The sonopartogram.

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Maternal-Fetal Medicine

Background:

• Digital vaginal examination for labor progress assessment has not evolved in over a century.
• Traditional partograms rely on subjective, inconsistently reproducible clinical findings.
• Advances in portable ultrasound technology enable new intrapartum applications.

Purpose of the Study:

• To explore the potential of an ultrasound-based partogram (sonopartogram) as an objective tool for labor progress assessment.
• To investigate the utility of combining clinical and ultrasound parameters for predicting intrapartum adverse outcomes.
• To inform delivery management and shared decision-making through improved risk prediction models.

Main Methods:

• Review of current practices in labor assessment and intrapartum ultrasound utilization.
• Conceptualization of a sonopartogram for objective graphical representation of labor.
• Discussion of the need for developing and validating prediction models using clinical and ultrasound data.

Main Results:

• Sonopartograms may offer greater accuracy in assessing fetal head position and station compared to digital examination.
• Ultrasound has not yet demonstrated a reduction in maternal or neonatal morbidity.
• Quantification of individual risk factors (clinical and ultrasound) for operative delivery is lacking.

Conclusions:

• A sonopartogram could complement traditional assessments, providing more objective labor progress data.
• Developing robust, validated prediction models integrating maternal characteristics and ultrasound findings is crucial for prognostic value.
• Improved prediction models can enhance intrapartum management and facilitate shared decision-making with expectant parents.