Use of a pocket-device point-of-care ultrasound to assess cervical dilation in labor: correlation and patient experience
-
Phillip Connell
Abstract
Objectives
To estimate the correlation of cervical dilation between pocket-device point-of-care transperineal ultrasound (TPUS) and digital cervical examination (DCE).
Methods
Laboring pregnant individuals ≥37 weeks of gestation presenting were prospectively evaluated for cervical dilation with a handheld pocket-sized ultrasound (Butterfly iQ+®) applied to the perineum, with a blinded DCE directly following. Subjects completed a survey to rate pain and for any preference from the examinations. To detect a moderate correlation (r=0.5) between TPUS and DCE, with an alpha of 0.05 and power of 80%, a sample size of 30 examinations were needed.
Results
From April 2022 to July 2022, 30 pregnant individuals were assessed. The median cervical dilation by TPUS vs. DCE was 5.1 and 5 cm, respectively, with a Pearson’s correlation coefficient, r=0.86 (95% CI 0.72 to 0.93), p<0.001. Transperineal ultrasound had a significantly less pain score than DCE, median pain score 0 vs. 2 for TPUS and DCE respectively, p<0.001. All individuals preferred the TPUS over the DCE.
Conclusions
Measurement of cervical dilation using a pocket-device point-of-care TPUS has a strong positive correlation with DCE and offers a non-invasive, convenient alternative to traditional digital exams in term, laboring patients.
Acknowledgments
Accepted for poster presentation at The Society of Maternal Fetal Medicine 43rd Annual Pregnancy Meeting, February 6 – February 11, 2023.
-
Research funding: None declared.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Ethical approval: This trial was approved by the Baylor College of Medicine Institutional Review Board (protocol H-50937).
References
1. Rizzo, G, Ghi, T, Henrich, W, Tutschek, B, Kamel, R, Lees, CC, et al.. Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World association of perinatal medicine and the PMF-perinatal medicine foundation. J Perinat Med 2022;50:1007–29. https://doi.org/10.1515/jpm-2022-0160.Suche in Google Scholar PubMed
2. Richey, SD, Ramin, KD, Roberts, SW, Ramin, SM, Cox, SM, Twickler, DM. The correlation between transperineal sonography and digital examination in the evaluation of the third-trimester cervix. Obstet Gynecol 1995;85:745–8. https://doi.org/10.1016/0029-7844(95)00027-o.Suche in Google Scholar PubMed
3. Hassan, WA, Eggebo, TM, Ferguson, M, Lees, C. Simple two-dimensional ultrasound technique to assess intrapartum cervical dilatation: a pilot study. Ultrasound Obstet Gynecol 2013;41:413–8. https://doi.org/10.1002/uog.12316.Suche in Google Scholar PubMed
4. Benediktsdottir, S, Eggebø, TM, Salvesen, KA. Agreement between transperineal ultrasound measurements and digital examinations of cervical dilatation during labor. BMC Preg Childbirth 2015;15:273. https://doi.org/10.1186/s12884-015-0704-z.Suche in Google Scholar PubMed PubMed Central
5. Wiafe, YA, Whitehead, B, Venables, H, Dassah, ET, Eggebø, TM. Intrapartum ultrasound assessment of cervical dilatation and its value in detecting active labor. J Ultrasound 2018;21:233–9. https://doi.org/10.1007/s40477-018-0309-2.Suche in Google Scholar PubMed PubMed Central
6. Usman, S, Wilkinson, M, Barton, H, Lees, CC. The feasibility and accuracy of ultrasound assessment in the labor room. J Matern Fetal Neonatal Med 2019;32:3442–51. https://doi.org/10.1080/14767058.2018.1465553.Suche in Google Scholar PubMed
7. Recker, F, Weber, E, Strizek, B, Gembruch, U, Westerway, SC, Dietrich, CF. Point-of-care ultrasound in obstetrics and gynaecology. Arch Gynecol Obstet 2021;303:871–6. https://doi.org/10.1007/s00404-021-05972-5.Suche in Google Scholar PubMed PubMed Central
8. Kim, J, Kim, S, Jeon, S, Jung, S. A longitudinal study investigating cervical changes during labor using a wireless ultrasound device. J Matern Fetal Neonatal Med 2018;31:1787–91. https://doi.org/10.1080/14767058.2017.1329292.Suche in Google Scholar PubMed
9. Seval, MM, Yuce, T, Kalafat, E, Duman, B, Aker, SS, Kumbasar, H, et al.. Comparison of effects of digital vaginal examination with transperineal ultrasound during labor on pain and anxiety levels: a randomized controlled trial. Ultrasound Obstet Gynecol 2016;48:695–700. https://doi.org/10.1002/uog.15994.Suche in Google Scholar PubMed
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Reviews
- Covid-19 vaccination and pregnancy: a systematic review of maternal and neonatal outcomes
- Improvised bubble continuous positive airway pressure ventilation use in neonates in resource-limited settings: a systematic review and meta-analysis
- Opinion Papers
- Anger: an underappreciated destructive force in healthcare
- Severe maternal thrombocytopenia and prenatal invasive procedures: still a grey zone
- Commentary
- The care of the magic of life before and after its beginning
- Original Articles – Obstetrics
- The impact of trimester of COVID-19 infection on pregnancy outcomes after recovery
- Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience
- Are bacteria, fungi, and archaea present in the midtrimester amniotic fluid?
