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. 2025 Jan;41(1):147-150.
doi: 10.12669/pjms.41.1.9930.

Measurement of angle of progression by trans perineal-ultrasound in labour to predict mode of delivery in nulliparous women

Humaira Masood  1 , Rubaba Abid  2 , Mohammad Ahmed  3 , Munir Mehmood  4
Affiliations

Measurement of angle of progression by trans perineal-ultrasound in labour to predict mode of delivery in nulliparous women

Humaira Masood et al. Pak J Med Sci. 2025 Jan.

Abstract

Objective: The objective of the study was to assess whether the measurement of the angle of progression in nulliparous women in labour can predict the mode of delivery.

Methods: This prospective observational study was conducted at Benazir Bhutto Hospital, Rawalpindi Medical University from 16th February to 25th March 2024. Nulliparous pregnant women in the active first stage of labour with singleton pregnancy and cephalic presentation were included in the study after taking informed consent. The angle of progression (AOP) was measured by trans-perineal ultrasound using the curvilinear probe. The primary outcome was the mode of delivery in relation to angle of progression.

Results: Seventy-eight patients were included in the study. Angle of progression was wider in patients who underwent vaginal delivery and narrower in patients who underwent cesarean section. AOP of 121 or more is associated with 86.6% of vaginal delivery and an angle of progression of 70 or less is associated with 83.3% of cesarean section.

Conclusion: The angle of progression is a reliable tool for predicting the mode of delivery. Wider angle is associated with vaginal delivery and a narrower angle is associated with cesarean section.

Keywords: Angle of descent; Angle of progression; Trans-perineal ultrasound.

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Figures

Fig.1
Fig.1
Ultrasound image showing angle of progression.
Fig.2
Fig.2
Comparison between different angles of progression with mode of delivery.
See this image and copyright information in PMC

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