Ultrasound Guided Pelvic Assessment in Case of Term Vaginal Delivery in a Tertiary Hospital in Bangladesh

Background:Evaluating labor progress, especially for first-time mothers, can be tough. Doctors usually rely on manual vaginal exams, but these can vary widely between different providers. Recently, ultrasound has become more popular because it’s quick, painless, and gives a clear visual picture of what’s happening during labor.

Objectives:The goal of this study was to see if specific ultrasound measurements angle of progression (AoP), head-perineum distance (HPD), midline angle (MLA), and fetal head direction can reliably predict who will deliver vaginally and who might need a caesarean section, especially in women having their first baby.

Methods: We did a prospective observational study from December 2024 to May 2025. The study included 50 women at term, all first-time mothers, admitted at Dinajpur Medical College Hospital and the 250 Bedded General Hospital in Dinajpur, Bangladesh. During labor, participants had both regular clinical exams and ultrasound scans. All data were tracked using both standard labor charts and ultrasound-based sonopartograms. We used SPSS (version 25) for data analysis, performing chi-square and independent t-tests to identify significant relationships.

Results:Among the 50 participants, 38 women (76%) had successful vaginal deliveries, and 12 (24%) required caesarean sections mostly due to stalled labor or fetal distress. The women who delivered vaginally showed clear differences in ultrasound measurements compared to those who had caesareans. For vaginal deliveries, AoP was typically above 110 degrees, HPD was under 3 cm, and MLA was usually below 20 degrees. These differences were statistically significant  (p <0.001).

Conclusion:Ultrasound during labor gives valuable, practical information that helps clinicians manage childbirth more effectively. Adding measurements like AoP, HPD, and MLA into routine labor checks can improve the accuracy of delivery predictions and reduce unnecessary interventions. Further studies with more participants could confirm these benefits and encourage wider use of ultrasound in everyday labor practice.