Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;7(23):718.
doi: 10.21037/atm.2019.12.11.

Using transperineal ultrasound to predict labor onset

Fanghua Peng  1 , Yang Yu  1 , Yanan Sun  1 , Shan Jiang  1 , Yun Han  1 , Zhikun Zhang  1
Affiliations

Using transperineal ultrasound to predict labor onset

Fanghua Peng et al. Ann Transl Med. 2019 Dec.

Abstract

Background: Accurate diagnosis of labor onset is especially important for the counseling about elective induction of labor. The study aimed to evaluate whether transperineal ultrasound could better predict the timing and likelihood of spontaneous labor at term.

Methods: This single-center study was conducted between 2018 and 2019.Data on singleton pregnant women after 39 weeks and before labor onset were retrospectively reviewed.

Results: All the transperineal ultrasound parameters were well reproducible between the two doctors [intraclass correlation coefficient (ICC) for progression distance(PD) was 0.892, P<0.001], [ICC for angle of progression (AoP) was 0.881, P<0.001], [ICC for subpubic arch angle (SPA) was 0.766, P<0.001], [ICC for width of symphysis pubis (WSP) was 0.803, P<0.001]. For the pregnant women before 40 weeks, the width of symphysis pubis changed gradually with the of spontaneous labor (WSP) (r=0.33, P<0.05). For all included women, the SPA correlated with the time of spontaneous labor (SPA) (r=0.31, P<0.05).

Conclusions: The antepartum transperineal ultrasound is a simple and objective technique that better observes the initiation of labor. And with the WSP and SPA we were able to predict labor onset and help in counseling about elective induction of labor.

Keywords: Labor onset; angle of progression (AoP); progression distance (PD); subpubic arch angle (SPA); width of symphysis pubis (WSP).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The ultrasound transducer is placed on the perineum in a mid-sagittal position, between the labia, and below the pubic symphysis.
Figure 2
Figure 2
Transperineal ultrasound image (sagittal view) PD (pink line) is the distance between the lower edge symphysis pubis and the closest point of the fetal skull along a line passing perpendicular to the longitudinal axis of the symphysis pubis and tangential to its lower edge. PD, progression distance.
Figure 3
Figure 3
Transperineal ultrasound image (sagittal view) AoP (pink triangle) is the angle between the long axis of the pubic symphysis and the line extending from the most inferior point of the symphysis tangentially to the fetal skull contour (the two red lines). AoP, angle of progression.
Figure 4
Figure 4
4D views of symphysis pubis joint and measurement of the wide symphysis pubis (the pink line). 4D, four-dimensional.
Figure 5
Figure 5
4D volumes were acquired using the transperineal ultrasound. 4D, four-dimensional.
Figure 6
Figure 6
The plane of the pubic rami is then automatically displayed. The 3-point or the 2-line functions then measure the angle formed by the 2 pubic rami.
Figure 7
Figure 7
The scatter diagram of the association between all included pregnancies’ ultrasound measurements and labor onset, according to these values, the time of labor onset computed by using these two variables was equal to −298.78 + 3.937 × SPA. SPA, subpubic arch angle.
Figure 8
Figure 8
The scatter diagram of the association between 39–40 weeks pregnancies’ ultrasound measurements and labor onset. The time of labor onset computed by using these two variables was equal to −112.12 + 30.275 × WSP. WSP, width of symphysis pubis.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Buchmann EJ, Libhaber E. Accuracy of cervical assessment in the active phase of labour. BJOG 2007;114:833-7. 10.1111/j.1471-0528.2007.01386.x - DOI - PubMed
    1. Brubaker L, Wolfe AJ. The female urinary microbiota, urinary health and common urinary disorders. Ann Transl Med 2017;5:34. 10.21037/atm.2016.11.62 - DOI - PMC - PubMed
    1. Eggebo TM, Gjessing LK, Heien C, et al. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. Ultrasound Obstet Gynecol 2006;27:387-91. 10.1002/uog.2744 - DOI - PubMed
    1. Ghi T, Youssef A, Martelli F, et al. Narrow subpubic arch angle is associated with higher risk of persistent occiput posterior position at delivery. Ultrasound Obstet Gynecol 2016;48:511-5. 10.1002/uog.15808 - DOI - PubMed
    1. Youssef A, Ghi T, Awad EE, et al. Ultrasound in labor: a caregiver's perspective. Ultrasound Obstet Gynecol 2013;41:469-70. 10.1002/uog.12267 - DOI - PubMed