Pubic arch angle in prolonged second stage of labor: clinical significance
ABSTRACT Objective To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor. Methods We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2013-04, Vol.41 (4), p.442-446 |
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| creator | Gilboa, Y. Kivilevitch, Z. Spira, M. Kedem, A. Katorza, E. Moran, O. Achiron, R. |
| description | ABSTRACT
Objective
To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor.
Methods
We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal ultrasound (transverse plane) was used to measure the pubic arch angle. Correlations with fetomaternal characteristics, mode of delivery and perinatal outcome were evaluated.
Results
The mean PAA was 101.1° (± 13.1°; range, 80°–135°). We found a negative correlation with maternal age. Patients with an occipitotransverse fetal position had a significantly smaller angle compared with those with occipitoanterior positions (94.3° ± 5.5° vs 103.2° ± 14.8°, P < 0.05), as did those with operative deliveries compared with those with spontaneous vaginal delivery (97.1° ± 11.5° vs 110.1° ± 14.0°, P < 0.05). The prediction of operative delivery in prolonged second stage of labor by receiver–operating characteristics curve using PAA alone yielded an area under the curve of 0.75. The predicted probability for operative delivery increased as PAA decreased, with an odds ratio of 0.933 for each decrease in angle of 1°.
Conclusion
Our study suggests a correlation between the PAA and mode of delivery in prolonged second stage of labor. This may be used as an adjunctive parameter when considering delivery mode. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/uog.12304 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1434028734</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1434028734</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4214-7a2e0d6f28808563d94de568975f4ad0f6b4e2d79bccdfa2378d8a336267c1c43</originalsourceid><addsrcrecordid>eNqN0btKBTEQBuAgih4vhS8gARstVieXTbJ2Il4RtNB6ySbZNZKT6MZFfHujRy0EwWpSfPxk5kdom8ABAaCHUxoOCGXAl9CMcNFUIKFeRjNoBFRSNHQNref8CACCM7GK1ooFoqSYoavbqfMG69E8YB2H4LCP-GlMIcXBWZydSbGMFz04nHocdJfGI2yCj97ogLMfou_LMxq3iVZ6HbLb-pob6P7s9O7korq-Ob88Ob6uDKeEV1JTB1b0VClQtWC24dbVQjWy7rm20IuOO2pl0xlje02ZVFZpxgQV0hDD2QbaW-SWbz5PLr-0c5-NC0FHl6bcEs44UCXZPyijQARXdVPo7i_6mKYxlkU-FCU1I7Iuan-hzJhyHl3fPo1-rse3lkD70UVbumg_uyh25ytx6ubO_sjv4xdwuACvPri3v5Pa-5vzReQ7yaeQmA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1322153175</pqid></control><display><type>article</type><title>Pubic arch angle in prolonged second stage of labor: clinical significance</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Gilboa, Y. ; Kivilevitch, Z. ; Spira, M. ; Kedem, A. ; Katorza, E. ; Moran, O. ; Achiron, R.</creator><creatorcontrib>Gilboa, Y. ; Kivilevitch, Z. ; Spira, M. ; Kedem, A. ; Katorza, E. ; Moran, O. ; Achiron, R.</creatorcontrib><description>ABSTRACT
Objective
To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor.
Methods
We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal ultrasound (transverse plane) was used to measure the pubic arch angle. Correlations with fetomaternal characteristics, mode of delivery and perinatal outcome were evaluated.
Results
The mean PAA was 101.1° (± 13.1°; range, 80°–135°). We found a negative correlation with maternal age. Patients with an occipitotransverse fetal position had a significantly smaller angle compared with those with occipitoanterior positions (94.3° ± 5.5° vs 103.2° ± 14.8°, P < 0.05), as did those with operative deliveries compared with those with spontaneous vaginal delivery (97.1° ± 11.5° vs 110.1° ± 14.0°, P < 0.05). The prediction of operative delivery in prolonged second stage of labor by receiver–operating characteristics curve using PAA alone yielded an area under the curve of 0.75. The predicted probability for operative delivery increased as PAA decreased, with an odds ratio of 0.933 for each decrease in angle of 1°.
