Role of 'Angle of Progression' in Prediction of Delivery Mode Publisher Pubmed



Marsoosi V¹ ; Pirjani R¹ ; Mansouri B¹ ; Eslamian L¹ ; Jamal A¹ ; Heidari R² ; Rahimiforoushani A³
Source: Journal of Obstetrics and Gynaecology Research Published:2015

Abstract

Aim The aim of this study was to investigate the role of the 'angle of progression' (AOP) in the prediction of vaginal delivery. Material and Methods In this prospective study, we followed 70 singleton pregnant women. AOP was measured at admission time and also at the beginning of the second stage immediately after digital examination. Digital and ultrasound examiners were unaware of each other's results. The digital examiner decided on the delivery mode based on clinical assessment. Results Sixty-five (92.9%) women had vaginal delivery. In the first stage of labor, the area under the curve was 87.5% (95% confidence interval [CI], 77.9-97.1; P-=-0.005) for the AOP and 85.5% (95%CI, 75.2-95.6; P-=-0.009) for digital examination and in the second stage of labor, the area under the curve was 90.2% (95%CI, 81-99.3; P-=-0.003) for the AOP and 94.9% (95%CI, 89.1-100; P-=-0.001) for digital examination. An AOP of ≥113° at the second stage was associated with a 90.8% probability of vaginal delivery. Conclusion We found a significant relation between AOP and cervical dilatation during the first stage of labor. A larger angle at the beginning of the second stage was significantly associated with shorter time to delivery. © 2015 Japan Society of Obstetrics and Gynecology.