Ecografia intrapartum

Intrapartum assessment of labor progress indicators (cervical dilatation, fetal head position, etc) is currently performed through highly subjective and experience-dependent transvaginal digital inspections. Actually, there is a wide literature evidence that digital pelvic examinations do not provide reliable labor progress assessments, demonstrating the inaccuracy of human fingers for these measurements. However, an accurate knowledge of labor progress parameters is crucial to properly identify the cases, generally around 40%, in which vaginal delivery cannot occur spontaneously and a prompt medical intervention is required. Unfortunately, also the recent technical advances to produce partograms, which show the progress of cervical dilatation and fetal head station, still present several limitations (invasiveness, reduced applicability, increased infections and lesions), resulting in the common manual monitoring, with unavoidable high rates of errors (up to 88% of cases). Therefore, it is clear how pregnancy management needs new approaches and new guidelines to rely on, exploiting objective indications through suitable methods and technologies for standardized quantitative labor monitoring and appropriate medical decision taking.