Title :

Ultrasound assessment of fetal head position and station before operative delivery: can it predict difficulty?

Author(s) :

Plurien, Alix [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Berveiller, Paul [Auteur]
CHI Poissy-Saint-Germain
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Hanssens, Sandy [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Subtil, Damien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Garabedian, Charles [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Journal title :

Journal of Gynecology Obstetrics and Human Reproduction

Abbreviated title :

J Gynecol Obstet Hum Reprod

Volume number :

51

Pages :

102336

Publication date :

2022-02-23

ISSN :

2468-7847

English keyword(s) :

Head perineum distance
Head position
Head station
Operative vaginal delivery
Ultrasound xrr

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective To evaluate whether ultrasound assessment of fetal head position and station though head perineum distance (HPD), is more predictive of a difficult operative vaginal delivery (OVD) than digital examination. ...
Show more >Objective To evaluate whether ultrasound assessment of fetal head position and station though head perineum distance (HPD), is more predictive of a difficult operative vaginal delivery (OVD) than digital examination. Methods Retrospective, monocentric case control study including all singleton OVD at ≥34 weeks gestation. The principal criteria for a difficult OVD were based on a composite criterion of: an OVD considered “difficult” by the birth attendant, and/or two vacuum device detachments if a vacuum was used, and/or change of instrument, and/or a cesarean delivery for OVD failure. Results Two hundred eighty-six OVDs were included, among which 65 (22.7%) were difficult. The area under the curve (AUC) for predicting difficult OVD according to fetal position from digital examination or ultrasound was 0.62 (95% CI: 0.54–0.70) and 0.66 (95% CI: 0.58–0.73), respectively. Regarding fetal station, the AUCs of HPD without and with pressure were 0.59 (95% CI: 0.51–0.66) and 0.60 (95% CI: 0.51–0.68), respectively. Factors associated with difficult OVD were posterior and transverse positions (OR: 2.931, 95% CI: 1.640–5.239; p= 0.0003), HPD without pressure (threshold of 37 mm, OR: 2.327, 95% CI: 1.247–4.245; p= 0.0080), and HPD with pressure (threshold of 17 mm, OR: 2.594, 95% CI: 1.230–5.429; p= 0.0114). Conclusion Ultrasound assessment of fetal head position and station before OVD moderately predicts difficult OVD. Ultrasound assessment of posterior or transverse positions and HPD with a threshold of 37 mm (without compression of soft tissue) and 17 mm (with compression) were factors associated with difficult OVD.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T04:34:37Z
2024-04-15T15:03:39Z