- Bioavailability of the tumor necrosis factor alpha/regulated on activation, normal T cell expressed and secreted (RANTES) biosystem inside the gestational sac during the pre-immune stages of embryo development
- The role of the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PIGF) – ratio in clinical practice in obstetrics: diagnostic and prognostic value
- Prenatal diagnosis of non-mosaic sex chromosome abnormalities: a 10-year experience from a tertiary referral center
- Prediction of lung maturity through quantitative ultrasound analysis of fetal lung texture in women with diabetes during pregnancy
- Evaluation of an artificial intelligent algorithm (Heartassist™) to automatically assess the quality of second trimester cardiac views: a prospective study
- Original Article – Fetus
- Fetal brain activity and the free energy principle
- Predictive value of ultrasound in prenatal diagnosis of hypospadias: hints for accurate diagnosis
- The effect of maternal diabetes on the expression of gamma-aminobutyric acid and metabotropic glutamate receptors in male newborn rats’ inferior colliculi
- Original Articles – Neonates
- Respiratory function monitoring during early resuscitation and prediction of outcomes in prematurely born infants
- Quality improvement sustainability to decrease utilization drift for therapeutic hypothermia in the NICU
- Short Communication
- Use of a pocket-device point-of-care ultrasound to assess cervical dilation in labor: correlation and patient experience
- Letters to the Editor
- Correspondence on “COVID-19 vaccination and pregnancy”
- Response to the letter to the editor regarding “Covid-19 vaccination and pregnancy: a systematic review of maternal and neonatal outcomes”
Artikel in diesem Heft
- Frontmatter
- Reviews
- Covid-19 vaccination and pregnancy: a systematic review of maternal and neonatal outcomes
- Improvised bubble continuous positive airway pressure ventilation use in neonates in resource-limited settings: a systematic review and meta-analysis
- Opinion Papers
- Anger: an underappreciated destructive force in healthcare
- Severe maternal thrombocytopenia and prenatal invasive procedures: still a grey zone
- Commentary
- The care of the magic of life before and after its beginning
- Original Articles – Obstetrics
- The impact of trimester of COVID-19 infection on pregnancy outcomes after recovery
- Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience
- Are bacteria, fungi, and archaea present in the midtrimester amniotic fluid?
- Bioavailability of the tumor necrosis factor alpha/regulated on activation, normal T cell expressed and secreted (RANTES) biosystem inside the gestational sac during the pre-immune stages of embryo development
- The role of the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PIGF) – ratio in clinical practice in obstetrics: diagnostic and prognostic value
- Prenatal diagnosis of non-mosaic sex chromosome abnormalities: a 10-year experience from a tertiary referral center
- Prediction of lung maturity through quantitative ultrasound analysis of fetal lung texture in women with diabetes during pregnancy
- Evaluation of an artificial intelligent algorithm (Heartassist™) to automatically assess the quality of second trimester cardiac views: a prospective study
- Original Article – Fetus
- Fetal brain activity and the free energy principle
- Predictive value of ultrasound in prenatal diagnosis of hypospadias: hints for accurate diagnosis
- The effect of maternal diabetes on the expression of gamma-aminobutyric acid and metabotropic glutamate receptors in male newborn rats’ inferior colliculi
- Original Articles – Neonates
- Respiratory function monitoring during early resuscitation and prediction of outcomes in prematurely born infants
- Quality improvement sustainability to decrease utilization drift for therapeutic hypothermia in the NICU
- Short Communication
- Use of a pocket-device point-of-care ultrasound to assess cervical dilation in labor: correlation and patient experience
- Letters to the Editor
- Correspondence on “COVID-19 vaccination and pregnancy”
- Response to the letter to the editor regarding “Covid-19 vaccination and pregnancy: a systematic review of maternal and neonatal outcomes”
