Can ultrasound on admission in active labor predict labor duration and a spontaneous delivery?

BACKGROUND Identifying predictive factors for a normal outcome at admission in the labor ward would be of value planning care, timing interventions, and preventing dystocia. Clinical assessments fetal head station position start have some value, but ultrasound methods this purpose has not been investigated. Studies using transperineal before onset show possibilities these to predict outcomes. OBJECTIVE This study aimed investigate whether measurements during first examination active phase were associated with duration phases need operative delivery. STUDY DESIGN was secondary analysis prospective cohort Landspitali University Hospital, Reykjavík, Iceland. Nulliparous women ?37 weeks’ gestation single fetus cephalic presentation spontaneous eligible study. The recruitment period from January 2016 April 2018. Women examined by midwife on included if they labor, which defined as regular contractions fully effaced cervix, dilatation ?4 cm. An performed separate examiner within 15 minutes; both examiners blinded other's results. Transabdominal examinations used assess position, cervical dilatation, station, expressed head-perineum distance angle progression. Duration estimated hazard ratio delivery Kaplan-Meier curves Cox regression analysis. ratios adjusted maternal age body mass index. associations between parameters mode evaluated receiver operating characteristic curves. RESULTS Median times 490 minutes ?45 mm 682 >45 (log-rank test, P=.009; shorter distance, 1.47 [95% confidence interval, 0.83–2.60]). median durations 506 an progression ?93° 732 <93° P=.008; ratio, 2.07 1.15–3.72]). nonocciput posterior positions 677 occiput P=.07; 1.52 0.96–2.38]) 429 ?6 cm 704 4 5 P=.002; 3.11 1.68–5.77]). Overall, there 75 deliveries; among those deliveries, 16 instrumental vaginal deliveries (1 forceps ventouse deliveries), 8 cesarean deliveries. Head-perineum area under 0.68 (95% 0.55–0.80) 0.67 0.55–0.80), respectively. Ultrasound measurement or inclusion significantly CONCLUSION showed that labor; however, variables best