Ecografía durante la primera y segunda fase del trabajo de parto como predictor preciso de la vía del parto: una revisión sistemática de la literatura

Abstract

The digital examination or vaginal touch has been through the years the study carried out during labor to estimate the relationships between the fetus and the birth canal, however, unfavorable outcomes have been documented due to the subjectivity of the measurement, main limitation of it. Currently, in some countries the measurement of different variables through intrapartum obstetric ultrasound has been implemented to define the route of delivery to which to proceed, however the usefulness and precision of the image is not clear in order to reduce possible complications derived from prolonged labor. Objective To review the available scientific literature on the use of obstetric ultrasound during labor as an accurate predictor of the route of delivery. Methods We carried out a systematic review of the literature which included descriptive observational studies found in PUBMED, EBSCO, EMBASE, SCOPUS as multidisciplinary databases; GOOGLE SCHOLAR and OPEN GRAY as an open search engine for gray literature. Pregnant women, between 18 and 45 years old, with a term pregnancy greater than 37 weeks' gestation, who had vertex cephalic presentation and patients in the first or second phase of labor were included. Only studies in Spanish and English were applied. The QUADAS-2 tool was applied to assess the risk of bias. Result The search strategy yielded 951 records of which 138 were excluded in duplicates. Of the total articles, 790 were excluded, leaving 23 full-text articles to assess their eligibility. Of these, 12 articles were excluded for different reasons, which is why a total of 11 articles were obtained for the qualitative synthesis and 5 articles for the quantitative synthesis. Discussion Obstetric ultrasound during the first and second phases of labor is recommended as a more objective tool for taking different measurements and angles of the birth canal, showing the diagnostic precision of the test. Although great heterogeneity was found between the studies, it is suggested to implement this type of diagnostic aids in the short term to specify the route of delivery to which to proceed.