Dall’Asta A, Angeli L, Masturzo B, et al. - Among nulliparous women with a prolonged second stage of labor, researchers assessed the role of transabdominal and transperineal sonographic findings in the anticipation of spontaneous vaginal delivery. This investigation was carried out at two Tertiary Maternity Units. Overall, 109 were women included in this two-centre prospective study. In 40 and 69 patients, respectively, spontaneous vaginal delivery and obstetric intervention were recorded. Findings suggested an association of spontaneous vaginal delivery with a higher rate of occiput anterior position, lower head-perineum distance and head-symphysis distance, narrower midline angle and wider angle of progression at the acme of the pushing effort and Delta-angle of progression. Only the midline angle and the head-symphysis distance were independent predictors of spontaneous vaginal delivery when evaluating logistic regression. In nulliparous women with a prolonged second stage of labor, transabdominal and transperineal intrapartum ultrasound parameters can predict the possibility of spontaneous vaginal delivery.