Validation of Ultrasound "Angle of Progression" Measurement to Decrease the Cesarean Rate

Launched by HOSPITAL ST. JOSEPH, MARSEILLE, FRANCE · Mar 9, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new way to help reduce the number of cesarean deliveries during labor. Researchers are looking at a technique called "Angle of Progression" using ultrasound to see how well the baby's head is moving down the birth canal. They believe that measuring this angle can provide valuable information, especially after a prolonged second stage of labor, which is when a woman has been pushing for an extended period. The goal is to see if using this ultrasound measurement, alongside traditional checks, can lower the cesarean rate significantly.

To participate, women must be at least 37 weeks pregnant, either having their first baby or having had previous pregnancies without vaginal deliveries. They need to have their baby in the head-down position, but there should be some uncertainty about whether the baby's head is engaged in the birth canal after pushing for at least two hours. If eligible, participants can expect to be part of a randomized trial, which means they may be placed in either the ultrasound measurement group or the standard care group. This research could play an important role in understanding how to help more women have vaginal births safely.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Nulliparous or multiparous women with no history of vaginal delivery,
• • \> or = 37 weeks amenorrhoea
• • Cephalic presentation in anterior position (occipito-pubic position, left anterior occipito-iliac and right anterior occipito-iliac ) confirmed by ultrasound
• • uncertain fetal head engagement on digital examination or midline fetal presentation in prolonged second stage of labor (at least 2 hours),
• Exclusion Criteria:
• • Multiparous women who were previous vaginal deliveries,
• • Presentation other than cephalic,
• • Twin pregnancies,
• • Posterior or transverse position
• • Transperineal ultrasound for head-perineum distance measurement
• • Fetal heart rate abnormalities requiring rapid delivery,
• • Contraindication to vaginal delivery whether maternal or fetal