Head-perineum Distance and Delivery Mode

Study Overview
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Brief Summary
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In a prospective cohort of patients in the second phase of labor, the investigators measured the head-perineum distance and correlate it to the mode of delivery (spontaneous delivery - instrumental delivery - ceasarean section).

Detailed Description
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Head-perineum distance measured by transperineal ultrasound is a simple and well-known tool to help diagnose the fetal head engagement and predictive value to instrumental extraction succeeds. It is performed in labor room and is a non-invasive test, realized on a healthy skin. The investigators performed a systematical measure of head perineum distance at the beginning of the expulsive labor phase. The investigators made the hypothesis, based on our clinical experience, that starting expulsive labor phase with head perineum distance greater than forty five millimeters, lead to an increased risk of instrumental extraction and therefore an increase in materno-fetal morbidity and mortality. The investigators sought to evaluate the optimal head perineum distance at the beginning of expulsive efforts.

Official Title
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Correlation Between Head Perineum Distance Measured by Trans-périneal Ultrasound and Delivery Mode in Patient in the Second Stage of Labor

Conditions
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Pregnancies, Obstetric Labor

Intervention / Treatment
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* Diagnostic Test: Mesure of head-perineum distance by transperineal ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Single pregnancy In labor (spontaneous or induced) Term superior at 37 SA Delivery by summit presentation Exclusion Criteria: Non single pregnancy Suspected malformative abnormalities in the unborn fetus Refusal of participation Minor patient Adult patient subject to legal protection or patient deprived of liberty Poor French language understanding

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mesure of head-perineum distance by transperineal ultrasound<br>A mesure of head-perineum distance by ultrasound will be realized at the beginning of maternal pushing efforts by a junior gynecologist. | Diagnostic Test: Mesure of head-perineum distance by transperineal ultrasound<br>* A mesure of head-perineum distance by ultrasound will be realized at the beginning of maternal pushing efforts by a junior gynecologist<br>* Other names: Echography;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delivery mode | spontaneous or instrumental vaginal delivery | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Head perineum distance, ultrasound measure, delivery mode, instrumental delivery, spontaneous delivery, pushing maternal efforts