{"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":1789024506920,"version":"build-2803163510"},"reference-count":38,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["ajogmfm.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Obstetrics &amp; Gynecology MFM"],"published-print":{"date-parts":[[2019,5]]},"DOI":"10.1016\/j.ajogmf.2019.05.001","type":"journal-article","created":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T03:05:20Z","timestamp":1557457520000},"page":"148-155","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"title":["A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign"],"prefix":"10.1016","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-366X","authenticated-orcid":false,"given":"Federica","family":"Bellussi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginevra","family":"Salsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Simonazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Cataneo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Cariello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1823-1096","authenticated-orcid":false,"given":"Tullio","family":"Ghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Pilu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajogmf.2019.05.001_bib1","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1097\/AOG.0000000000001147","article-title":"ACOG Practice Bulletin No. 154: operative vaginal delivery","volume":"126","year":"2015","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1002\/uog.103","article-title":"Comparison of transvaginal digital examination with intrapartum sonography to determine fetal head position before instrumental delivery","volume":"21","author":"Akmal","year":"2003","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib3","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000457124","article-title":"Intrapartum ultrasound to differentiate flexion and deflexion in occipitoposterior rotation","volume":"42","author":"Bellussi","year":"2017","journal-title":"Fetal Diagn Ther"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib4","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.ajog.2004.09.028","article-title":"Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification","volume":"192","author":"Dupuis","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib5","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1111\/j.1471-0528.2007.01302.x","article-title":"The impact of a trial of instrumental delivery in theatre on neonatal outcome","volume":"114","author":"Olagundoye","year":"2007","journal-title":"BJOG"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib6","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1097\/AOG.0b013e3181bbf3be","article-title":"Failed operative vaginal delivery","volume":"114","author":"Alexander","year":"2009","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib7","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1056\/NEJM199912023412301","article-title":"Effect of mode of delivery in nulliparous women on neonatal intracranial injury","volume":"341","author":"Towner","year":"1999","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib8","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1046\/j.1471-0528.2003.01463.x","article-title":"Cohort study of operative delivery in the second stage of labour and standard of obstetric care","volume":"110","author":"Murphy","year":"2003","journal-title":"BJOG"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ejogrb.2011.03.008","article-title":"Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend","volume":"157","author":"Unterscheider","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib10","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/ajo.12374","article-title":"Caesarean section at full cervical dilatation","volume":"55","author":"Davis","year":"2015","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib11","doi-asserted-by":"crossref","first-page":"638.e1","DOI":"10.1016\/j.ajog.2015.11.007","article-title":"Evaluation of delivery options for second-stage events","volume":"214","author":"Bailit","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib12","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/AOG.0000000000001000","article-title":"Maternal and neonatal morbidity after attempted operative vaginal delivery according to fetal head station","volume":"126","author":"Ducarme","year":"2015","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ajog.2004.01.013","article-title":"Pelvic floor morbidity up to one year after difficult instrumental delivery and cesarean section in the second stage of labor: a cohort study","volume":"191","author":"Liebling","year":"2004","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib14","doi-asserted-by":"crossref","first-page":"E764","DOI":"10.1503\/cmaj.161156","article-title":"Perinatal and maternal morbidity and mortality after attempted operative vaginal delivery at midpelvic station","volume":"189","author":"Muraca","year":"2017","journal-title":"CMAJ"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib15","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/1471-0528.14820","article-title":"Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery","volume":"125","author":"Muraca","year":"2018","journal-title":"BJOG"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib16","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/S0140-6736(01)06341-3","article-title":"Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study","volume":"358","author":"Murphy","year":"2001","journal-title":"Lancet"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib17","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1136\/bmj.38971.466979.DE","article-title":"Caesarean delivery in the second stage of labour","volume":"333","author":"Spencer","year":"2006","journal-title":"BMJ"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib18","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.ajog.2017.07.025","article-title":"The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations","volume":"217","author":"Bellussi","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib19","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/uog.14951","article-title":"Angle of fetal head progression measured using transperineal ultrasound as a