| Ultrasound assessment of fetal head-perineum distance before induction of labor. | |
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MedLine Citation:
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PMID: 18528923 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate fetal head-perineum distance measured by ultrasound imaging as a predictive factor for induction of labor, and to compare this distance with maternal factors, the Bishop score and ultrasound measurements of cervical length, cervical angle and occiput position. METHODS: The study included 275 women admitted for induction of labor. The fetal head-perineum distance was measured by transperineal ultrasound imaging as the shortest distance from the outer bony limit of the fetal skull to the skin surface of the perineum. Cervical length and angle was measured by transvaginal ultrasound examination, and fetal head position was assessed by transabdominal ultrasound imaging. The Bishop score was assessed without knowledge of ultrasound measurements. Receiver-operating characteristics (ROC) curves were used for evaluation of the probability of a successful vaginal delivery. The time from induction to delivery was tested using Cox regression analysis with ultrasound measurements, parity and body mass index (BMI) as possible predictive factors. RESULTS: Areas under the ROC curve for prediction of vaginal delivery were 62% (95% CI, 52-71%) for fetal head-perineum distance (P = 0.03), 61% (95% CI, 51-71%) for cervical length (P = 0.03), 63% (95% CI, 52-74%) for cervical angle (P = 0.02), 61% (95% CI, 52-70%) for Bishop score (P = 0.03) and 60% (95% CI, 51-69%) for BMI (P = 0.05). The Cesarean delivery rate was 22% among nulliparous and 5% among parous women (P < 0.01). Parity, fetal head-perineum distance, cervical length and cervical angle were contributing factors predicting vaginal delivery within 24 h in a Cox regression model. Occiput posterior position had no significant predictive value. CONCLUSIONS: Fetal head-perineum distance measured by transperineal ultrasound examination can predict vaginal delivery after induction of labor, with a predictive value similar to that of ultrasonographically measured cervical length and the Bishop score. However, we judge none of these methods used alone to be good enough in a clinical setting. |
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Authors:
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T M Eggebø; C Heien; I Økland; L K Gjessing; P Romundstad; K A Salvesen |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 32 ISSN: 1469-0705 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-04 Completed Date: 2009-01-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 199-204 Citation Subset: IM |
Copyright Information:
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(c) 2008 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway. tme@lyse.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cervical Ripening / physiology Cervix Uteri / physiopathology, ultrasonography* Female Fetus Head / embryology, ultrasonography* Humans Infant, Newborn Labor Onset Labor, Induced Perineum / embryology, ultrasonography* Pregnancy Pregnancy Outcome Pregnancy Trimester, Third Proportional Hazards Models ROC Curve Regression Analysis Ultrasonography, Prenatal / methods* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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