[INTRAPARTUM ULTRASOUND - THE FUTURE IS HERE]

Abstract

This review aims to present the different applications and benefits of intrapartum ultrasound (IPUS) compared to the traditional digital vaginal examination. IPUS is non-invasive, does not cause pain or discomfort to the woman and may reduce the rate of ascending infections. In comparison to the vaginal exam, IPUS is more accurate in diagnosing fetal head position and station, is easy to acquire and has a faster learning curve. Applications of IPUS include: 1. Diagnosing the fetal head position either by suprapubic or trans-perineal ultrasound when the fetal head is low, which is more accurate than the digital vaginal exam; 2. Measuring cervical dilatation and effacement by trans-perineal ultrasound. This may be of more value especially in patients with ruptured membranes or patients who have difficulty with invasive examinations; 3. Assessing fetal head station and labor progress by measuring the head-perineal distance (HPD) and the angle of progression (AOP); 4. Estimating the pelvic size relative to the fetal head by measuring the pubic arch angle and fetal head circumference; 5. Predicting the mode of delivery before and during the labor process; 6. Prior to deciding the mode of delivery in a prolonged second stage of labor; 7. Providing a visual biofeedback to improve pushing efforts and mother-baby connection.