Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women

Journal article


Wiafe, Y., Whitehead, B., Venables, H. and Dassah, E.T. 2019. Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women. Journal of Ultrasonography. 19, p. 249–254. https://doi.org/10.15557/jou.2019.0037
AuthorsWiafe, Y., Whitehead, B., Venables, H. and Dassah, E.T.
Abstract

We aimed to examine the agreement between intrapartum ultrasound and digital vaginal examination in assessing the occiput position in black African women who were in the first stage of labor and to evaluate the influence of ruptured membranes on this agreement. Material and method: This was a cross-sectional study conducted in a teaching hospital in Ghana. Transabdominal ultrasound determination of the fetal head position was compared with digital vaginal examination of women in labor. The agreement between the two methods was examined with Cohen’s kappa statistics. Results: Altogether, 196 women in active labor were studied. The fetal head position could not be determined by digital vaginal examination in 62 cases (32%) while ultrasound could determine all. Moderate agreement (kappa = 0.4) was obtained in the 134 cases determined by both methods. Agreement on the occiput posterior position was very low (kappa = 0.1). Agreement on the occiput posterior position was not significantly different in ruptured versus intact membranes. Conclusion: This study shows poor agreement between ultrasound and digital VE on the occiput posterior position in black African women who were in the first stage of labor. Again, over 85% of fetal head positions that could not be determined by digital vaginal examination were occiput transverse and posterior positions. This confirms that digital vaginal examination has difficulty in detecting malpositions, with no significant influence of intact or ruptured membranes. Ultrasound is therefore more useful than digital vaginal examination whenever malposition is suspected in the first stage of labor.

Keywordsultrasound; digital vaginal examination; head position; labor
Year2019
JournalJournal of Ultrasonography
Journal citation19, p. 249–254
PublisherPolish Ultrasound Society
ISSN2451-070X
Digital Object Identifier (DOI)https://doi.org/10.15557/jou.2019.0037
Web address (URL)http://www.scopus.com/inward/record.url?eid=2-s2.0-85078340168&partnerID=MN8TOARS
http://jultrason.pl/index.php/issues/volume-19-no-79/comparing-intrapartum-ultrasound-and-clinical-examination-in-the-assessment-of-fetal-head-position-in-african-women?aid=760
Output statusPublished
Publication dates31 Dec 2019
Publication process dates
Accepted24 Jun 2019
Deposited16 Aug 2022
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