Imperial College London
Alternate

Dr Sana Usman

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Lecturer
 
 
 
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Contact

 

s.usman

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Usman:2018:10.1080/14767058.2018.1465553,
author = {Usman, S and Wilkinson, M and Barton, H and Lees, CC},
doi = {10.1080/14767058.2018.1465553},
journal = {Journal of Maternal-Fetal and Neonatal Medicine},
pages = {3442--3451},
title = {The feasibility and accuracy of ultrasound assessment in the labor room},
url = {http://dx.doi.org/10.1080/14767058.2018.1465553},
volume = {32},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: Vaginal examination is widely used to assess the progress of labor; however, it is subjective and poorly reproducible. We aim to assess the feasibility and accuracy of transabdominal and transperineal ultrasound compared to vaginal examination in the assessment of labor and its progress. METHODS: Women were recruited as they presented for assessment of labor to a tertiary inner city maternity service. Paired vaginal and ultrasound assessments were performed in 192 women at 24-42 weeks. Fetal head position was assessed by transabdominal ultrasound defined in relation to the occiput position transformed to a 12-hour clock face; fetal head station defined as head-perineum distance by transperineal ultrasound; cervical dilatation by anterior to posterior cervical rim measurement and caput succedaneum by skin-skull distance on transperineal ultrasound. RESULTS: Fetal head position was recorded in 99.7% (298/299) of US and 51.5% (154/299) on vaginal examination (p < .0001 1 ). Bland-Altman analysis showed 95% limits of agreement, -5.31 to 4.84 clock hours. Head station was recorded in 96.3% (308/320) on vaginal examination (VE) and 95.9% (307/320) on US (p = .79 1 ). Head station and head perineum distance were negatively correlated (Spearman's r = -.57, p < .0001). 54.4% (178/327) of cervical dilatation measurements were determined using US and 100% on VE/speculum (p < .0001). Bland-Altman analysis showed 95% limits of agreement -2.51-2.16 cm. The presence of caput could be assessed in 98.4% (315/320) of US and was commented in 95.3% (305/320) of VEs, with agreement for the presence of caput of 76% (p < .05). Fetuses with caput greater than 10 mm had significantly lower head station (p < .0001). CONCLUSIONS: We describe comprehensive ultrasound assessments in the labor room that could be translated to the assessment of women in labor.
AU  - Usman,S
AU  - Wilkinson,M
AU  - Barton,H
AU  - Lees,CC
DO  - 10.1080/14767058.2018.1465553
EP  - 3451
PY  - 2018///
SN  - 1476-4954
SP  - 3442
TI  - The feasibility and accuracy of ultrasound assessment in the labor room
T2  - Journal of Maternal-Fetal and Neonatal Medicine
UR  - http://dx.doi.org/10.1080/14767058.2018.1465553
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29712501
UR  - http://hdl.handle.net/10044/1/69083
VL  - 32
ER  -
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