{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:29:18Z","timestamp":1792294158213,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,25]],"date-time":"2013-03-25T00:00:00Z","timestamp":1364169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare longitudinal changes in angle of progression (<jats:styled-content style=\"fixed-case\">AoP<\/jats:styled-content>) and midline angle (<jats:styled-content style=\"fixed-case\">MLA<\/jats:styled-content>) during the active second stage of labor according to the mode of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A three\u2010dimensional transperineal ultrasound volume was acquired in a series of nulliparous women at the beginning of the active second stage (<jats:styled-content style=\"fixed-case\">T1<\/jats:styled-content>) and every 20\u2009min thereafter (<jats:styled-content style=\"fixed-case\">T2<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">T3<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">T4<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">T5<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">T6<\/jats:styled-content>). Following delivery, all ultrasound volumes were analyzed and <jats:styled-content style=\"fixed-case\">AoP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MLA<\/jats:styled-content> were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 71 women included in the study, 58 underwent spontaneous vaginal delivery (Group A) and 13 underwent operative delivery (Group B) (eight by vacuum extraction and five by Cesarean section). When compared with Group B, Group A had a wider <jats:styled-content style=\"fixed-case\">AoP<\/jats:styled-content> only at <jats:styled-content style=\"fixed-case\">T1<\/jats:styled-content> (140.0\u2009\u00b1\u200920.2\u00b0 <jats:italic>vs<\/jats:italic> 122.9\u2009\u00b1\u200916.7\u00b0; <jats:italic>P<\/jats:italic>\u2009=\u20090.010) and <jats:styled-content style=\"fixed-case\">T2<\/jats:styled-content> (149.7\u2009\u00b1\u200920.7\u00b0 <jats:italic>vs<\/jats:italic> 126.9\u2009\u00b1\u200917.5\u00b0; <jats:italic>P<\/jats:italic>\u2009=\u20090.006). <jats:styled-content style=\"fixed-case\">MLA<\/jats:styled-content> was narrower in Group A only at <jats:styled-content style=\"fixed-case\">T3<\/jats:styled-content> (21.2\u2009\u00b1\u200911.7\u00b0 <jats:italic>vs<\/jats:italic> 40.8\u2009\u00b1\u200927.9\u00b0; <jats:italic>P<\/jats:italic>\u2009=\u20090.043), <jats:styled-content style=\"fixed-case\">T4<\/jats:styled-content> (18.2\u2009\u00b1\u200915.0\u00b0 <jats:italic>vs<\/jats:italic> 47.4\u2009\u00b1\u200929.6\u00b0; <jats:italic>P<\/jats:italic>\u2009=\u20090.020) and <jats:styled-content style=\"fixed-case\">T5<\/jats:styled-content> (18.3\u2009\u00b1\u20096.0\u00b0 <jats:italic>vs<\/jats:italic> 34.7\u2009\u00b1\u20094.2\u00b0; <jats:italic>P<\/jats:italic>\u2009=\u20090.034). On stepwise forward multiple logistic regression analysis, both <jats:styled-content style=\"fixed-case\">AoP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MLA<\/jats:styled-content> were independently associated with operative delivery (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2009=\u20090.955 and <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u2009=\u20091.018, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultrasonographic assessment of fetal head descent in the second stage of labor may play a role in the prediction of the mode of delivery. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12379","type":"journal-article","created":{"date-parts":[[2013,1,3]],"date-time":"2013-01-03T10:51:49Z","timestamp":1357210309000},"page":"430-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Intrapartum transperineal ultrasound assessment of fetal head progression in active second stage of labor and mode of delivery"],"prefix":"10.1002","volume":"41","author":[{"given":"T.","family":"Ghi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Maroni","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Arcangeli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"De Musso","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bellussi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nanni","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Giorgetta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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