{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:29:45Z","timestamp":1791462585518,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T00:00:00Z","timestamp":1544054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hong Kong Obstetrical and Gynecological Trust Fund"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the angle of progression (AoP) measured by transperineal ultrasonography before indicating an instrumental delivery or cesarean delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective observational study was conducted among women with singleton term pregnancies with prolonged second stage of labor at Kwong Wah Hospital, Hong Kong, China, between May 16, 2011, and May 25, 2016. Transabdominal and transperineal ultrasonography were performed to determine fetal head position and AoP, respectively, both at rest and during uterine contraction with pushing. Mode of delivery was decided after vaginal examination without relying on ultrasonography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 143 women, 116 underwent successful instrumental delivery and 27 underwent cesarean delivery. Median AoP was 153.0\u00b0 in the instrumental group versus 139.0\u00b0 in the cesarean group at rest (<jats:italic>P<\/jats:italic>&lt;0.001), and 182.5\u00b0 in the instrumental group versus 156.5\u00b0 in the cesarean group during contraction (<jats:italic>P<\/jats:italic>&lt;0.001). The best predictive cutoff AoP for successful instrumental delivery was 138.7\u00b0 at rest (sensitivity 86.2%, specificity 51.9%) and 160.9\u00b0 during contraction (sensitivity 87.1%, specificity 74.1%). No between\u2010group differences in AoP were found for ease of vacuum extraction at rest (<jats:italic>P<\/jats:italic>=0.457) or during contraction with pushing (<jats:italic>P<\/jats:italic>=0.095).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The AoP predicted approximately 80% of successful instrumental deliveries performed for prolonged second stage of labor.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12712","type":"journal-article","created":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T17:02:54Z","timestamp":1542301374000},"page":"192-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Measuring angle of progression by transperineal ultrasonography to predict successful instrumental and cesarean deliveries during prolonged second stage of labor"],"prefix":"10.1002","volume":"144","author":[{"given":"Viola Y.T.","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kwong Wah Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai\u2010lam","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kwong Wah Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike K.P.","family":"So","sequence":"additional","affiliation":[{"name":"Department of information Systems, Business Statistics and Operations Management School of Business and Management The Hong Kong University of Science and Technology  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing\u2010cheong","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kwong Wah Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7456.24"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182749ac9"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06341-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050701412297"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000188"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001273"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13186"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610500040547"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.029"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.10.4.283.286"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6329"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6336"},{"issue":"161","key":"e_1_2_8_14_1","first-page":"e1","article-title":"Angle of progression measurements of fetal head at term: A systematic comparison between open magnetic resonance imaging and transperineal ultrasound","volume":"206","author":"Bamberg C","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6294"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8951"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.12.3.172.177"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.958459"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.976547"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1048680"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12379"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13256"},{"key":"e_1_2_8_23_1","first-page":"3400","article-title":"Intrapartum translabial ultrasound with pushing used to predict the difficulty in vacuum\u2010assisted delivery of fetuses in non\u2010occiput posterior position","volume":"29","author":"Sainz JA","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14951"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6400"},{"key":"e_1_2_8_26_1","first-page":"3276","article-title":"Is intrapartum translabial ultrasound examination painless?","volume":"29","author":"Chan YTV","year":"2016","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["International Journal of Gynecology &amp; 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