title: Intrapartum sonographic signs: new diagnostic tools in malposition and malrotation.
abstract: In the past years, numerous studies have been published on the use of ultrasound during labor, showing this is an effective, accurate and objective tool for the assessment of the fetal head position and station. Literature affirmed that traditional transvaginal digital examination is highly subjective and dependent on the operator's experience. On the contrary, the use of intrapartum suprapubic transabdominal ultrasound can improve accuracy in determination of fetal head position and the precise knowledge of the location of specific fetal head landmarks in relationship to maternal pelvis. Intrapartum ultrasound will assist obstetricians in the diagnosis of normal labor progression, suggesting when medical and or operative intervention should be taken in case of complications. During each fetal head movement, there is a very specific relationship between fetal head landmarks and well-identified maternal structures, so the ultrasound diagnosis is performed step by step. In this review, we summarized the clinical situation of the fetal head in the pelvis and the relative ultrasonographic signs. Moreover, we collected all the ultrasonographic measures to diagnose the fetal head progression and rotations in the birth canal.
authors.affiliation: a Department of Gynecology and Obstetrics , Santa Maria Hospital , Bari , Italy .|b Department of Applied Mathematics , Moscow Institute of Physics and Technology, State University , Moscow , Russian Federation .
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
authors.affiliation: c Department of Obstetrics and Gynecology , SS. Annunziata Hospital, University of Chieti , Chieti , Italy .
authors.forename: Francesco
authors.initials: F
authors.lastname: Giacci
authors.affiliation: c Department of Obstetrics and Gynecology , SS. Annunziata Hospital, University of Chieti , Chieti , Italy .
authors.forename: Sarah
authors.initials: S
authors.lastname: Gustapane
authors.affiliation: d Clinic for Gynecology and Obstetrics, Clinical Center of Serbia , Belgrade , Serbia .
authors.forename: Radmila
authors.initials: R
authors.lastname: Sparic
authors.affiliation: e Department of Obstetrics and Gynecology , Denver School of Medicine, University of Colorado , Denver , CO , USA .|f Banner Fort Collins Medical Center, Department of Obstetrics and Gynecology, Banner Health Center , Fort Collins , CO , USA , and.
authors.forename: Antonio
authors.initials: A
authors.lastname: Barbera
authors.affiliation: b Department of Applied Mathematics , Moscow Institute of Physics and Technology, State University , Moscow , Russian Federation .|g Department of Gynecology and Obstetrics , Vito Fazzi Hospital , Lecce , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
mesh_terms: D005260:Female; D005333:Fetus; D006801:Humans; D007746:Labor Presentation; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging*; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: Asynclitism; dystocia; intrapartum ultrasound; labor progress; occiput posterior position; operative delivery; sonographic assessment