Brief Summary: Show To assess whether ultrasound methods can predict outcome of operative vaginal deliveries in nulliparous women at term with singleton pregnancies and prolonged second stage of labor. To compare different ultrasound assessments Compare digital assessments and ultrasound findings. Investigate if movement of the fetal head during active pushing is a predictive factor Null hypotheses:
Primary Outcome Measures :
Secondary Outcome Measures :
Other Outcome Measures:
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Nulliparous women with a singleton live fetus in cephalic presentation at term (≥ 37 weeks) with prolonged active second stage and a clinical decision to expedite delivery by vacuum due to poor progression Inclusion Criteria:
Exclusion Criteria:
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Helse Stavanger HF St.Olavs Hospital, Trondheim University Hospital, Norway Lund University Hospital University of Bologna Copenhagen University Hospital, Hvidovre Queen Charlotte's and Chelsea Hospital University of Parma Layout table for investigator information
Ghi T, Youssef A, Maroni E, Arcangeli T, De Musso F, Bellussi F, Nanni M, Giorgetta F, Morselli-Labate AM, Iammarino MT, Paccapelo A, Cariello L, Rizzo N, Pilu G. Intrapartum transperineal ultrasound assessment of fetal head progression in active second stage of labor and mode of delivery. Ultrasound Obstet Gynecol. 2013 Apr;41(4):430-5. doi: 10.1002/uog.12379. Layout table for additonal information
Keywords provided by Helse Stavanger HF:
How is the fetus assessed throughout labor?There are two methods of fetal heart rate monitoring in labor. Auscultation is a method of periodically listening to the fetal heartbeat. Electronic fetal monitoring is a procedure in which instruments are used to continuously record the heartbeat of the fetus and the contractions of the woman's uterus during labor.
What assessment should be made to evaluate the progress of labor?Currently, the most common recommendations for monitoring progress in labour are measuring the descent of the fetal head and a vaginal examination of cervical dilatation every four hours.
Which assessment finding is expected as the transition phase begins?A nurse is assessing a client in active labor for signs that the transition phase is beginning. What change does the nurse expect? Rectal pressure occurs at the beginning of the transition phase of labor when the fetal head starts to press on the rectum during contractions.
How should progress of labor be monitored during the first stage?During the 1st stage of labor, maternal heart rate and blood pressure and fetal heart rate should be checked continuously by electronic monitoring or intermittently by auscultation, usually with a portable Doppler ultrasound device (see fetal monitoring.
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In which manner is the fetal status best assessed during the active and transition stages of labor?
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