Fetal pelvic index to predict cephalopelvic disproportion – a retrospective clinical cohort study

Korhonen, Ulla R.; Taipale, Pekka; Heinonen, Seppo

doi:10.1111/aogs.12608

Cited by 22 publications

(26 citation statements)

References 34 publications

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“…The continuing effort to search for objective risk assessment, parallel with the introduction of ultrasonography equipment into the delivery rooms, has led to many reports regarding the value of various sono-pelvimetric parameters in predicting dysfunctional labor and unplanned operative delivery [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. The angle of progression, widely reported in the literature as a predictive measurement when obtained before the onset of labor, during the rst and second stages of labor, and before assisted delivery, represents the fetal head station.…”

Section: Introductionmentioning

confidence: 99%

Sonographic risk assessment for an unplanned operative delivery: a prospective study

Perlman

Schreiber

Kivilevitch

et al. 2022

Arch Gynecol Obstet

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Purpose: To assess the value of pre-labor maternal and fetal sonographic variables to predict an unplanned operative delivery.Methods: In this prospective study, nulliparous women were recruited at 37.0-42.0 weeks of gestation.Sonographic measurements included estimated fetal weight, maternal pubic arch angle, and the angle of progression. We performed a descriptive and comparative analysis between two outcome groups: spontaneous vaginal delivery (SVD) and unplanned operative delivery (UOD) (vacuum-assisted, forcepsassisted and cesarean deliveries). Multivariate logistic regression with ROC analysis was used to create discriminatory models for UOD.Results: Among 234 patients in the study group, 175 had a spontaneous vaginal delivery and 59 an unplanned operative delivery. Maternal height and pubic arch angle (PAA) signi cantly correlated with UOD.Analysis of Maximum Likelihood Estimates revealed a multivariate model for the prediction of UOD, including the parameters of maternal age, maternal height, sonographic PAA, angle of progression (AOP), and estimated fetal weight, with an area under the curve of 0.7118. Conclusion: Sonographic parameters representing maternal pelvic con guration (PAA) and maternal-fetal interface (AOP) improve the prediction ability of pre-labor models for a UOD. These data may aid the obstetrician in the counseling process before delivery.

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Section: Introductionmentioning

confidence: 99%

Sonographic risk assessment for an unplanned operative delivery: a prospective study

Perlman

Schreiber

Kivilevitch

et al. 2022

Arch Gynecol Obstet

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“…The purpose of pelvimetry is to predict the vaginal delivery. The aim is to reduce the number of unnecessary cesarean sections while improving perinatal care (Korhonen et al, 2014;Korhonen et al, 2015). A wayto achieve this is by calculating The lower strait is also involved in the genesis of dystocic deliveries.…”

Section: Outcome Of Deliveriesmentioning

confidence: 99%

CT pelvimetry of variant pelvis and child birth prognosis

Lalèyè¹,

Azonbakin²,

Delmas³

et al. 2018

Anat. J. Afr.

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The aim of this study was to determine the threshold values of pelvimetry by scanning and to evaluate the ability of the pelvimetry alone to diagnose a fetal-pelvic disproportion. It was an observational retrospective study on 410 pregnant women who had a scanner pelvimetry for any reasons. Based on the fetal presentations, two subgroups (breech and cephalic -others) have been defined. Measurements of the main obstetric diameters (promonto-retropubic, median transverse and dual sciatica) were taken. The 5th and 10th percentile were calculated as well as the 90th and 95th to determine the threshold values of pelvimetry by scanner. The scanner values found on CT were compared with the standard X ray pelvimetry values. Referring to extreme values obtained by pelvimetry scanner, some pathological pelvic brim were reconstructed in 3D. Moreover, the delivery prognostic was analyzed by crossing the pelvic inlet dimensions (Magnin index) and pelvic outlet dimensions (bi-sciatic diameter) with the outcome of the delivery. The mean values of the scanno-pelvimetry measurement in our series were:m12,39 cm (± 1) for the promonto-retropubic diameter, 12.88 cm (± 1.01) for the transverse median diameter and 11 cm (± 1.32) for the bi-sciatic diameter. These measurements provided an accuracy less than 1 cm compared to the standard ray pelvimetry. Although Magnin index at 23 allows a vaginal delivery, 51% of oursample have failed. Moreover, for the Magnin index at 24 and 25, the vaginal delivery failure rate remains high:45.1% and 39.61% respectively. Compared to classical pelvimetry, pelvimetry by scanner provides additional precision and allows to study the geometry of the basin. However, the pelvimetry alone could not be effective to establish the prognosis of vaginal delivery.Keywords: scanno-pelvimetry, prognosis, delivery

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“…13 To our current knowledge, no speci c tools have been employed, to date, to effectively predict or negate the need for CPD-related ECS or IVD 14 prior to the start of labor. Only imprecise assessment methods are available, such as those based on pelvimetry with imaging, 15 clinical examination, simple CPD indices, 16,17 and transperineal ultrasound imaging during labor. 18 Radiopelvimetry, 19 pelvic computed tomography, 20 and MRI pelvimetry 21 have been routinely performed worldwide for decades without identi ed biological risks for fetuses under usual clinical practice conditions.…”

Section: Introductionmentioning

confidence: 99%

Childbirth simulation to assess cephalopelvic dystocia and chances for failed labor

Ami¹,

Maran²,

Cohen³

et al. 2021

Preprint

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Objectives: Reducing the rate of failed labor and emergency caesarean section is of vital significance. A childbirth simulation software tool based on 5 minutes’ magnetic resonance imaging (MRI) performed at 37 weeks’ gestation, used to enhance the consulting obstetrician’s ability to predict the optimal delivery mode. Here, we aimed to analyze the predictive ability of this childbirth simulation software tool for choosing the optimal delivery mode compared with not using it. Methods: A retrospective cohort study was performed on 401 patients referred by their obstetrician for MRI pelvimetry at approximately 37 weeks of gestation between December 15, 2015 and December 15, 2016. We employed a childbirth simulation software to predict the optimal delivery mode. Those results were compared with results from the actual delivery mode. Results: The rate of emergency caesarean sections, inappropriately scheduled caesarean sections, and instrumental vaginal deliveries would have been reduced by 30·1%, 20·7%, and 20%, respectively, had the predictions from the childbirth simulation software been considered. The use of the childbirth simulation software did not significantly affect the overall caesarean section rate, but it improved the allocation between scheduled and emergency caesarean sections. Conclusions: The routine use of the childbirth simulation software as a clinical support tool for choosing the optimal delivery mode of singleton pregnancies with a cephalic presentation could reduce the number of emergency caesarean sections, insufficiently justified Caesarean sections, and instrumental deliveries.

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Fetal pelvic index to predict cephalopelvic disproportion – a retrospective clinical cohort study

Abstract: The fetal pelvic index was not a clinically useful tool to predict the mode of delivery for patients at high risk of cephalopelvic disproportion. The pooled analysis of the current and previous studies strengthened this conclusion.

Cited by 22 publications

References 34 publications

Sonographic risk assessment for an unplanned operative delivery: a prospective study

Sonographic risk assessment for an unplanned operative delivery: a prospective study

CT pelvimetry of variant pelvis and child birth prognosis

Childbirth simulation to assess cephalopelvic dystocia and chances for failed labor

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