Discussion
oedema
PROLONGED LABOUR, POSTPARTUM HAEMORRHAGE, OEDEMA
The foetal head position plays an important role during vaginal delivery and is one of the known predictors of labour outcome. Earlier studies by Shetty et al. [Inappropriate estimation of the foetal head position is associated with prolonged labour, a higher rate of caesarean section, postpartum haemorrhage, and a higher rate of morbidity for the mother and the newborn [The skull of the foetal head is soft, with soft tissue oedema of the foetal head, overlapping of the skull, and deformation of the bone joints because of the compression of the birth canal during labour, which leads to difficulties in identifying the position of the foetal head for inexperienced residents. Our study showed that the accuracy of digital examination of the foetal head position was higher in resident with an additional theoretical training. The findings of this study suggest that residents did not have a deep understanding of the theoretical knowledge of examining foetal head position, which is an important reason for the high failure rate of determining the foetal head position. Our new theory simplifies the method of determining the anterior fontanelle and posterior fontanelle, allowing residents to acquire the skills to determine the position of the foetal head in a relatively short period of time. This kind of education can include theoretical teaching before entering clinical practice and then real-time teaching on the labour unit to increase the depth of understanding of foetal head position examination. Ultrasonography can help unexperienced residents improve the accuracy of digital vaginal examination in determining the position of the foetal head [One of the strengths of our study is that the additional theoretical training we propose can significantly reduce the time residents need to be skilled in determining foetal head position through vaginal examination. Additionally, our theoretical training can improve the accuracy of vaginal examination of the foetal head position and facilitate vaginal delivery. This study has some limitations, ultrasound is the standard for diagnosing foetal head position, but it is not 100% accurate. The study was conducted in one hospital, so the sample size was relatively small. We need a larger sample size to provide evidence for these results.