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Agreement between two- and three-dimensional transperineal ultrasound methods in assessing fetal head descent in the first stage of labor

Torkildsen, E. A.; Salvesen, Kjell LU and Eggebo, T. M. (2012) In Ultrasound in Obstetrics & Gynecology 39(3). p.310-315
Abstract
Objective To study intraobserver repeatability and intermethod agreement between two- (2D) and three-dimensional (3D) transperineal ultrasound methods in assessing fetal head descent during the first stage of labor. Methods Fetal head descent was measured with transperineal ultrasound as the fetal head-perineum distance and the angle of progression in 106 primiparous women with prolonged first stage of labor. A single obstetrician performed all the scans, and another obstetrician analyzed the acquired 2D images and 3D volumes, blinded to clinical assessments and labor outcome. Intraobserver repeatability and intermethod agreement between 2D and 3D methods were analyzed. Results The repeatability coefficient was +/- 4.1 mm in 2D... (More)
Objective To study intraobserver repeatability and intermethod agreement between two- (2D) and three-dimensional (3D) transperineal ultrasound methods in assessing fetal head descent during the first stage of labor. Methods Fetal head descent was measured with transperineal ultrasound as the fetal head-perineum distance and the angle of progression in 106 primiparous women with prolonged first stage of labor. A single obstetrician performed all the scans, and another obstetrician analyzed the acquired 2D images and 3D volumes, blinded to clinical assessments and labor outcome. Intraobserver repeatability and intermethod agreement between 2D and 3D methods were analyzed. Results The repeatability coefficient was +/- 4.1 mm in 2D acquisitions and +/- 1.7 mm in 3D acquisitions of fetal head-perineum distance. The intraclass correlation coefficients ( ICC) were 0.94 for 2D and 0.99 for 3D measurements. The angle of progression repeatability coefficients were +/- 6.7. using 2D and +/- 5.7. using 3D ultrasound and ICCs were 0.91 and 0.94, respectively. The intermethod ICC for fetal head-perineum distance in 2D vs 3D acquisitions was 0.95 and for angle of progression it was 0.93; the intermethod 95% limits of agreement were -5.8 mm to + 7.2 mm and -8.9. to + 13.7., respectively. Cohen's kappa for 2D vs 3D acquisitions was 0.85 using 40 mm as a cut-off level for fetal head-perineum distance and 0.79 using 110. as cut-off level for angle of progression. Conclusions For one ultrasound operator the intraobserver repeatability and agreement between 2D and 3D ultrasound methods in prolonged first stage of labor were good. Given that 2D methods are simpler to learn and can be analyzed quickly online, 2D equipment might therefore be preferred in the labor room. Copyright (C) 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
agreement, angle of progression, fetal head-perineum distance, intrapartum ultrasound, reproducibility, three-dimensional, transperineal ultrasound, two-dimensional
in
Ultrasound in Obstetrics & Gynecology
volume
39
issue
3
pages
310 - 315
publisher
John Wiley & Sons
external identifiers
  • wos:000300839000011
  • scopus:84857837712
ISSN
1469-0705
DOI
10.1002/uog.9065
language
English
LU publication?
yes
id
1ff286ec-47d2-49d0-905c-da90fb116c14 (old id 2591493)
date added to LUP
2012-06-01 09:37:42
date last changed
2017-06-18 03:59:41
@article{1ff286ec-47d2-49d0-905c-da90fb116c14,
  abstract     = {Objective To study intraobserver repeatability and intermethod agreement between two- (2D) and three-dimensional (3D) transperineal ultrasound methods in assessing fetal head descent during the first stage of labor. Methods Fetal head descent was measured with transperineal ultrasound as the fetal head-perineum distance and the angle of progression in 106 primiparous women with prolonged first stage of labor. A single obstetrician performed all the scans, and another obstetrician analyzed the acquired 2D images and 3D volumes, blinded to clinical assessments and labor outcome. Intraobserver repeatability and intermethod agreement between 2D and 3D methods were analyzed. Results The repeatability coefficient was +/- 4.1 mm in 2D acquisitions and +/- 1.7 mm in 3D acquisitions of fetal head-perineum distance. The intraclass correlation coefficients ( ICC) were 0.94 for 2D and 0.99 for 3D measurements. The angle of progression repeatability coefficients were +/- 6.7. using 2D and +/- 5.7. using 3D ultrasound and ICCs were 0.91 and 0.94, respectively. The intermethod ICC for fetal head-perineum distance in 2D vs 3D acquisitions was 0.95 and for angle of progression it was 0.93; the intermethod 95% limits of agreement were -5.8 mm to + 7.2 mm and -8.9. to + 13.7., respectively. Cohen's kappa for 2D vs 3D acquisitions was 0.85 using 40 mm as a cut-off level for fetal head-perineum distance and 0.79 using 110. as cut-off level for angle of progression. Conclusions For one ultrasound operator the intraobserver repeatability and agreement between 2D and 3D ultrasound methods in prolonged first stage of labor were good. Given that 2D methods are simpler to learn and can be analyzed quickly online, 2D equipment might therefore be preferred in the labor room. Copyright (C) 2012 ISUOG. Published by John Wiley & Sons, Ltd.},
  author       = {Torkildsen, E. A. and Salvesen, Kjell and Eggebo, T. M.},
  issn         = {1469-0705},
  keyword      = {agreement,angle of progression,fetal head-perineum distance,intrapartum ultrasound,reproducibility,three-dimensional,transperineal ultrasound,two-dimensional},
  language     = {eng},
  number       = {3},
  pages        = {310--315},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Agreement between two- and three-dimensional transperineal ultrasound methods in assessing fetal head descent in the first stage of labor},
  url          = {http://dx.doi.org/10.1002/uog.9065},
  volume       = {39},
  year         = {2012},
}