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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(04): 181-187
DOI: 10.1055/s-0040-1709690
Original Article
Obstetrics
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Pubic Arch Angle Measurement by Transperineal Ultrasonography: A Prospective Cross-Sectional Study

Medida do ângulo do arco púbico por ultrassonografia transperineal: um estudo prospectivo transversal
Raimundo Homero Carvalho Neto 
1   Maternal Fetal Medicine Service, Maternidade Assis Chateaubriand, Universidade Federal do Ceará, Fortaleza, CE, Brazil
,
Antonio Brazil Viana Junior 
1   Maternal Fetal Medicine Service, Maternidade Assis Chateaubriand, Universidade Federal do Ceará, Fortaleza, CE, Brazil
,
Antonio Fernandes Moron 
2   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Edward Araujo Júnior 
2   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
3   Medical Course, Universidade Municipal de São Caetano do Sul, São Paulo, SP, Brazil
,
Francisco Herlânio Costa Carvalho 
1   Maternal Fetal Medicine Service, Maternidade Assis Chateaubriand, Universidade Federal do Ceará, Fortaleza, CE, Brazil
,
Helvécio Neves Feitosa 
1   Maternal Fetal Medicine Service, Maternidade Assis Chateaubriand, Universidade Federal do Ceará, Fortaleza, CE, Brazil
4   Department of Obstetrics and Gynecology, Universidade de Fortaleza, Fortaleza, CE, Brazil
› Author Affiliations
Further Information

Publication History

14 November 2018

09 March 2020

Publication Date:
24 April 2020 (online)

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Abstract

Objective To evaluate the ability of the pubic arch angle (PAA) as measured by transperineal ultrasonography during labor to predict the delivery type and cephalic pole disengagement mode.

Methods The present prospective cross-sectional study included 221 women in singleton-gestational labor ≥ 37 weeks with cephalic fetuses who underwent PAA measurement using transperineal ultrasonography. These measurements were correlated with the delivery type, cephalic pole disengagement mode, and fetal and maternal characteristics.

Results Out of the subjects, 153 (69.2%) had spontaneous vaginal delivery, 7 (3.2%) gave birth by forceps, and 61 (27.6%) delivered by cesarean section. For the analysis, deliveries were divided into two groups: vaginal and surgical (forceps and cesarean). The mean PAA was 102 ± 7.5° (range, 79.3–117.7°). No statistically significant difference was observed in delivery type (102.6 ± 7.2° versus 100.8 ± 7.9°, p = 0.105). The occipitoanterior position was seen in 94.1% of the fetuses and the occipitoposterior position in 5.8%. A narrower PAA was found in the group of surgical deliveries (97.9 ± 9.6° versus 102.6 ± 7.3°, p = 0.049). Multivariate regression analysis showed that PAA was a predictive variable for the occurrence of head disengagement in occipital varieties after birth (odds ratio, 0.9; 95% confidence interval, 0.82–0.99; p = 0.026).

Conclusion Ultrasonographic measurement of the PAA was not a predictor of delivery type, but was associated with the persistence of occipital varieties after birth.

Resumo

Objetivo Avaliar a medida do ângulo do arco púbico (AAP) por ultrassonografia transperineal durante trabalho de parto em predizer tipo de parto e modo de desprendimento do polo cefálico.

Métodos Um estudo prospectivo transversal foi conduzido com 221 mulheres em trabalho de parto com gestação única ≥ 37 semanas, com fetos em apresentação cefálica, foram submetidas à avaliação ultrassonográfica por via transperineal para aferição do AAP. Correlações com tipo de parto, modo de desprendimento do polo cefálico e características fetais e maternas foram realizadas.

Resultados Um total de 153 (69,2%) mulheres apresentaram parto vaginal espontâneo, 7 (3,2%) parto a fórceps e 61 (27,6%) parto cesárea. Para fins de análise, dividiu-se os partos em dois grupos: partos vaginais e cirúrgicos (fórceps e cesáreas). A média do AAP foi 102 ± 7,5° (variação: 79,3–117,7°). Não foi observada significância estatística do AAP em relação ao tipo de parto (102,6 ± 7,2° versus 100,8 ± 7,9°; p = 0,105). Um total de 94,1% dos fetos desprenderam em variedade de posição occipito anterior e 5,8% em occipito posterior. Encontrou-se AAP mais estreitado no grupo de partos cirúrgicos (97,9 ± 9,6° versus 102,6 ± 7,3°; p = 0,049). A análise de regressão multivariada demonstrou que AAP foi uma variável de proteção para a ocorrência de desprendimento da cabeça em variedades occipito posteriores ao nascimento (odds ratio [OR]= 0,9; índice de confiança (IC) 95%: 0,82–0,99; p = 0,026).

Conclusão A medida ultrassonográfica do AAP não foi preditora do tipo de parto, porém demonstrou associação com persistência de variedades occipito posteriores ao nascimento.

Keywords

labor - ultrasonography - cephalopelvic disproportion - vaginal delivery - cesarean section

Palavras-chave

trabalho de parto - ultrassonografia - desproporção cefalo-pélvica - parto vaginal - cesárea

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.


 

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