title: Vaginal versus ultrasound examination of fetal occiput position during the second stage of labor.
abstract: OBJECTIVE
  The purpose of this study was to determine whether ultrasonography is more accurate than vaginal examination in the determination of fetal occiput position in the second stage of labor.
  
  
  METHODS
  Eighty-eight patients in the second stage of labor were evaluated by vaginal examination and by combined transabdominal and transperineal ultrasound examination to determine occiput position. These predictions of position were compared with the actual delivery position at vaginal delivery after spontaneous restitution or at cesarean delivery. Different examiners performed the vaginal examinations and the ultrasound examinations. Each examiner was blinded to the determination of the other examiner.
  
  
  RESULTS
  Vaginal examination determined fetal occiput position correctly 71.6% of the time; ultrasound examination determined fetal occiput position correctly 92.0% of the time (P=.018).
  
  
  CONCLUSIONS
  Ultrasound examination is more accurate than vaginal examination in the diagnosis of fetal occiput position in the second stage of labor.
authors.affiliation: Stanford University Department of Obstetrics and Gynecology, Lucile S. Packard Children's Hospital at Stanford University, Stanford, CA, USA.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Chou
authors.forename: Doron
authors.initials: D
authors.lastname: Kreiser
authors.forename: M Mark
authors.initials: MM
authors.lastname: Taslimi
authors.forename: Maurice L
authors.initials: ML
authors.lastname: Druzin
authors.forename: Yasser Y
authors.initials: YY
authors.lastname: El-Sayed
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007746:Labor Presentation; D007748:Labor Stage, Second; D009777:Occipital Bone; D010808:Physical Examination; D011247:Pregnancy; D016216:Ultrasonography, Prenatal