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The assessment of labor progress from digital vaginal examination has remained largely unchanged for at least a century, despite the current major advances in maternal and perinatal care. Although inconsistently reproducible, the findings from digital vaginal examination are customarily plotted manually on a partogram, which is composed of a graphical representation of labor, together with maternal and fetal observations. The partogram has been developed to aid recognition of failure to labor progress and guide management-specific obstetrical intervention. In the last decade, the use of ultrasound in the delivery room has increased with the advent of more powerful, portable ultrasound machines that have become more readily available for use. Although ultrasound in intrapartum practice is predominantly used for acute management, an ultrasound-based partogram, a sonopartogram, might represent an objective tool for the graphical representation of labor. Demonstrating greater accuracy for fetal head position and more objectivity in the assessment of fetal head station, it could be considered complementary to traditional clinical assessment. The development of the sonopartogram concept would require further undertaking of serial measurements. Advocates of ultrasound will concede that its use has yet to demonstrate a difference in obstetrical and neonatal morbidity in the context of the management of labor and delivery. Taking a step beyond the descriptive graphical representation of labor progress is the question of whether a specific combination of clinical and demographic parameters might be used to inform knowledge of labor outcomes. Intrapartum cesarean deliveries and deliveries assisted by forceps and vacuum are all associated with a heightened risk of maternal and perinatal adverse outcomes. Although these outcomes cannot be precisely predicted, many known risk factors exist. Malposition and high station of the fetal head, short maternal stature, and other factors, such as caput succedaneum, are all implicated in operative delivery; however, the contribution of individual parameters based on clinical and ultrasound assessments has not been quantified. Individualized risk prediction models, including maternal characteristics and ultrasound findings, are increasingly used in women's health—for example, in preeclampsia or trisomy screening. Similarly, intrapartum cesarean delivery models have been developed with good prognostic ability in specifically selected populations. For intrapartum ultrasound to be of prognostic value, robust, externally validated prediction models for labor outcome would inform delivery management and allow shared decision-making with parents. [ABSTRACT FROM AUTHOR]

This document provides abstracts from various studies on labor and childbirth. The studies examine different ultrasound parameters and their relationship to outcomes such as ECV effectiveness, fetal cardiac function, mode of delivery, cervical dilatation, CPD, and OASI. The findings suggest that ultrasound measurements can be useful in evaluating clinical conditions and predicting outcomes. However, more research is needed to establish specific parameters and improve diagnostic accuracy. Other studies explore the use of intrapartum ultrasound in labor management, including predicting vaginal delivery, diagnosing complications, evaluating the pelvic floor, and assessing fetal position. The studies indicate that intrapartum ultrasound is a valuable tool for decision-making and improving outcomes. Transperineal ultrasound has shown promise in assessing anal sphincter injuries, and both parents and healthcare providers have positive attitudes towards using ultrasound for predicting delivery mode. Additionally, fetal head molding during labor was found to be common and not associated with difficult deliveries, except for parieto-parietal molding which was linked to failed operative deliveries. [Extracted from the article]