Mapping Intrusive and Non-Intrusive Ultrasound Technologies and Devices Used in Vaginal Examinations During Intrapartum: A Scoping Review

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Background: Technology like ultrasonography (US) has revolutionised the process of measuring cervical dilatation, cervical elasticity, station, and position of the foetal head to assess progress of labour. Ultrasound (US) is deemed non-traumatic, accurate, and user-friendly, offering an objective alternative to traditional vaginal examination (VE). Alternative methods such as position-tracking systems with fingertip sensors have shown limited precision, despite their widespread use. Additionally, US technologies have not been shown to measure effacement, caput, and moulding, as compared to VE. There is a lack of strong evidence supporting US effectiveness in improving outcomes for women and babies. Further research is required to enable respectful care in monitoring of women during labour and birth while eradicating preventable morbidity and mortality by utilising US. Objective: This scoping review aimed to map intrusive and non-intrusive ultrasound technologies and devices used in vaginal examinations during intrapartum. Methods: This scoping review followed Arksey and O’Malley’s five-step framework and the population, concepts, and contexts (PCC) model. A comprehensive search was conducted across seven databases using refined keywords. The protocol for this scoping review has been registered on the open science framework. The data were extracted, charted, synthesised, and summarised. Result: This scoping review included 47 original articles with a combined sample size of over 9000 women in labour or delivery. Most studies focused on ultrasound-based labour monitoring methods such as transabdominal, transperineal, 2D, 3D, and automated approaches—compared to traditional vaginal examination (VE). These ultrasound techniques were consistently praised for their accuracy, reliability, and feasibility in assessing cervical dilation, foetal head station, and angle of progression. Ultrasound was particularly effective in determining foetal head engagement during the second stage of labour, which can influence clinical decision-making and outcomes. Additionally, the review identified emerging intrapartum technologies, including non-invasive purple line observation and low-intensity light imaging probes. These innovations reflect a growing shift toward objective and less invasive labour monitoring methods. Tools like ultrasound and automated tracking algorithms demonstrated superior sensitivity, specificity, and patient comfort compared to VE. However, challenges remain in clinical applicability, standardisation, and implementation, particularly in resource-limited settings. Overall, the findings suggest a transition toward digital and ultrasound-based technologies as central components of modern labour monitoring, with further research needed to validate newer devices and ensure equitable integration into clinical practice. Conclusions: This scoping review highlights a shift toward ultrasound-based technologies transabdominal, transperineal with 2D/3D, and automated as more accurate and patient-friendly alternatives to vaginal examination. These methods improve assessment of cervical dilation, foetal head station, and progression angle. Emerging tools like the purple line and light imaging probes show promise but require further validation. Policymakers should support investment in affordable digital tools; clinical practice must prioritise training and integration; and research should focus on standardisation, long-term outcomes, and feasibility to ensure equitable and effective implementation of these technologies in labour monitoring.

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