Transperineal ultrasound in predicting labor outcome in the second stage of labor: A literature review
DOI:
https://doi.org/10.37800/RM.3.2025.574Keywords:
transperineal ultrasound (TPUS), angle of progression (AoP), ultrasound navigation of labor, contracted pelvis, posterior asynclitismAbstract
Relevance: Transperineal ultrasound (TPUS) is a valuable tool to predict and diagnose cephalopelvic disrptoportion during the second stage of labor. Lack of fetal head descent through the birth canal, clinical signs of a contracted pelvis, and posterior asynclitism serve are key indicators for emergency operative delivery at this stage.
The study aimed to review the available scientific and practical data on the use of transperineal intrapartum ultrasound as an objective method for determining management tactics in the second stage of labor.
Materials and methods: A search for scientific publications with a depth of 15 years was carried out in the following databases: PubMed, Scopus, Wiley, Medline, Google Scholar and Web of Science by keywords using MESH: transperineal ultrasound, angle of progression (AoP), discrepancy between the pelvis and the head, ultrasound navigation of labor, conracted pelvis, posterior asynclitism.
Results: The objective of intrapartum TPUS is to assess the progression of the fetal head through the bony ring of the woman’s pelvis and determine whether natural delivery is possible or surgical intervention is required. Standard ultrasound parameters for assessing the progression of labor include the distance between the head and the perineum, AoP, midline angle, direction of the fetal head, etc. AoP is the most accessible and informative of the specified ultrasound parameters.
Conclusion: The obtained results indicate the potential of using TPUS for an objective assessment of labor progress. This method, which offers several diagnostic advantages over traditional clinical approaches, represents a relatively new direction in obstetric practice and requires further in-depth study to determine its clinical significance and optimize protocols for its use. The use of this method allows obtaining valuable information on the movement of the fetal head along the birth canal, including AoP, which contributes to effective feedback during labor. Given these scientific findings, the use of intrapartum TPUS to assess fetal head progression is an important tool for improving obstetric practice. Its use may significantly reduce the number of emergency cesarean sections and reduce the risk of complications associated with them, which in turn contributes to improved maternal and fetal outcomes.
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