Conclusion
Our study suggests a correlation between the PAA and mode of delivery in prolonged second stage of labor. This may be used as an adjunctive parameter when considering delivery mode. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.12304</identifier><identifier>PMID: 23001876</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Births ; Childbirth & labor ; Delivery, Obstetric - methods ; Delivery, Obstetric - statistics & numerical data ; Female ; Humans ; Labor Stage, Second - physiology ; Obstetrics ; Perineum - diagnostic imaging ; Pregnancy ; Prospective Studies ; pubic arch angle ; Pubic Bone - anatomy & histology ; Pubic Symphysis - anatomy & histology ; second stage of labor ; Time Factors ; transperineal ultrasound ; Ultrasonic imaging ; Ultrasonography, Prenatal - methods ; Young Adult</subject><ispartof>Ultrasound in obstetrics & gynecology, 2013-04, Vol.41 (4), p.442-446</ispartof><rights>Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</rights><rights>Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4214-7a2e0d6f28808563d94de568975f4ad0f6b4e2d79bccdfa2378d8a336267c1c43</citedby><cites>FETCH-LOGICAL-c4214-7a2e0d6f28808563d94de568975f4ad0f6b4e2d79bccdfa2378d8a336267c1c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.12304$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.12304$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23001876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gilboa, Y.</creatorcontrib><creatorcontrib>Kivilevitch, Z.</creatorcontrib><creatorcontrib>Spira, M.</creatorcontrib><creatorcontrib>Kedem, A.</creatorcontrib><creatorcontrib>Katorza, E.</creatorcontrib><creatorcontrib>Moran, O.</creatorcontrib><creatorcontrib>Achiron, R.</creatorcontrib><title>Pubic arch angle in prolonged second stage of labor: clinical significance</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>ABSTRACT
Objective
To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor.
Methods
We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal ultrasound (transverse plane) was used to measure the pubic arch angle. Correlations with fetomaternal characteristics, mode of delivery and perinatal outcome were evaluated.
Results
The mean PAA was 101.1° (± 13.1°; range, 80°–135°). We found a negative correlation with maternal age. Patients with an occipitotransverse fetal position had a significantly smaller angle compared with those with occipitoanterior positions (94.3° ± 5.5° vs 103.2° ± 14.8°, P < 0.05), as did those with operative deliveries compared with those with spontaneous vaginal delivery (97.1° ± 11.5° vs 110.1° ± 14.0°, P < 0.05). The prediction of operative delivery in prolonged second stage of labor by receiver–operating characteristics curve using PAA alone yielded an area under the curve of 0.75. The predicted probability for operative delivery increased as PAA decreased, with an odds ratio of 0.933 for each decrease in angle of 1°.
Conclusion
Our study suggests a correlation between the PAA and mode of delivery in prolonged second stage of labor. This may be used as an adjunctive parameter when considering delivery mode. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</description><subject>Adult</subject><subject>Births</subject><subject>Childbirth & labor</subject><subject>Delivery, Obstetric - methods</subject><subject>Delivery, Obstetric - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Labor Stage, Second - physiology</subject><subject>Obstetrics</subject><subject>Perineum - diagnostic imaging</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>pubic arch angle</subject><subject>Pubic Bone - anatomy & histology</subject><subject>Pubic Symphysis - anatomy & histology</subject><subject>second stage of labor</subject><subject>Time Factors</subject><subject>transperineal ultrasound</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Prenatal - methods</subject><subject>Young Adult</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0btKBTEQBuAgih4vhS8gARstVieXTbJ2Il4RtNB6ySbZNZKT6MZFfHujRy0EwWpSfPxk5kdom8ABAaCHUxoOCGXAl9CMcNFUIKFeRjNoBFRSNHQNref8CACCM7GK1ooFoqSYoavbqfMG69E8YB2H4LCP-GlMIcXBWZydSbGMFz04nHocdJfGI2yCj97ogLMfou_LMxq3iVZ6HbLb-pob6P7s9O7korq-Ob88Ob6uDKeEV1JTB1b0VClQtWC24dbVQjWy7rm20IuOO2pl0xlje02ZVFZpxgQV0hDD2QbaW-SWbz5PLr-0c5-NC0FHl6bcEs44UCXZPyijQARXdVPo7i_6mKYxlkU-FCU1I7Iuan-hzJhyHl3fPo1-rse3lkD70UVbumg_uyh25ytx6ubO_sjv4xdwuACvPri3v5Pa-5vzReQ7yaeQmA</recordid><startdate>201304</startdate><enddate>201304</enddate><creator>Gilboa, Y.