Measurement of Angle of Progression by Trans Perineal 2D Ultrasonography to Predict Mode of Delivery in Fetal Occipito-Posterior Position During Second Stage of Labor

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

https://doi.org/10.21608/aimj.2025.446641

Abstract

Background: The period from the time the cervix fully dilates until delivery is known as the second stage of labour.
Aim: To assess the accuracy of trans perineal 2D ultrasonography for the measurement of the angle of progression in predicting the mode of delivery, whether spontaneous vaginal delivery or cesarean section.
Patients and methods: The research was designed as a prospective group study and conducted in the Emergency Delivery Room at the Obstetrics and Gynecology Department of Al Azhar University Maternity Hospitals. It included 150 women selected from those attending the emergency delivery room during the second stage of labor, with samples collected using a systematic random method.
Results: AOP showed a steady increase during labor, starting at 115.3° in the early second stage, rising to 127.4° in the mid-second stage, and reaching a peak of 142.5°. ROC analysis demonstrated excellent predictive accuracy for vaginal delivery, with AOP >130° and HPD <40mm showing the highest diagnostic performance (AUC=0.923, sensitivity 94.2%, specificity 91.3%). While AOP alone (AUC=0.892) and HPD alone (AUC=0.854) were strong predictors, their combined measurement provided superior accuracy, making it a valuable tool for assessing delivery outcomes.
Conclusion: Transperineal 2D ultrasonography measuring an angle of progression >130° and HPD >40mm shows potential for predicting successful vaginal delivery in the 2nd stage of labor, but larger studies are needed to ensure these findings.
 

Keywords

Files

Share

How to cite

Statistics