Objective To explore the application value of prenatal pelvic floor ultrasound examination in improving maternal and neonatal delivery outcomes, with a focus on the predictive efficacy of the angle of progression (AOP) and cervical length (CL) for delivery mode and labor duration. Methods A total of 100 puerperae who underwent regular prenatal examinations and delivered at Jiangbin Hospital of Guangxi Zhuang Autonomous Region between July 2021 and December 2023 were selected as study subjects. They were divided into an observation group or a control group using a random number table, with 50 cases in each group. In addition to Grade Ⅰ prenatal ultrasound examination, the control group underwent traditional vaginal digital examination, while the observation group underwent pelvic floor ultrasound examination to measure AOP, CL, angle of subpubic arch, as well as the area, perimeter, anteroposterior diameter, and transverse diameter of the levator hiatus at rest and during maximum Valsalva maneuver, according to which scores for expulsive forces, bony birth canal, and soft birth canal were quantitatively assessed, and the total score was calculated. Delivery outcomes were compared between the control and observation groups. The observation group was further divided into a spontaneous delivery subgroup (n=37) or an assisted delivery/cesarean section subgroup (n=13) based on delivery mode; AOP, CL, and scores for expulsive force, bony birth canal, soft birth canal, and the total score were compared between the two subgroups, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of these indicators for delivery mode. Spearman rank correlation analysis was applied to explore the correlation between pelvic floor ultrasound examination indicators and the duration of the second stage of labor; the spontaneous delivery subgroup was divided based on the median CL (2.7 cm) to compare the duration of the second stage of labor between puerperae with different CLs. Results The observation group had a higher 1-minute Apgar score of the newborn and a lower incidence of perineal laceration than the control group (all P<0.05). The assisted delivery/cesarean section subgroup had a smaller AOP, a longer CL, and a lower score for bony birth canal than the spontaneous delivery subgroup (all P<0.05). ROC curve analysis showed that AOP and CL had certain predictive value for delivery mode, with areas under the ROC curves of 0.764 (95% CI: 0.598-0.930, P=0.005) and 0.722 (95% CI: 0.564-0.881, P=0.018) for AOP and CL, respectively. Spearman rank correlation analysis results revealed a positive correlation between the duration of the second stage of labor and CL in the spontaneous delivery subgroup (rs=0.375, P=0.022). The group with CL ≤2.7 cm had a shorter duration of the second stage of labor than the group with CL >2.7 cm (P<0.05). Conclusions Prenatal pelvic floor ultrasound examination may help improve delivery outcomes, with its core value lying in providing objective quantitative indicators such as AOP and CL. AOP and CL demonstrate good predictive value for delivery mode, and CL is closely related to the duration of the second stage of labor, serving as an important indicator for assisting clinical decision-making.  

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