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Introduction: There is evolving literature on the superiority of transperineal ultrasound (TPU) in predicting the mode of delivery either before induction or during the course of labour. An ultrasound score (USG score) similar to a Bishop score or an ultrasound scoring method based on independent predictors before the onset of labour at term gestation would serve as a baseline objective record over which further progress of labour could be evaluated. Objective: 1. To sonographically examine the clinical parameters evaluated during a digital examination. 2. To derive an USG score using TPU parameters, similar to a Bishop score, and determine its performance in predicting pregnancy outcomes. 3. To identify which are the independent predictors of caesarean section among all the studied ultrasound (USG) parameters. Materials and methods: In this prospective study, all the eligible women who came for routine antenatal care at term gestation and who were due for pelvic assessment were recruited. They underwent transabdominal ultrasound (TAS) for evaluating head position and head circumference, and TPU for evaluating head station with and without applying fundal pressure, various cervical parameters, sub pubic angle. Equivalent five USG parameters were scored along similar lines as the Bishop score. These women underwent vaginal examination for Bishop score and pelvic adequacy by an obstetrician who was blinded about USG parameters. While spontaneous onset of labour (SOL) was awaited in some of these women, some were induced as and when indicated. After delivery, the Bishop scores, pregnancy outcome in terms of SOL or induction of labour (IOL), mode of delivery and duration of labour were noted retrospectively from case records. Independent predictors of caesarean were obtained by univariate and multivariate analysis. Results: All the parameters were assessed for predictive ability of caesarean section by univariate analysis. The cervical length, angle of progression (AOP) at rest, head perineal distance (HPD) at rest and with pressure, Bishop score and USG score were found significant. On multivariate analysis, cervix length and USG score were found to be statistically significant. At a USG score of ≤ 5, the sensitivity and specificity to predict caesarean section were 84% and 68%, respectively. The relative risk (RR) was 4.9 (95% CI 2.3–12). The USG score could predict SOL. The p value was 0.001. The area under the curve (AUC) for the ultrasound score was 0.74. Conclusions: USG examination by USG score at term gestation before the onset of labour can predict mode of delivery by caesarean section. It can predict spontaneous onset of labour. However, among all the individual parameters, cervix length has best predictive ability for caesarean section. [ABSTRACT FROM AUTHOR]

Background and Aims Transabdominal ultrasonography [TAUS] appears comparable to colonoscopy for evaluating ulcerative colitis [UC] activity, but it has low accuracy in rectal evaluation. In this study, the accuracy of transperineal ultrasonography [TPUS] for evaluating rectal activity was compared to that of colonoscopy in paediatric UC cases. Methods Faecal calprotectin [FCP] values and TPUS and colonoscopic findings were compared prospectively in paediatric UC cases. Rectal wall thickening [RWT] and rectal wall flow [RWF] on power Doppler evaluated by TPUS were compared with the colonoscopy findings and were also measured on TAUS and assessed for the concordance rate of each finding. Results Thirty Mayo endoscopic sub-score [MES] 0–1 UC cases and 57 MES 2–3 UC cases were enrolled. FCP, RWT and RWF showed significant differences between the two groups [ p  < 0.05]. RWT and RWF were independent predictors of UC endoscopic activity, showing sensitivity of 95.8% and specificity of 100% with RWT ≥ 4.5 mm and positive RWF. The concordance rates between TPUS and TAUS findings in MES 2–3 were moderate to fair, whereas those in MES 0–1 were fair to poor. The concordance rates between ultrasonic examiners were good for both TAUS and TPUS. Conclusions TPUS may evaluate rectal activity of UC with accuracy comparable to endoscopy. If accurate ultrasonic screening for the total colon can be performed by TPUS and TAUS, repeated evaluation of short-term treatment response may be possible. [ABSTRACT FROM AUTHOR]

Objective To assess, using transperineal ultrasonography (TPUS), the numerical value of the rotation of the bladder neck [represented by the difference in the anterior (α angle) and posterior urethral angles (β angle)] at rest and straining, in continent women and women with stress urinary incontinence (SUI), to ascertain if there are significant differences in the angles of rotation (Rα and Rβ) between the groups. Patients, subjects and methods In all, 30 women with SUI (SUI group) and 30 continent women (control group) were included. TPUS was performed at rest and straining (Valsalva manoeuver), and the threshold value for the urethral angles (α and β angles) for each group were estimated. The degree of rotation for each angle was calculated and was considered as the angle of rotation. Results Both the α and β angles were significantly different between the groups at rest and straining, and there was a significant difference in the mean increment in the value of each angle. Higher values of increment (higher rotation angles) were reported in the SUI group for both the α and β angles compared with those of the control group [mean (SD) Rα SUI group 19.43 (12.76) vs controls 10.53 (2.98) °; Rβ SUI group 28.30 (12.96) vs controls 16.33 (10.8) °; P < 0.001]. Conclusion Urethral rotation angles may assist in the assessment and diagnosis of patients with SUI, which may in turn reduce the need for more sophisticated urodynamic studies. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this preliminary study was to present an alternative method to assess the anal sphincters by ultrasonography using a conventional ultrasound surface probe by transperineal approach. METHODS: Transperineal ultrasonography was performed in 20 asymptomatic volunteers to assess the anal sphincters. Ultrasonographic findings were compared with conventional anal endosonography pictures available in the literature. RESULTS: Images of the anal sphincters obtained by transperineal ultrasound were found to be similar to those produced by conventional anal endosonography. Internal and external anal sphincters were easily demonstrated in addition to mucosal and sub mucosal layers. CONCLUSIONS: Transperineal ultrasonography is a new technique that enables imaging of anal sphincters and anal canal structures with potential application in functional and inflammatory anorectal disorders. [ABSTRACT FROM AUTHOR]