Intrapartum ultrasound and mother acceptance: A study with informed consent and questionnaire

Antonio Malvasi; Gianluca Raffaello Damiani; Edoardo DI Naro; Amerigo Vitagliano; Miriam Dellino; Reuven Achiron; Kosmas Ioannis; Antonella Vimercati; Maria Gaetani; Ettore Cicinelli; Marina Vinciguerra; Ilaria Ricci; Andrea Tinelli; Giorgio Maria Baldini; Erica Silvestris; Giuseppe Trojano

doi:10.1016/j.eurox.2023.100246

Intrapartum ultrasound and mother acceptance: A study with informed consent and questionnaire

Eur J Obstet Gynecol Reprod Biol X. 2023 Oct 12:20:100246. doi: 10.1016/j.eurox.2023.100246. eCollection 2023 Dec.

Authors

Antonio Malvasi^{1

2}, Gianluca Raffaello Damiani¹, Edoardo DI Naro¹, Amerigo Vitagliano¹, Miriam Dellino¹, Reuven Achiron³, Kosmas Ioannis⁴, Antonella Vimercati¹, Maria Gaetani¹, Ettore Cicinelli¹, Marina Vinciguerra¹, Ilaria Ricci¹, Andrea Tinelli^{2

5

6}, Giorgio Maria Baldini⁷, Erica Silvestris⁸, Giuseppe Trojano⁹

Affiliations

¹ Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, School of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy.
² Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological & Medical Physics, Moscow Institute of Physics and Technology (State University), 141701 Moscow, Russia.
³ Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
⁴ Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁵ Department of Obstetrics and Gynecology, "Veris delli Ponti" Hospital, Scorrano, 73020 Lecce, Italy.
⁶ Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, 73100 Lecce, Italy.
⁷ MOMO Fertilife-IVF Center, 76011 Bisceglie, Italy.
⁸ Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy.
⁹ Department of Maternal and Child Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, ItalyHealth, "Madonna delle Grazie" Hospital ASM, 75100 Matera, Italy.

Abstract

Introduction: Intrapartum ultrasound (IU) is used in the delivery ward; even if IU monitors the labouring women, it could be perceived as a discomfort and even as an" obstetric violence", because it is a young technique, not often well "accepted". A group of clinicians aimed at obtain an informed consent from patients, prior to perform a translabial ultrasound (TU). The aim of this study was to evaluate the acceptance of both translabial and transabdominal IU.

Methods: In this study, performed at the University Hospital of Bari (Unit of Obstetrics and Gynecology), were enrolled 103 patients in the first or second stage of labor in singleton cephalic presentation. A statistical frequency and an association analysis were performed. As a significant result, we consider the peace of mind/satisfaction and the" obstetric violence". IU was performed both transabdominal and translabial to determine the presentation, head positions, angle of progression and head perineum distance. During the first and second stage of labor, the ASIUG questionnaires (Apulia study intrapartum ultrasonography group) were administered.

Results: 74 (71, 84%) patients underwent IU and 29 had a vaginal examination (28, 15%). Significant less "violence" has been experienced with a IU (73 out 74/98, 65%) and only one person (1 /1, 35%) recorded that. On the contrary, 10 patients (10/29) perceived that "violence" (34, 48%) while 19 (65, 52%) did not respond on a similar way, after a vaginal examination (VE). More patients felt satisfaction (71 out 74/95, 95%) with the use of IU and only 3 (3/4, 05%) felt unease. A different picture was evident in the vaginal examination group. Only 17 patients (17 out 29/58, 62%) felt comfort while 12 (41, 38%) felt unease.

Conclusions: In our study, IU use is well accepted by most of patients, because it could reassure women about their fetal condition. Moreover, they can see the fetus on the screen, while the obstetrician is performing the US and this is important for a visual feedback, in comparison with the classical VE.

Keywords: Discomfort; Informed consent; Intrapartum ultrasonography; Labour; Obstetric violence; Visual biofeedback.