Sequential Spatial-Temporal Network for Interpretable Automatic Ultrasonic Assessment of Fetal Head During Labor

The intrapartum ultrasound guideline established by ISUOG highlights the Angle of Progression (AoP) and Head Symphysis Distance (HSD) as pivotal metrics for assessing fetal head descent and predicting delivery outcomes. Accurate measurement of the AoP and HSD requires a structured process. This begins with identifying standardized ultrasound planes, followed by the detection of specific anatomical landmarks within the regions of the pubic symphysis and fetal head that correlate with the delivery parameters AoP and HSD. Finally, these measurements are derived based on the identified anatomical landmarks. Addressing the clinical demands and standard operation process outlined in the ISUOG guideline, we introduce the Sequential Spatial-Temporal Network (SSTN), the first interpretable model specifically designed for the video of intrapartum ultrasound analysis. The SSTN operates by first identifying ultrasound planes, then segmenting anatomical structures such as the pubic symphysis and fetal head, and finally detecting key landmarks for precise measurement of HSD and AoP. Furthermore, the cohesive framework leverages task-related information to improve accuracy and reliability. Experimental evaluations on clinical datasets demonstrate that SSTN significantly surpasses existing models, reducing the mean absolute error by 18% for AoP and 22% for HSD.