOP), head-perineum distance (HPD) and head-symphysis distance (HSD), have been suggested to assess fetal head station during labor. The aim of this study was to analyze the relationship between these ultrasound parameters and to compare them with digital palpation. METHODS We analyzed 106 stored volume dataset pairs that had been acquired at Stavanger University Hospital, Norway, from nulliparous women at term with prolonged first stage of labor. The volumes were acquired using a three-dimensional transducer applied between the labia majora in a mid-sagittal plane and perineally in a transverse plane. Digitally palpated head station and cervical dilatation were also noted. The results were compared using regression and correlation coefficients. RESULTS There were good correlations between ITU head station and HPD (r = 0.71), between ITU head station and HSD (r = 0.74) and between HSD and HPD (r = 0.75). Palpated head station showed only moderate correlation with ITU head station (r = 0.52). Cervical dilatation showed a weak correlation with ITU head station (r = 0.30). CONCLUSION The ultrasound parameters showed a high degree of correlation with each other, but only moderate correlation to vaginally palpated fetal head station.
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Affiliation(s)
- B Tutschek
- Heinrich Heine University, Düsseldorf, Germany.
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