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Intrapartum fetal head circumference and estimated fetal weight as predictors of operative delivery
Author(s) -
Rabei Noha H.,
ElHelaly Amr M.,
Farag Amr H.,
ElNaggar Ahmed K.,
Etman Mohamed K.,
ElMoteily Moataz M.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12098
Subject(s) - medicine , obstetrics , cutoff , fetus , prospective cohort study , fetal weight , vaginal delivery , head circumference , predictive value , fetal head , ultrasonography , receiver operating characteristic , gynecology , birth weight , pregnancy , surgery , physics , quantum mechanics , biology , genetics
Objective To assess intrapartum sonographic measurements of fetal head circumference ( HC ) and estimated fetal weight ( EFW ) to predict operative delivery. Methods In a prospective study, 200 spontaneously parturient primiparous women aged 20–30 years were enrolled at a teaching hospital in Cairo, Egypt, between October 2, 2015, and January 28, 2016. HC and EFW were measured by transabdominal ultrasonography. After delivery, the association between type of delivery and ultrasonography findings was assessed. Results Intrapartum HC and EFW were significantly higher among women with operative delivery (n=76) than among those with normal vaginal delivery (n=124; P <0.001 for both). Intrapartum HC of 36.8 cm or more was associated with an increased risk of operative delivery (relative risk [ RR ] 2.87, 95% CI 1.87–4.41), as was EFW of 3920 g or more ( RR 3.69, 95% CI 2.13–6.40). The area under the receiver operating characteristic curve was 0.807 and 0.748 for HC and EFW , respectively ( P <0.001 for both). At 36.8‐cm cutoff, HC had 44.7% sensitivity, 91.9% specificity, 77.3% positive predictive value ( PPV ), and 73.1% negative predictive value ( NPV ). At 3920‐g cutoff, EFW had 68.4% sensitivity, 82.3% specificity, 70.3% PPV , and 81.0% NPV . Intrapartum HC and EFW were directly correlated with second‐stage duration ( P =0.005 and 0.002, respectively). Conclusion Intrapartum HC and EFW seem to be good predictors of operative delivery.