title: Sonographic assessment of fetal occiput position during the second stage of labor: how reliable is the transperineal approach?
abstract: OBJECTIVE
  To compare the accuracy of transperineal (TP) ultrasound with transabdominal (TA) approach in the sonographic assessment of fetal occiput position during the second stage of labour.
  
  
  METHODS
  A series of low-risk women at term attending the labour ward of three university hospitals were prospectively recruited for the purpose of this study. During the second stage of labor patients were evaluated first by TP and than by TA ultrasound to determine the fetal position. The occiput position was labelled as DOA (direct occiput anterior), ROA (right occiput anterior), LOA (left occiput anterior), DOP (direct occiput posterior), ROP (right occiput posterior), LOP (left occiput posterior), ROT (right occuput transverse) and LOT (left occiput transverse). The agreement between the two techniques was assessed.
  
  
  RESULTS
  Overall 80 patients were recruited in the study group. Ultrasound examination was performed at 21(± 8) minutes from the beginning of the active pushing. The ultrasound findings of the fetal occiput position were recorded. In all cases TA ultrasound confirmed the fetal occiput position as determined at TP approach except in one case of ROA that had been recorded as ROT using TP ultrasound.
  
  
  CONCLUSIONS
  Ultrasound TP examination is accurate in the diagnosis of fetal occiput position during the second stage of labor.
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: T
authors.initials: T
authors.lastname: Ghi
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: F
authors.initials: F
authors.lastname: Bellussi
authors.affiliation: b Department of Obstetrics and Gynecology , Stavanger University Hospital , Stravanger , Norway , and.
authors.forename: T
authors.initials: T
authors.lastname: Eggebø
authors.affiliation: c Department of Obstetrics and Gynaecology , San Giovanni di Dio Hospital , Florence , Italy.
authors.forename: F
authors.initials: F
authors.lastname: Tondi
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: G
authors.initials: G
authors.lastname: Pacella
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: G
authors.initials: G
authors.lastname: Salsi
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: L
authors.initials: L
authors.lastname: Cariello
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: A
authors.initials: A
authors.lastname: Piastra
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: A
authors.initials: A
authors.lastname: Youssef
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: G
authors.initials: G
authors.lastname: Pilu
authors.affiliation: a Department of Obstetrics and Gynecology , St. Orsola Malpighi University Hospital , Bologna , Italy .
authors.forename: N
authors.initials: N
authors.lastname: Rizzo
mesh_terms: D000005:Abdomen; D000328:Adult; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007746:Labor Presentation; D007748:Labor Stage, Second; D010502:Perineum; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Fetal occiput position; labor; transabdominal ultrasound; transperineal ultrasound