EJMS

Abstract

Background: Transperineal ultrasound (TPUS) is an innovative technique that could be done using the conventional 7.5 Mhz Convex probe. Applying the probe to the perineum between the ischial tuberosities allows clear visualization of pelvic structures during labor, including the cervix and fetal head. This study aimed to evaluate the role of TPUS in predicting labor and delivery outcome in premature rupture of membrane (PROM) cases.
Methods: This study was performed at El-Sahel Teaching Hospital, Cairo, Egypt, from March 2008 to October 2009 and included 304 patients with a singleton, cephalic presentation after PROM (at GA ≥ 37 weeks). They were subjected to TPUS to measure the cervical length and the shortest distance between the fetal head and maternal labial skin. The time from membrane rupture to delivery was tested against ultrasound measurements, parity, maternal age, body mass index, and birth weight as possible predictive factors.
Results: Forty-eight hours after PROM, 32% of women with a short head-perineal distance (< 45 mm) and 43% of women with a long distance (≥ 45 mm) were still in labor. The mean cervical length was 21.5mm, and the mean distance from the internal cervical os to the perineum was 69 mm. No statistically significant associations were found between the cervical length or the distance from the internal os to the perineum and the outcome of labor.
Conclusion: TPUS assessment of fetal head engagement may help clinicians to predict the course of labor in women with PROM. TPUS is risk-free, and an easy-to-do procedure, as ultrasound devices are readily available in all labor wards.