title: Determination of fetal occiput position by ultrasound during the second stage of labor.
abstract: OBJECTIVE
  To investigate whether ultrasonography is superior to vaginal examination for determination of fetal occiput position during the second stage of labor.
  
  
  METHODS
  We conducted a prospective cohort study of 44 parturients. During the second stage of labor, an attending obstetrician performed a vaginal examination to detect fetal occiput position. This was followed by combined abdominal and perineal ultrasound examination. The two methods were compared to the true position. Results were analyzed using Student's t test for quantitative parameters. McNemar's and Fisher's exact tests were applied in order to examine differences between the study groups.
  
  
  RESULTS
  The error rate in detecting fetal occiput position was significantly lower using the ultrasound technique (6.8%) compared to vaginal examination (29.6%, p = 0.011). Parity, maternal body mass index or fetal weight had no influence on the error rate.
  
  
  CONCLUSIONS
  Ultrasonographic determination of the fetal position is an accurate technique and is superior to vaginal examination.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Israel. dkreiser@stanford.edu
authors.forename: D
authors.initials: D
authors.lastname: Kreiser
authors.forename: E
authors.initials: E
authors.lastname: Schiff
authors.forename: S
authors.initials: S
authors.lastname: Lipitz
authors.forename: Z
authors.initials: Z
authors.lastname: Kayam
authors.forename: A
authors.initials: A
authors.lastname: Avraham
authors.forename: R
authors.initials: R
authors.lastname: Achiron
mesh_terms: D015331:Cohort Studies; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007746:Labor Presentation; D007748:Labor Stage, Second; D009777:Occipital Bone; D010808:Physical Examination; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014621:Vagina