title: Intrapartum sonographic imaging of fetal head asynclitism.
abstract: Anterior asynclitism was suspected on digital examination of a laboring woman with late arrest of dilatation and no evidence of fetal head progression. Clinical examination revealed a fixed non-engaged fetal head (station −1), with a transverse posterior sagittal suture. A static three-dimensional volume was obtained by translabial ultrasound, offline analysis of which confirmed the clinical diagnosis of anterior asynclitism. Owing to the posterior twisting of the head towards the sacrum, the midline echo could only be obtained by cutting the volume with an oblique line, the direction of which was not perpendicular to the pubis as expected in cases of synclitic head. The sonographic appearance of the midline echo approaching the sacrum in a non-engaged transverse fetal head strongly supports the clinical suspicion of anterior asynclitism.
authors.affiliation: Department of Obstetrics and Gynecology, S.Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy. tullioghi@yahoo.com
authors.forename: T
authors.initials: T
authors.lastname: Ghi
authors.forename: A
authors.initials: A
authors.lastname: Youssef
authors.forename: G
authors.initials: G
authors.lastname: Pilu
authors.forename: A
authors.initials: A
authors.lastname: Malvasi
authors.forename: A
authors.initials: A
authors.lastname: Ragusa
mesh_terms: D002585:Cesarean Section; D005260:Female; D006257:Head / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D007746:Labor Presentation; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging*; D010294:Parietal Bone / Q000000981:diagnostic imaging* / Q000196:embryology; D011247:Pregnancy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods