Digital Examination vs. 4D Transperineal Ultrasound-Do They Compare in Labour Management? A Pilot Study.

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Reproductive Medicine

Background:

• The Bishop Score is a standard method for assessing cervical ripeness and labor progress.
• Limitations exist in subjective digital examination (DE) for labor management.
• Transperineal ultrasound (TPU) offers objective, non-invasive measurements during labor.

Purpose of the Study:

• To compare transperineal ultrasound (TPU) parameters with Bishop Score components.
• To evaluate the utility of TPU in improving labor management during the first stage of labor.
• To assess the agreement between TPU and DE for cervical dilation (CD) and cervical length (CL).

Main Methods:

• 42 women in the first stage of labor underwent both digital examination (DE) and transperineal ultrasound (TPU).
• TPU measurements included head-symphysis distance, angle of progression, cervical wall diameter, cervical dilation (CD), and cervical length (CL).
• Correlation and agreement analyses were performed between TPU parameters and DE, stratified by labor stage (latent vs. active).

Main Results:

• TPU parameters showed a moderate negative correlation between cervical dilation (CD) and cervical length (CL).
• Agreement between DE and TPU for CD was better during the latent stage of labor compared to the active stage.
• Other TPU parameters demonstrated weak to moderate correlations with labor progress indicators.

Conclusions:

• Transperineal ultrasound (TPU) shows promise as an adjunct to digital examination (DE) for monitoring labor progress.
• A combined approach of TPU and DE may enhance management during the latent first stage of labor.
• Digital examination (DE) alone may be sufficient for monitoring during the active stage of labor.