Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women
Introduction: 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: Thi...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2019-12-01
|
| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://www.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 |
| _version_ | 1818000709157650432 |
|---|---|
| author | Yaw A. Wiafe Bill Whitehead Heather Venables Edward T. Dassah |
| author_facet | Yaw A. Wiafe Bill Whitehead Heather Venables Edward T. Dassah |
| author_sort | Yaw A. Wiafe |
| collection | DOAJ |
| description | Introduction: 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. |
| first_indexed | 2024-04-14T03:25:09Z |
| format | Article |
| id | doaj.art-3865e6de9b8b4765bde2a912e57834da |
| institution | Directory Open Access Journal |
| issn | 2084-8404 2451-070X |
| language | English |
| last_indexed | 2024-04-14T03:25:09Z |
| publishDate | 2019-12-01 |
| publisher | Sciendo |
| record_format | Article |
| series | Journal of Ultrasonography |
| spelling | doaj.art-3865e6de9b8b4765bde2a912e57834da2022-12-22T02:15:11ZengSciendoJournal of Ultrasonography2084-84042451-070X2019-12-01197924925410.15557/JoU.2019.0037Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African womenYaw A. Wiafe0Bill Whitehead1Heather Venables2 Edward T. Dassah3College of Health and Social Care, University of Derby, Derby, UK; Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaCollege of Health and Social Care, University of Derby, Derby, UK Department of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital and School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaIntroduction: 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.http://www.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=760ultrasounddigital vaginal examinationhead positionlabor |
| spellingShingle | Yaw A. Wiafe Bill Whitehead Heather Venables Edward T. Dassah Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women Journal of Ultrasonography ultrasound digital vaginal examination head position labor |
| title | Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women |
| title_full | Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women |
| title_fullStr | Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women |
| title_full_unstemmed | Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women |
| title_short | Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women |
| title_sort | comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in african women |
| topic | ultrasound digital vaginal examination head position labor |
| url | http://www.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 |
| work_keys_str_mv | AT yawawiafe comparingintrapartumultrasoundandclinicalexaminationintheassessmentoffetalheadpositioninafricanwomen AT billwhitehead comparingintrapartumultrasoundandclinicalexaminationintheassessmentoffetalheadpositioninafricanwomen AT heathervenables comparingintrapartumultrasoundandclinicalexaminationintheassessmentoffetalheadpositioninafricanwomen AT edwardtdassah comparingintrapartumultrasoundandclinicalexaminationintheassessmentoffetalheadpositioninafricanwomen |