This article is devoted to a pressing issue in modern obstetrics: the use of ultrasound navigation in labor to reduce the incidence of cesarean sections and optimize delivery strategies. The authors analyze the experience of international and domestic colleagues, paying particular attention to key ultrasound parameters such as the angle of progression (AoP), the occiput-spine angle (OSA), the head-perineum distance (HPD), and others. They emphasize that the use of traditional vaginal examination alone during labor is prone to errors, while ultrasound monitoring allows for an objective assessment of the fetal head position, predicting the success of vaginal delivery, and minimizing surgical interventions. The article presents research data demonstrating the prognostic value of ultrasound parameters: for example, an AoP ≥145° is associated with successful vaginal delivery (98%), and an HPD >55 mm correlates with unsuccessful attempts at vacuum extraction. In addition, new parameters such as the buttock flexion angle in breech presentation and the posterior cervical angle are considered for predicting successful labor induction. Particular attention is paid to the use of ultrasound examination during labor in women with a uterine scar, in whom a lower uterine segment thickness of less than 2.3 mm may indicate the risk of uterine rupture.