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Transabdominal and transperineal ultrasound vs routine care before instrumental vaginal delivery : a randomized controlled trial

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dc.contributor.authorBarros, Joana
dc.contributor.authorAfonso, Maria
dc.contributor.authorMartins, Ana T.
dc.contributor.authorCarita, Ana I.
dc.contributor.authorClode, Nuno
dc.contributor.authorAyres-de-Campos, Diogo
dc.contributor.authorGraça, Luís M.
dc.date.accessioned2022-03-30T15:37:35Z
dc.date.available2022-03-30T15:37:35Z
dc.date.issued2021
dc.description© 2020 Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). Published by John Wiley & Sons Ltd.pt_PT
dc.description.abstractIntroduction: The role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal and transperineal ultrasound with routine clinical care before performing an instrumental vaginal delivery, regarding the incidence of adverse maternal and neonatal outcomes. Material and methods: A randomized controlled trial was conducted between October 2016 and March 2019 in two tertiary care maternity hospitals in Lisbon, Portugal. Women at term, with full cervical dilatation, singleton fetuses in cephalic presentation, and with an established indication for instrumental vaginal delivery, were approached for enrollment. After informed consent was obtained, randomization into one of two groups was carried out. In the experimental arm, women underwent transabdominal ultrasound for determination of the fetal head position and transperineal ultrasound for evaluation of the angle of progression, before instrumental vaginal delivery. In the control arm, no ultrasound was carried out before instrumental vaginal delivery. Primary outcomes were composite measures of maternal and neonatal morbidity. Composite maternal morbidity consisted of severe postpartum hemorrhage, perineal trauma, and prolonged hospital stay. Composite neonatal morbidity consisted of low 5-minute Apgar score, umbilical artery metabolic acidosis, birth trauma, and neonatal intensive care unit admission. Results: A total of 222 women were enrolled (113 in the experimental arm and 109 in the control arm). No significant differences between the two arms were found in composite measures of maternal (23.9% in the experimental group vs 22.9% in the control group, odds ratio 1.055, 95% CI 0.567-1.964) or neonatal morbidity (9.7% in the experimental group vs 6.4% in the control group, odds ratio 1.571, 95% CI 0.586-4.215), nor in any of the individual outcomes. Conclusions: In this small randomized controlled trial that was stopped for futility before reaching the required sample size, transabdominal and transperineal ultrasound performed just before instrumental vaginal delivery did not reduce the incidence of adverse maternal and neonatal outcomes, when compared with routine clinical care.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Obstet Gynecol Scand. 2021 Jun;100(6):1075-1081pt_PT
dc.identifier.doi10.1111/aogs.14065pt_PT
dc.identifier.eissn1600-0412
dc.identifier.issn0001-6349
dc.identifier.urihttp://hdl.handle.net/10451/52102
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://obgyn.onlinelibrary.wiley.com/journal/16000412pt_PT
dc.subjectDeliverypt_PT
dc.subjectMorbiditypt_PT
dc.subjectNeonatologypt_PT
dc.subjectPregnancypt_PT
dc.subjectUltrasoundpt_PT
dc.titleTransabdominal and transperineal ultrasound vs routine care before instrumental vaginal delivery : a randomized controlled trialpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1081pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1075pt_PT
oaire.citation.titleActa Obstetricia et Gynecologica Scandinavicapt_PT
oaire.citation.volume100pt_PT
person.familyNameBarros
person.familyNameCarita
person.familyNameAyres-de-Campos
person.familyNameGraça
person.givenNameJoana
person.givenNameAna Isabel
person.givenNameDiogo
person.givenNameLuís Mendes
person.identifierN-2525-2013
person.identifier.ciencia-idDC1C-7F1D-5F26
person.identifier.ciencia-id4414-0F40-DCFE
person.identifier.orcid0000-0002-3468-4231
person.identifier.orcid0000-0003-0472-7541
person.identifier.orcid0000-0002-7136-6240
person.identifier.orcid0000-0002-9972-5129
person.identifier.ridH-9131-2013
person.identifier.scopus-author-id6603806720
person.identifier.scopus-author-id7004181721
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationaf8318d4-b471-49bd-912c-7971a26d343a
relation.isAuthorOfPublicatione11f4d00-9a1f-4740-ba1b-99d3507d9e29
relation.isAuthorOfPublication108dde37-683c-4dc3-b963-98afdcd0d8cd
relation.isAuthorOfPublicationa54c1de9-1f03-465d-8e81-5a13d7b975d3
relation.isAuthorOfPublication.latestForDiscoverya54c1de9-1f03-465d-8e81-5a13d7b975d3

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