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<p>
<bold>Introduction:</bold> 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. <bold>Material and method:</bold> 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. <bold>Results:</bold> 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. <bold>Conclusion:</bold> 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.</p>
</abstract>

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.

Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Introduction: We aimed to examine the agreement between intrapartum ultrasound and digital vaginal examination in assessing the occiput position in black...

Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women

Article Category: research-article

Published Online: Dec 31, 2019

Page range: 249 - 254

Received: Mar 25, 2019

Accepted: Jun 24, 2019

DOI: https://doi.org/10.15557/jou.2019.0037

Keywords
ultrasound, digital vaginal examination, head position, labor

© 2019 Yaw A. Wiafe et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women

Article Category: research-article

Published Online: Dec 31, 2019

Page range: 249 - 254

Received: Mar 25, 2019

Accepted: Jun 24, 2019

DOI: https://doi.org/10.15557/jou.2019.0037

Keywordsultrasound, digital vaginal examination, head position, labor

© 2019 Yaw A. Wiafe et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
ultrasound, digital vaginal examination, head position, labor