ULTRASOUND EXAMINATION DURING DELIVERY - IS AN ADDITIONAL TOOL FOR OBSTRUCTIVE BIRTH PREDICTION

Complications during labor are one of the causes of maternal and perinatal morbidity and, sometimes, mortality. That is why the search aimed at improving existing obstetric practices continues to be relevant. Obstructive labor is a clinical situation that the obstetrician-gynecologist encounters quite often, especially given the existing trend to increase the number of fetuses with high weight (over 95‰). The criteria used today are not effective enough and do not allow to detect complications in time, and therefore, always prevent intranatal injuries of the fetus and mother on the one hand. On the other hand, the subjectivity of part of the existing criteria in the diagnosis of obstructive labor in some cases is the cause of unreasonable surgical completion of labor by cesarean section. Therefore, the search for a better model for diagnosing this complication continues to be relevant. The purpose of this study is to improve existing methods for diagnosing the mismatch of the size of the fetal head to the size of the mother’s pelvis during childbirth. The objective: establish effective use of ultrasound (US) during childbirth to predict the method of delivery. Materials and methods. The article presents the data of a prospective cohort study of ultrasound examination during labor. The study included 112 mothers in the period 37–41 weeks, who underwent ultrasound: transabdominal in the first period of labor when opening the uterine cervix from 3 cm or more (determined fetal presentation, fetal position and type of position, additionally determined localization of the placenta, amount of amnio, fetal heart rate); in the second period of labor, transperineal ultrasound was performed to determine the angle of progression. Results. The possibility of using ultrasound during labor as a predictor of the development of complications during labor – obstructive labor. The use of the proposed method allows to identify in time the risk group of complications of delivery associated with the dissonanse size of the fetal head to the size of the pelvis of the mother. The use of ultrasound imaging technologies helps to accurately detect the difficulty of rocking the anterior head of the fetus through the birth canal. The expediency of measuring the angle of progression for predicting the onset of obstructive labor has been established. The efficiency of the proposed method is proved. Conclusions. It has been established that ultrasound during labor is an additional research method that can improve the quality of obstetric care for mothers. The proposed practices are objective, easy to implement in health care facilities that provide services related to pregnancy and childbirth, and effective for early detection of a group of mothers in whom the risk of obstructive labor is high