{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:41:03Z","timestamp":1785775263665,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T00:00:00Z","timestamp":1726358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Digital vaginal examination (DVE) is considered the standard of care for assessing labor progress and cervical dilatation. However, it may be painful and is a subjective method that can increase the risk of chorioamnionitis. Known inter\u2010 and intra\u2010observer variability exists in measurements of cervical dilatation obtained digitally. However, little is known about the inter\u2010 and intra\u2010observer variability when using intrapartum transperineal ultrasound (TPUS). Our objectives were to investigate the relationship between cervical dilatation as assessed by TPUS and DVE. To assess inter\u2010 and intra\u2010observer variability in both single and repeated ultrasound assessments of cervical dilatation during active labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This single\u2010center study was conducted at an inner\u2010city maternity unit in London, UK. Nulliparous participants at term with a live, singleton fetus in cephalic presentation were recruited between May 2021 and November 2022. During active labor, TPUS was performed subsequent to DVE. Repeat ultrasound assessments were performed where feasible. Participants were in a supine position, with flexed hips and knees and with an empty bladder. The ultrasound transducer was placed transversely on the maternal perineum. The anteroposterior (AP) diameter of the cervix was measured, and two\u2010dimensional (2D) cine\u2010loop videos were analyzed to obtain accurate measurements. Data were excluded if the time difference between DVE and TPUS exceeded 60\u2009min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 206 participants who consented to the study, complete data were obtained from 110 participants, yielding 147 paired TPUS and DVE observations. Ninety\u2010six participants were excluded. The absolute difference between TPUS and DVE assessments was 0\u2009cm in 34% of the observations, 1\u2009cm in 46.3%, and between 2 and 4\u2009cm in 19.7%. The mean difference was \u22120.9\u2009cm (intraclass correlation coefficient\u2009=\u20090.85; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Data from 30 participants, with 50 cervical dilatation measurements, were used to assess inter\u2010 and intra\u2010observer variability. The mean difference for the first ultrasound assessment was 0.07\u2009cm (95% limit of agreement\u2009=\u2009\u22120.96 to 1.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), for inter\u2010observer variability, and 0.01\u2009cm (95% limit of agreement\u2009=\u2009\u22120.29 to 0.30; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) for intra\u2010observer variability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Assessment of the cervix with TPUS during active labor is feasible and shows a strong correlation with DVE measurements. The majority of ultrasound measurements yielded readings within 1\u2009cm of the corresponding DVE values, demonstrating high intraclass correlation and good inter\u2010 and intra\u2010observer agreement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14970","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:33:41Z","timestamp":1726446821000},"page":"2455-2464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Intrapartum ultrasound for cervical dilatation: Inter\u2010 and intra\u2010observer agreement"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0689-3466","authenticated-orcid":false,"given":"Arwa","family":"Hanidu","sequence":"first","affiliation":[{"name":"Queen Charlotte's and Chelsea Hospital Imperial Healthcare NHS Trust  London UK"},{"name":"Institute of Reproductive and Developmental Biology Department of Metabolism, Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Kovalenko","sequence":"additional","affiliation":[{"name":"Queen Charlotte's and Chelsea Hospital Imperial Healthcare NHS Trust  London UK"},{"name":"Institute of Reproductive and Developmental Biology Department of Metabolism, Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Usman","sequence":"additional","affiliation":[{"name":"Queen Charlotte's and Chelsea Hospital Imperial Healthcare NHS Trust  London UK"},{"name":"Institute of Reproductive and Developmental Biology Department of Metabolism, Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-548X","authenticated-orcid":false,"given":"Lorenzo","family":"Monasta","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo\u201d  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Zamagni","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo\u201d  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9080-3848","authenticated-orcid":false,"given":"Tamara","family":"Stampalija","sequence":"additional","affiliation":[{"name":"Unit of Fetal Medicine and Prenatal Diagnosis Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo\u201d  Trieste Italy"},{"name":"Department of Medicine, Surgery and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2104-5561","authenticated-orcid":false,"given":"Christoph","family":"Lees","sequence":"additional","affiliation":[{"name":"Queen Charlotte's and Chelsea Hospital Imperial Healthcare NHS Trust  London UK"},{"name":"Institute of Reproductive and Developmental Biology Department of Metabolism, Digestion and Reproduction, Imperial College London  London UK"},{"name":"Department of Development and Regeneration KU Leuven  Leuven 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