Episode 4.12 Angle of Progression, Two Layer Closure, and Deliverance

In this episode, we discuss the newest evidence for two layer closure at the time of Cesarean. Plus, delivery vs birth, a clarification from the prior episode about sexism. Finally, we take a deep dive into the angle of progression and how it can be used to reduces cesareans and promote safety during delivery. 

Links Discussed:
Symphysiotomy – Ireland’s brutal alternative to caesareans

Muslim women choice for gender of obstetricians and gynecologist in Turkey

The Case for Standardizing Cesarean Delivery Technique

The impact of subcutaneous irrigation on wound complications after cesarean sections: A prospective randomised study

Vaginal Cleansing Before Unscheduled Cesarean Delivery to Reduce Infection: A Randomized Clinical Trial

The Comedy of Errors

Angle of progression measured using transperineal ultrasound for prediction of uncomplicated operative vaginal delivery: systematic review and meta-analysis

Fagan’s Nomogram

Angle of progression measured using transperineal ultrasound for prediction of uncomplicated operative vaginal delivery: systematic review and meta-analysis

Prognostic accuracy of ultrasound measures of fetal head descent to predict outcome of operative vaginal birth: a comparative systematic review and meta-analysis

The head direction to the angle of progression ratio: a quantitative parameter for intrapartum evaluation of cephalic malposition

Uncertain fetal head engagement: a prospective randomized controlled trial comparing digital exam with angle of progression

The role of the angle of progression in the prediction of the outcome of occiput posterior position in the second stage of labor

Transperineal ultrasound imaging in prolonged second stage of labor with occipitoanterior presenting fetuses: how well does the ‘angle of progression’ predict the mode of delivery?