Document Detail


Impact on delivery outcome of ultrasonographic fetal head position prior to induction of labor.
MedLine Citation:
PMID:  17329512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess clinical and sonographic fetal head position before induction of labor, position at delivery, and whether occiput posterior (OP) position is associated with adverse delivery outcome. METHODS: Abdominal palpation and ultrasonographic fetal head and spine position were determined at 36 weeks or more of gestation in 289 women immediately before induction of labor and the head position at delivery noted. Chi-square, Mann-Whitney U tests, and logistic regression were used to assess whether OP position was associated with cesarean delivery. RESULTS: Ninety-seven (36%) of 270 women with full outcome data had an OP position on ultrasonography before induction of labor. Of these 97 women, eight (8%) were OP at delivery. Sixty-eight percent of the 25 OP positions at delivery occurred due to a mal-rotation from a non-OP position during labor. Logistic regression showed that OP position before induction of labor was not an independent predictor of cesarean delivery (odds ratio 1.75, 95% confidence interval 0.97-3.15, P=.06). CONCLUSION: Two thirds of OP positions at delivery after induction of labor occur due to a mal-rotation in labor from a non-OP position. Ultrasonography is an easy method of assessing fetal head position before induction of labor. In clinical practice, its usefulness is limited by the fact that, contrary to conventional teaching, OP position before induction of labor does not appear to be associated with an increased risk of cesarean delivery. LEVEL OF EVIDENCE: II.
Authors:
Elisabeth Peregrine; Patrick O'Brien; Eric Jauniaux
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  109     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-01     Completed Date:  2007-03-30     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  618-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, University College London Hospitals, London, United Kingdom. e.peregrine@ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Female
Head / embryology*,  ultrasonography
Humans
Infant, Newborn
Labor Presentation*
Labor, Induced*
Parity
Pregnancy
Pregnancy Outcome*
Spine / embryology
Ultrasonography, Prenatal*

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