Inter‐ and intra‐observer agreement of 2D and 3D transperineal ultrasound of pelvic floor hiatal measurements in the second stage of labor

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Two-dimensional and three-dimensional transperineal ultrasound demonstrate good inter- and intra-observer agreement for measuring levator hiatal dimensions during the second stage of labor. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mariya Kovalenko; Giulia Zamagni; Ingrid Volløyhaug; Caroline T. Carreras; Usman Sm; Arwa Hanidu; Tamara Stampalija; Lorenzo Monasta; KJELL SALVESEN; C. Lees

doi:10.1111/aogs.70270

June 16, 2026Acta Obstetricia Et Gynecologica ScandinavicaOpen Access

Inter‐ and intra‐observer agreement of 2D and 3D transperineal ultrasound of pelvic floor hiatal measurements in the second stage of labor

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Key Points

To evaluate inter- and intra-observer agreement in measuring levator hiatal dimensions during the second stage of labor using 2D and 3D transperineal ultrasound.
Prospectively recruited nulliparous women at term (N=95) for ultrasound assessment during labor.
Measurements included levator hiatal area (LHa), transverse hiatal diameter (TD), and anteroposterior distance (APD) using 2D and 3D ultrasound.
Quality of ultrasound images was scored by two independent observers.
Inter-observer agreement for APD in 3D: Mean difference -0.22 cm (ICC=0.85; p<0.001); for 2D: Mean difference -0.35 cm (ICC=0.79; p<0.001).
Intra-observer agreement for 2D APD: Mean difference -0.03 cm (ICC=0.91; p<0.001).
3D imaging quality: Kappa score of 0.40 for symphysis pubis, 0.72 for puborectalis, and 0.77 for levator hiatus.

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Implication

Assesses inter- and intra-observer agreement in pelvic floor ultrasound measurements in nulliparous women during labor, indicating reliable measurement techniques.

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Kovalenko et al. (2026) studied this question.

synapsesocial.com/papers/6a34dd1d65a5b0777af2ceda https://doi.org/10.1111/aogs.70270

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Inter‐ and intra‐observer agreement of 2D and 3D transperineal ultrasound of pelvic floor hiatal measurements in the second stage of labor

Key Points

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Implication

Discussion

Cite This Study

Inter‐ and intra‐observer agreement of 2D and 3D transperineal ultrasound of pelvic floor hiatal measurements in the second stage of labor

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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