Impact of intrapartum ultrasound on mode of delivery guidance and adverse pregnancy outcomes in primigravidae undergoing vaginal trial labor

This study aims to analyze the impact of intrapartum ultrasound on mode of delivery guidance and the occurrence of adverse pregnancy outcomes in primigravidae undergoing a vaginal trial of labor. A total of 200 primigravidae admitted to our hospital from January 2021 to December 2022 were included as the subjects of this study. They were randomly divided into a control group and a study group, with 100 cases in each group. The control group underwent the vaginal finger test, while the study group underwent a combination of the vaginal finger test and intrapartum ultrasound. The consistency between the vaginal finger test and intrapartum ultrasound in determining fetal position was evaluated in the study group, and the mode of delivery and pregnancy outcomes were compared between the two groups. The consistency of fetal occiput position between ultrasound and vaginal finger examination in the study group was 54.5% for occiput anterior position, 46.1% for occiput posterior position, and 31.4% for occiput transverse position, with an overall consistency of 46.5%. There was no significant difference in the cesarean section rate between the two groups. The rate of vaginal delivery in the control group was significantly lower than that in the study group, while the rate of perineal laceration was significantly higher in the control group. There were no significant differences in adverse outcomes for mothers and newborns between the two groups. The Angle of Progression (AOP) during natural vaginal delivery was significantly higher than that in other delivery modes, while AOP in cesarean section was significantly lower than that in other delivery modes. The head–perineum distance (HPD) during natural vaginal delivery was significantly lower than that in other delivery modes, while HPD in cesarean section was significantly higher than that in other delivery modes. Intrapartum ultrasound serves as an important adjunct in a vaginal trial of labor for primigravidae, aiding healthcare providers in accurately determining fetal head position, reducing the rate of perineal laceration, and increasing the rate of vaginal delivery. Notably, there are significant differences in ultrasound findings between women undergoing natural vaginal delivery and those with other delivery modes.