Intrapartum ultrasound has become a topic of great interest lately. My unit was involved once we realised in 2001 that translabial ultrasound was potentially useful in determining head engagement. We were able to show that head engagement could be quantified by measuring the position of the fetal head relative to the symphysis pubis, and that it correlated well with clinical assessment. Other researchers have proposed similar other methodologies of determining head engagement via a change in head position or axis, and others have attempted to determine head rotation. This talk will give an overview of the proposed techniques and their potential applications.

There are several issues that impact on the utility of such techniques. Labour Ward is, in many countries, a rather conservative workplace environment, one dominated by practices justified by long tradition rather than evidence. As a result clinical research in the labour ward setting is often more difficult than in other areas.

At the moment we are unable to answer the question posed in the title of this talk. There is no evidence that ultrasound during labour can confer any benefits beyond the most obvious indications established decades ago, such as confirmation of cephalic presentation, exclusion of twin gestation, and assessment of antepartum haemorrhage. However, intrapartum ultrasound is likely to be useful for the purpose of teaching junior staff and for documenting findings objectively, especially prior to vaginal operative delivery. More widespread introduction of intrapartum assessment for progress in labour should await the results of prospective intervention trials.