</creator><creator>Kivilevitch, Z.</creator><creator>Spira, M.</creator><creator>Kedem, A.</creator><creator>Katorza, E.</creator><creator>Moran, O.</creator><creator>Achiron, R.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201304</creationdate><title>Pubic arch angle in prolonged second stage of labor: clinical significance</title><author>Gilboa, Y. ; Kivilevitch, Z. ; Spira, M. ; Kedem, A. ; Katorza, E. ; Moran, O. ; Achiron, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4214-7a2e0d6f28808563d94de568975f4ad0f6b4e2d79bccdfa2378d8a336267c1c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Births</topic><topic>Childbirth & labor</topic><topic>Delivery, Obstetric - methods</topic><topic>Delivery, Obstetric - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Labor Stage, Second - physiology</topic><topic>Obstetrics</topic><topic>Perineum - diagnostic imaging</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>pubic arch angle</topic><topic>Pubic Bone - anatomy & histology</topic><topic>Pubic Symphysis - anatomy & histology</topic><topic>second stage of labor</topic><topic>Time Factors</topic><topic>transperineal ultrasound</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Prenatal - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gilboa, Y.</creatorcontrib><creatorcontrib>Kivilevitch, Z.</creatorcontrib><creatorcontrib>Spira, M.</creatorcontrib><creatorcontrib>Kedem, A.</creatorcontrib><creatorcontrib>Katorza, E.</creatorcontrib><creatorcontrib>Moran, O.</creatorcontrib><creatorcontrib>Achiron, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gilboa, Y.</au><au>Kivilevitch, Z.</au><au>Spira, M.</au><au>Kedem, A.</au><au>Katorza, E.</au><au>Moran, O.</au><au>Achiron, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pubic arch angle in prolonged second stage of labor: clinical significance</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2013-04</date><risdate>2013</risdate><volume>41</volume><issue>4</issue><spage>442</spage><epage>446</epage><pages>442-446</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><coden>UOGYFJ</coden><abstract>ABSTRACT
Objective
To evaluate the clinical significance of the pubic arch angle (PAA) measured by transperineal ultrasound during prolonged second stage of labor.
Methods
We evaluated prospectively 62 women ≥ 37 weeks of gestation with failure to progress in the second stage of labor. Transperineal ultrasound (transverse plane) was used to measure the pubic arch angle. Correlations with fetomaternal characteristics, mode of delivery and perinatal outcome were evaluated.
Results
The mean PAA was 101.1° (± 13.1°; range, 80°–135°). We found a negative correlation with maternal age. Patients with an occipitotransverse fetal position had a significantly smaller angle compared with those with occipitoanterior positions (94.3° ± 5.5° vs 103.2° ± 14.8°, P < 0.05), as did those with operative deliveries compared with those with spontaneous vaginal delivery (97.1° ± 11.5° vs 110.1° ± 14.0°, P < 0.05). The prediction of operative delivery in prolonged second stage of labor by receiver–operating characteristics curve using PAA alone yielded an area under the curve of 0.75. The predicted probability for operative delivery increased as PAA decreased, with an odds ratio of 0.933 for each decrease in angle of 1°.
Conclusion
Our study suggests a correlation between the PAA and mode of delivery in prolonged second stage of labor. This may be used as an adjunctive parameter when considering delivery mode. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>23001876</pmid><doi>10.1002/uog.12304</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Births Childbirth & labor Delivery, Obstetric - methods Delivery, Obstetric - statistics & numerical data Female Humans Labor Stage, Second - physiology Obstetrics Perineum - diagnostic imaging Pregnancy Prospective Studies pubic arch angle Pubic Bone - anatomy & histology Pubic Symphysis - anatomy & histology second stage of labor Time Factors transperineal ultrasound Ultrasonic imaging Ultrasonography, Prenatal - methods Young Adult |
| title | Pubic arch angle in prolonged second stage of labor: clinical significance |
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