Introduction. Recent evidence indicates that clinical examination, for determination of fetal head position, is subjective and inaccurate. Present study was aimed to compare transabdominal ultrasound for fetal head position with vaginal examination during first stage of labor. Material and Methods. This prospective study was performed at a tertiary center during a two-year period. Before or after clinically indicated vaginal examinations, transverse suprapubic transabdominal real-time ultrasound fetal head position assessment was done. Frequencies of various ultrasound depicted fetal head positions were compared with position determined at vaginal examination. Results. In only 31.5% of patients, fetal head position determinations by vaginal examinations were consistent with those obtained by ultrasound. Cohen’s Kappa test of concordance indicated a poor concordance of 0.15. Accuracy of vaginal examination increased to 66% when fetal head position at vaginal examination was recorded correct if reported within +45° of the ultrasound assessment. Rate of agreement between the two assessment methods for consultants versus residents was 36% and 26%, respectively ( ). Conclusion. We found that vaginal examination was associated with a high error rate in fetal head position determination. Data supports the idea that intrapartum transabdominal ultrasound enhances correct determination of fetal head position during first stage of labor. 1. Introduction Digital vaginal examination has been the accepted standard to monitor labor. However, recently evidence is indicating that clinical examination (abdominal and vaginal) for the determination of fetal head position is subjective and inaccurate [1]. Furthermore, repeated vaginal examinations can be uncomfortable and associated with risk of introducing infections. Ultrasonography is noninvasive and has been found to be more accurate for assessing position of the fetal head, during labor [2, 3]. Recent studies by Sherer et al. [4], Chou et al. [5], Dupuis et al. [6], and Zahalka et al. [7] have shown that ultrasound scanning is a quick and efficient way of increasing the accuracy of the assessment of fetal head position during the second stage of labor. We would also like to highlight that ultrasound determination of fetal head may allow safe instrumental delivery if required in second stage. In the present study we aimed to compare ultrasound assessment of fetal head position with vaginal examination during first stage of labor in our setup. 2. Material and Methods This prospective study was carried out in the labor
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