Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor.

PURPOSE: To determine the validity of intrapartum ultrasound (IPUS), and particularly the angle of progression (AOP), in predicting delivery mode when measured in real-life clinical practice among women with protracted second stages of labor. METHODS: Using electronic medical records, nulliparous women with a second stage of labor of ≥ 3 h ("prolonged") and a documented AOP measurement during the second stage were identified. The ability of a single AOP measurement in "prolonged" second stage to predict a vaginal delivery (VD) was assessed. Fetal head descent, measured by AOP change/h (calculated from serial measurements), was compared between women who delivered vaginally and those who had a cesarean delivery (CD) for arrest of descent. RESULTS: Of the 191 women who met the inclusion criteria, 62 (32.5%) delivered spontaneously, 96 (50.2%) had a vacuum extraction (VE) and 33 (17.3%) had a CD. The mean AOP was wider among women who had VD (spontaneous or VE) compared to those who had CD (153° ± 19 vs. 133° ± 17, p < 0.001). Wider AOPs were associated with higher rates of VD and an AOP ≥ 127° was associated with a VD rate of 88.6% (148/167). Among the 87 women who had more than one AOP measurement, the mean AOP change per hour was higher in the VD group than in the CD group (15.1° ± 11.4° vs. 6.2° ± 6.3°, p < 0.001). CONCLUSION: Ultrasound-assessed fetal head station in nulliparous women with a protracted second stage of labor can be an accurate and objective additive tool in predicting the mode and interval time to delivery in real-life clinical practice.

Impact of a Brief Educational Intervention on Knowledge, Perceived Knowledge, Perceived Safety, and Resilience of the Public During COVID-19 Crisis.

Extraordinary and unprecedented public health measures have been implemented to contain the ongoing spread of the coronavirus disease 2019 (COVID-19) pandemic. There is paramount importance of cooperation and population engagement in reducing disease infection rates and relieving an outbreak's burden on society. The civil society's engagement may be achieved through disaster education interventions. In this cross-sectional study, a pre-post questionnaire was used to investigate the impact of a brief educational intervention on knowledge, perceived knowledge, perceived safety, and the individual resilience of the population relating to the COVID-19 outbreak. The results of the study display the benefits of the educational intervention to include a significant overall increase in all examined variables. The study also reviewed the overall trust of the public concerning the main responding authorities, as well as practices concerning protective measures for COVID-19. This study demonstrates that educational interventions, such as the brief video, provide an easily implementable design and effective means for educating and empowering the public and should, thus, be considered as a component of future outbreak responses.