Obstetric Outcomes of Position Abnormalities Detected by Intrapartum Suprapubic Transabdominal Ultrasound
DOI:
https://doi.org/10.20941/2309-4400.2019.07.2Keywords:
Abnormal fetal position, dysfunctional labor, second period of prolonged labor.Abstract
Objective: to propose the use of ultrasound during abnormal labor, as a detection of position abnormalities, to evaluate the way of resolution of pregnancy and reduce maternal-fetal complications.
Materials and Methods: Prospective, cross-sectional, descriptive study, carried out in term pregnant patients, carried out in a second level of care in December 2018 to July 2019, the population was divided into group 1 (it included 15 patients with evolution abnormal labor in which no ultrasound was performed to detect position abnormalities) and group 2 (15 patients with abnormal evolution of labor and ultrasound detection of position anomaly were included) to determine the usefulness of diagnosis by ultrasound and its association with maternal-fetal morbidity and mortality.
Results: A total of 30 patients were registered, both groups with 15 patients each, in group 1, 11 patients with maternal and fetal morbidity were reported, whose resolution was vaginal in which position abnormalities were detected during the obstetric event, In group 2, 15 patients were reported with abnormal evolution of labor and with a diagnosis of position abnormalities, detected by ultrasound during the second period of labor, whose resolution of pregnancy was abdominal, without complications, in 4 Patients the indication was due to fetal compromise.
Conclusions: Timely detection in the second period of labor for position abnormalities is an effective method to reduce maternal-fetal complications.
References
Molina, et al. Ultrasound in labor and delivery. Fetal Diagn Ther 2010; 27(2): 61-7. https://doi.org/10.1159/000287588
Akmal S, et al. Intrapartum sonography to determine fetal head position. J Matern Fetal Neonatal Med 2002; 12(3): 172-7. https://doi.org/10.1080/jmf.12.3.172.177
Souka A, et al. Intrapartum ultrasound for the examination of the fetal head position in normal and obstructed labor. J Matern Fetal Neonatal Med 2003; 13(1): 59-63. https://doi.org/10.1080/jmf.13.1.59.63
Bellusi F, et al. The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations. Am J Obstet Gynecol 2017; 217(6): 633-641. https://doi.org/10.1016/j.ajog.2017.07.025
Villagomez E, et al. Detección de anomalías de posición mediante ultrasonido transabdominal suprapúbico. Reporte de dos casos. Ginecol Obstet Mex 2019; 87(8): 549-554.
Fouche J, Simon E. Ultrasound in monitoring of the second stage of labour, Gynecologie Obstetrique & Fertilite 2012; 40: 658-665. https://doi.org/10.1016/j.gyobfe.2012.09.001
Gimovsky A, Berghella V. Randomized controlled trial of prolonged second extending the time limit vs usual guidelines. American Journal of Obstetrics and Gynecology March 2016. https://doi.org/10.1016/j.ajog.2015.10.139
FIGO Safe motherhood and newborn health (SMNH) Committee, Management of second stage of labor. International Journal of Gynecology and Obstetrics 2012; 119: 111-116. https://doi.org/10.1016/j.ijgo.2012.08.002
Senecal J, Xiong X. Effect of Fetal Position on Second-Stage Duration and Labor Outcome, The American College of Obstetricians and Gynecologists 2005; 105(4). https://doi.org/10.1097/01.AOG.0000154889.47063.84
Ghi T, Maroni E. Sonographic pattern of fetal head descent: relationship with duration of active second stage of labor and occiput position at delivery, Ultrasound Obstet Gynecol 2014; 44: 82-89. https://doi.org/10.1002/uog.13324
Martino V, Iliceto N. Occipito-posterior fetal head position, maternal and neonatal outcome, Minerva Ginecol 2007; 59(4): 459-64.
