title: Intrapartum sonography - eccentricity or necessity?
abstract: Ultrasonography has been extensively used in obstetrics and gynecology since 1980's. It found application in pediatric gynecology, procreation period, post-menopause, pregnancy monitoring and after delivery. Although the first reports on the use of ultrasonography in assessing delivery mechanism were published in 1990's, yet to date labor progress is evaluated by means of physical examination in most delivery units. Intrapartum sonography is not routinely performed despite the fact that numerous studies documented high error rates of conventional obstetrical examination. Even an experienced physician makes a mistake in every third case of the fetal head descent and fontanelle position assessment. Nowadays, obstetrician's role is not to strain for vaginal delivery at all costs, but to provide the patient in labor and her newborn with maximal safety. To achieve this objective, an obstetrician should distinguish between women who will deliver spontaneously and whose who require Cesarean section. Proper decision should be made on the basis of objective and valid evaluation of obstetric setting, which cannot be achieved solely with physical examination. Intrapartum sonography was shown to be far more accurate than digital examination. Moreover, it is not technically demanding, provides high reproducibility and neither increases the rate of ascending infection or causes discomfort to the patient. Current research suggests that if used routinely, intrapartum sonography can increase the safety of labor and reduce cesarean section rate.
authors.affiliation: II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Dębska
authors.affiliation: II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kretowicz
authors.affiliation: II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland.
authors.forename: Romuald
authors.initials: R
authors.lastname: Dębski
keywords: angle of progression; digital examination; fetal head descent; intrapartum ultrasound