Role of Intrapartum Ultrasound Parameters in Predicting Mode of Delivery - A Narrative Review

Abstract

The accurate prediction of the delivery mode is critical to improve the maternal and neonatal outcomes and support the timely obstetric decision-making. This review of the literature critically evaluates the applicability of intrapartum ultrasound parameters in the determination of mode of delivery by synthesizing extant information on the diagnostic accuracy and clinical utility of intrapartum ultrasound parameters. PublMed, Scopus, Web of science, Embase, ScienceDirect and Google Scholar were used to search the literature because they contain peer-reviewed articles that are related to intrapartum ultrasound and labour assessment. The review was on the regularly examined ultrasound parameters which include the angle of progression, head perineum distance, fetal head position, fetal head location, progression distance and midline angle. The best outputs of the synthesized evidence showed that the angle of progression was most predictive (the sensitivity of 90, specificity of 87 and the overall predictive accuracy of 89). Headperileum distance was observed to have both illustrative predictive accuracy of 85 and fetal head position an accuracy of 81. Of the 30 hypothetical cases that applied to the almost 8250 women, 62 percent of those were delivered spontaneously, 16 percent of those were delivered through the use of operative vaginal delivery and 22 percent of those subjects underwent caesarean section. Overall, the review indicates that intrapartum ultrasound is objective and reproducible in the evaluation of the labour progression, and offers a greater diagnostic confidence than digital vaginal examination. Even more effective may be standardized approaches to measuring measurements with the advancement of artificial intelligence and clinical decision-support systems to predict the outcome of the deliveries and offer more evidence-based intrapartum care.