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Prediction of delivery mode by ultrasound-assessed fetal position in nulliparous women with prolonged first stage of labor

Eggebo, T. M.; Hassan, W. A.; Salvesen, Kjell LU ; Torkildsen, E. A.; Ostborg, T. B. and Lees, C. C. (2015) In Ultrasound in Obstetrics & Gynecology 46(5). p.606-610
Abstract
Objectives To ascertain if fetal head position on transabdominal ultrasound is associated with delivery by Cesarean section in nulliparous women with a prolonged first stage of labor. Methods This was a prospective observational study performed at Stavanger University Hospital, Norway, and Addenbrooke's Hospital, Cambridge, UK, between January 2012 and April 2013. Nulliparous pregnant women with a singleton cephalic presentation at term and prolonged labor had fetal head position assessed by ultrasound. The main outcome was Cesarean section vs vaginal delivery, and secondary outcomes were association of fetal head position with operative vaginal delivery and duration of remaining time in labor. Results Fetal head position was assessed... (More)
Objectives To ascertain if fetal head position on transabdominal ultrasound is associated with delivery by Cesarean section in nulliparous women with a prolonged first stage of labor. Methods This was a prospective observational study performed at Stavanger University Hospital, Norway, and Addenbrooke's Hospital, Cambridge, UK, between January 2012 and April 2013. Nulliparous pregnant women with a singleton cephalic presentation at term and prolonged labor had fetal head position assessed by ultrasound. The main outcome was Cesarean section vs vaginal delivery, and secondary outcomes were association of fetal head position with operative vaginal delivery and duration of remaining time in labor. Results Fetal head position was assessed successfully by ultrasound examination in 142/150 (95%) women. In total, 19/50 (38%) women with a fetus in the occiput posterior (OP) position were delivered by Cesarean section compared with 16/92 (17%) women with a fetus in a non-OP position (P= 0.01). On multivariable logistic regression analysis, the OP position predicted delivery by Cesarean section with an odds ratio (OR) of 2.9 (95% CI, 1.3-6.7; P= 0.01) and induction of labor with an OR of 2.4 (95% CI, 1.0-5.6; P= 0.05). Fetal head position was not associated with operative vaginal delivery or with remaining time in labor. The agreement between a digital and an ultrasound assessment of OP position was poor (Cohen's kappa= 0.19; P= 0.18). Conclusion OP fetal head position assessed by transabdominal ultrasound was significantly associated with delivery by Cesarean section. Copyright (C) 2014 ISUOG. Published by John Wiley & Sons Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ultrasound, transperineal, occiput posterior, labor
in
Ultrasound in Obstetrics & Gynecology
volume
46
issue
5
pages
606 - 610
publisher
John Wiley & Sons
external identifiers
  • wos:000364315900016
  • scopus:84946488908
ISSN
1469-0705
DOI
10.1002/uog.14773
language
English
LU publication?
yes
id
2699083c-8006-4ef9-834a-c934b4c13f6c (old id 8380516)
date added to LUP
2016-01-04 07:04:40
date last changed
2017-05-28 04:05:17
@article{2699083c-8006-4ef9-834a-c934b4c13f6c,
  abstract     = {Objectives To ascertain if fetal head position on transabdominal ultrasound is associated with delivery by Cesarean section in nulliparous women with a prolonged first stage of labor. Methods This was a prospective observational study performed at Stavanger University Hospital, Norway, and Addenbrooke's Hospital, Cambridge, UK, between January 2012 and April 2013. Nulliparous pregnant women with a singleton cephalic presentation at term and prolonged labor had fetal head position assessed by ultrasound. The main outcome was Cesarean section vs vaginal delivery, and secondary outcomes were association of fetal head position with operative vaginal delivery and duration of remaining time in labor. Results Fetal head position was assessed successfully by ultrasound examination in 142/150 (95%) women. In total, 19/50 (38%) women with a fetus in the occiput posterior (OP) position were delivered by Cesarean section compared with 16/92 (17%) women with a fetus in a non-OP position (P= 0.01). On multivariable logistic regression analysis, the OP position predicted delivery by Cesarean section with an odds ratio (OR) of 2.9 (95% CI, 1.3-6.7; P= 0.01) and induction of labor with an OR of 2.4 (95% CI, 1.0-5.6; P= 0.05). Fetal head position was not associated with operative vaginal delivery or with remaining time in labor. The agreement between a digital and an ultrasound assessment of OP position was poor (Cohen's kappa= 0.19; P= 0.18). Conclusion OP fetal head position assessed by transabdominal ultrasound was significantly associated with delivery by Cesarean section. Copyright (C) 2014 ISUOG. Published by John Wiley & Sons Ltd.},
  author       = {Eggebo, T. M. and Hassan, W. A. and Salvesen, Kjell and Torkildsen, E. A. and Ostborg, T. B. and Lees, C. C.},
  issn         = {1469-0705},
  keyword      = {ultrasound,transperineal,occiput posterior,labor},
  language     = {eng},
  number       = {5},
  pages        = {606--610},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Prediction of delivery mode by ultrasound-assessed fetal position in nulliparous women with prolonged first stage of labor},
  url          = {http://dx.doi.org/10.1002/uog.14773},
  volume       = {46},
  year         = {2015},
}