Document Detail

Ultrasonographic occiput position in early labour in the prediction of caesarean section.
MedLine Citation:
PMID:  15198779     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the value of ultrasonographically determined occiput position in the early stages of the active phase of labour, in addition to traditional maternal, fetal and labour-related characteristics, in the prediction of the likelihood of caesarean section. DESIGN: Prospective observational study. SETTING: District general hospital in the UK. POPULATION: Six hundred and one singleton pregnancies with cephalic presentation in active labour at term with cervical dilatation of 3-5 cm. METHODS: Transabdominal sonography to determine fetal occiput position was carried out by an appropriately trained sonographer immediately before or after the routine clinical examination by the attending midwife or obstetrician. MAIN OUTCOME MEASURE: Caesarean section. RESULTS: Delivery was vaginal in 514 (86%) cases and by caesarean section in 87 (14%). The fetal occiput position was posterior in 209 (35%) cases and in this group the incidence of caesarean section was 19% (40 cases), compared with 11% (47 of 392) in the non-occiput posterior group. Multiple regression analysis revealed that significant independent contribution in the prediction of caesarean section was provided by maternal age (OR 1.1, 95% CI 1.0-1.2), Afro-Caribbean origin (OR 2.4, 95% CI 1.2-4.6), height (OR 0.93, 95% CI 0.89-0.97), parity (OR 0.2, 95% CI 0.1-0.4), type of labour (OR 2.2, 95% CI 1.3-3.8), gestation (OR 1.4, 95% CI 1.1-1.7), fetal head descent (OR 0.6, 95% CI 0.4-0.9), occiput posterior position (OR 2.2, 95% CI 1.3-3.7) and male gender (OR 2.0, 95% CI 1.2-3.5). CONCLUSIONS: The risk of caesarean section can be estimated during the early stage of active labour by the sonographically determined occiput position, in addition to traditional maternal, fetal and labour-related characteristics.
Serap Akmal; Nikos Kametas; Elly Tsoi; Richard Howard; Kypros H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  111     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-16     Completed Date:  2004-06-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  532-6     Citation Subset:  AIM; IM    
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
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MeSH Terms
Cesarean Section*
Cross-Sectional Studies
Labor Presentation*
Maternal Age
Obstetric Labor Complications / ultrasonography*
Predictive Value of Tests
Prospective Studies
Regression Analysis
Ultrasonography, Prenatal / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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