predictive factor of vacuum extraction failure","volume":"48","author":"Bultez","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib20","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1002\/uog.19091","article-title":"Randomised Italian Sonography for occiput POSition Trial Ante vacuum (R.I.S.POS.T.A.)","volume":"52","author":"Ghi","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib21","doi-asserted-by":"crossref","first-page":"69.e1","DOI":"10.1016\/j.ajog.2017.03.009","article-title":"Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study","volume":"217","author":"Kahrs","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib22","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1002\/uog.14785","article-title":"Influence of ultrasound determination of fetal head position on mode of delivery: a pragmatic randomized trial","volume":"46","author":"Popowski","year":"2015","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/uog.6313","article-title":"Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound","volume":"33","author":"Ghi","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib24","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/uog.3848","article-title":"Intrapartum translabial ultrasound (ITU): sonographic landmarks and correlation with successful vacuum extraction","volume":"28","author":"Henrich","year":"2006","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib25","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1471-0528.2010.02775.x","article-title":"A\u00a0study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent","volume":"118","author":"Tutschek","year":"2011","journal-title":"BJOG"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib26","first-page":"99","article-title":"Quantification of fetal head direction and descent Ultrasound","volume":"41","author":"Tutschek","year":"2013","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib27","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1002\/uog.6329","article-title":"A\u00a0new method to assess fetal head descent in labor with transperineal ultrasound","volume":"33","author":"Barbera","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib28","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1002\/uog.7752","article-title":"Three-dimensional ultrasound in monitoring progression of labor: a reproducibility study","volume":"36","author":"Ghi","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib29","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1002\/uog.6294","article-title":"Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the \u2018angle of progression\u2019 predict the mode of delivery?","volume":"33","author":"Kalache","year":"2009","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib30","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/uog.2744","article-title":"Prediction of labor and delivery by transperineal ultrasound in pregnancies with\u00a0prelabor rupture of membranes at term","volume":"27","author":"Eggebo","year":"2006","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"suppl1","key":"10.1016\/j.ajogmf.2019.05.001_bib31","first-page":"1","article-title":"The infrapubic fetal occiput: an objective sign of imminent vaginal delivery","volume":"36","author":"Contro","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib32","doi-asserted-by":"crossref","first-page":"84.e1","DOI":"10.1016\/j.ajog.2016.02.020","article-title":"The \u201cocciput-spine angle\u201d: a new sonographic index of fetal head deflexion during the first stage of labor","volume":"215","author":"Ghi","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib33","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1001\/jama.283.17.2275","article-title":"Determining when quality improvement initiatives should be considered research: proposed criteria and potential implications","volume":"283","author":"Casarett","year":"2000","journal-title":"JAMA"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib34","first-page":"624","article-title":"Soft cup vacuum extraction: a comparison of outlet delivery","volume":"66","author":"Dell","year":"1985","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib35","first-page":"CD005455","article-title":"Choice of instruments for assisted vaginal delivery","volume":"11","author":"O\u2019Mahony","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib36","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.ajog.2004.10.601","article-title":"Pelvic floor morbidity at 3 years after instrumental delivery and cesarean delivery in the second stage of labor and the impact of a subsequent delivery","volume":"192","author":"Bahl","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib37","doi-asserted-by":"crossref","first-page":"425.e1","DOI":"10.1016\/j.ajog.2012.06.055","article-title":"Obstetrical anal sphincter laceration and anal incontinence 5-10 years after childbirth","volume":"207","author":"Evers","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajogmf.2019.05.001_bib38","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/uog.13324","article-title":"Sonographic pattern of fetal head descent: relationship with duration of active second stage of labor and occiput position at delivery","volume":"44","author":"Ghi","year":"2014","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["American Journal of Obstetrics &amp; Gynecology MFM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589933319300424?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589933319300424?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T23:45:44Z","timestamp":1762904744000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589933319300424"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["S2589933319300424"],"URL":"https:\/\/doi.org\/10.1016\/j.ajogmf.2019.05.001","relation":{},"ISSN":["2589-9333"],"issn-type":[{"value":"2589-9333","type":"print"}],"subject":[],"published":{"date-parts":[[2019,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A simple sonographic finding is associated with a successful vacuum application: the fetal occiput or forehead sign","name":"articletitle","label":"Article Title"},{"value":"American Journal of Obstetrics & Gynecology MFM","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajogmf.2019.05.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}