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The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations.

Abstract：

:Fetal malpositions and cephalic malpresentations are well-recognized causes of failure to progress in labor. They frequently require operative delivery, and are associated with an increased probability of fetal and maternal complications. Traditional obstetrics emphasizes the role of digital examinations, but recent studies demonstrated that this approach is inaccurate and intrapartum ultrasound is far more precise. The objective of this review is to summarize the current body of literature and provide recommendations to identify malpositions and cephalic malpresentations with ultrasound. We propose a systematic approach consisting of a combination of transabdominal and transperineal scans and describe the findings that allow an accurate diagnosis of normal and abnormal position, flexion, and synclitism of the fetal head. The management of malpositions and cephalic malpresentation is currently a matter of debate, and individualized depending on the general clinical picture and expertise of the provider. Intrapartum sonography allows a precise diagnosis and therefore offers the best opportunity to design prospective studies with the aim of establishing evidence-based treatment. The article is accompanied by a video that demonstrates the sonographic technique and findings.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Bellussi F,Ghi T,Youssef A,Salsi G,Giorgetta F,Parma D,Simonazzi G,Pilu G

doi

10.1016/j.ajog.2017.07.025

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

633-641

issue

6

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(17)30869-4

journal_volume

217

pub_type

杂志文章,评审

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