{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:15:06Z","timestamp":1789024506925,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"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;amp; Gyne"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the usefulness of visual biofeedback using transperineal ultrasound to improve coached pushing during the active second stage of labor in nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized controlled trial of low\u2010risk nulliparous women in the active second stage of labor. Patients were allocated to either coached pushing aided by visual demonstration on transperineal ultrasound of the progress of the fetal head (sonographic coaching) or traditional coaching. Patients in both groups were coached by an obstetrician for the first 20\u2009min of the active second stage of labor and, subsequently, the labor was supervised by a midwife. Primary outcomes were duration of the active second stage and increase in the angle of progression at the end of the coaching process. Secondary outcomes included the incidence of operative delivery and complications of labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty women were recruited into the study. Those who received sonographic coaching had a shorter active phase of the second stage (30\u2009min (interquartile range (IQR), 24\u201342\u2009min) <jats:italic>vs<\/jats:italic> 45\u2009min (IQR, 39\u201355\u2009min); <jats:italic>P<\/jats:italic>\u2009=\u20090.01) and a greater increase in the angle of progression (13.5\u00b0 (IQR, 9\u201320\u00b0) <jats:italic>vs<\/jats:italic> 5\u00b0 (IQR, 3\u20139.5\u00b0); <jats:italic>P<\/jats:italic>\u2009=\u20090.01) in the first 20\u2009min of the active second stage of labor than did those who had traditional coaching. No differences were found in the secondary outcomes between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our preliminary data suggest that transperineal ultrasound may be a useful adjunct to coached pushing during the active second stage of labor. Further studies are required to confirm these findings and better define the benefits of this approach. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19044","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T10:24:21Z","timestamp":1521109461000},"page":"87-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Traditionally <i>vs<\/i> sonographically coached pushing in second stage of labor: a pilot randomized controlled trial"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-366X","authenticated-orcid":false,"given":"F.","family":"Bellussi","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences Obstetric and Gynecologic Unit, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Alcamisi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Obstetric and Gynecologic Unit, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Guizzardi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Obstetric and Gynecologic Unit, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Parma","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Obstetric and Gynecologic Unit, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Pilu","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Obstetric and Gynecologic Unit, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.1997.tb02747.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1993.18020171.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-2182(84)90324-0"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02910.x"},{"key":"e_1_2_5_6_1","first-page":"CD009124","article-title":"Pushing\/bearing down methods for the second stage of labour","volume":"3","author":"Lemos A","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2007.00208.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.06.022"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-35552011000100012"},{"key":"e_1_2_5_10_1","first-page":"CD009124","article-title":"Pushing\/bearing down methods for the second stage of labour","volume":"10","author":"Lemos A","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4096"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8951"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.07.025"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699206.2015.1016188"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699206.2015.1120345"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18962"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000457124"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13324"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000154889.47063.84"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12379"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6329"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.19044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.19044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.19044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.19044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:03:22Z","timestamp":1694361802000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.19044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,30]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1002\/uog.19044"],"URL":"https:\/\/doi.org\/10.1002\/uog.19044","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,30]]},"assertion":[{"value":"2017-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}