التفاصيل البيبلوغرافية
| العنوان: |
Prediction of persistent occiput posterior position by sonographic assessment of fetal head attitude at start of second stage of labor: prospective study |
| المؤلفون: |
Ramirez Zegarra, R., Dall'Asta, A., Di Pasquo, E., Morganelli, G., Falcone, V., Lizarraga Cepeda, E., Falvo, G., Bontempo, P., Kiener, A. J. O., Fieni, S., Ghi, T. |
| المصدر: |
Ultrasound in Obstetrics & Gynecology ; volume 63, issue 2, page 251-257 ; ISSN 0960-7692 1469-0705 |
| بيانات النشر: |
Wiley |
| سنة النشر: |
2024 |
| المجموعة: |
Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: |
Objectives To evaluate the relationship between the attitude of the fetal head quantified by means of the chin‐to‐chest angle (CCA) in fetuses in occiput posterior (OP) position at the beginning of the second stage of labor, and persistent OP position at birth. Methods This was a single‐center, prospective observational study conducted at the University Hospital of Parma, Parma, Italy. We included singleton pregnancies at term with fetuses in the OP position at the beginning of the second stage of labor. The fetal head position, station by means of angle of progression and head‐to‐perineum distance, and attitude by means of CCA were assessed using transabdominal or transperineal ultrasound. The primary outcome was persistent OP position at birth. Results Between January and July 2022, 76 women were included in the study. There were 48 (63.2%) spontaneous rotations of the fetal head and spontaneous vaginal delivery occurred in all. Among the 28 (36.8%) fetuses that did not rotate spontaneously into an occiput anterior position, eight (28.6%) had a spontaneous vaginal delivery, while operative vaginal delivery and Cesarean delivery was performed in 11 (39.3%) and nine (32.1%) cases, respectively. Multivariable logistic regression analysis showed that the CCA (adjusted odds ratio (aOR), 2.15 (95% CI, 1.22–3.78); P = 0.008) and nulliparity (aOR, 0.20 (95% CI, 0.06–0.76); P = 0.02) were associated independently with persistent OP position at birth. Moreover, the CCA showed an area under the receiver‐operating‐characteristics curve of 0.69 (95% CI, 0.56–0.82); P = 0.005) for the prediction of persistent OP position. The optimal cut‐off value of the CCA was 36.5°, and was associated with a sensitivity of 0.82 (95% CI, 0.63–0.94), specificity of 0.50 (95% CI, 0.35–0.65), positive predictive value of 0.49 (95% CI, 0.34–0.64), negative predictive value of 0.83 (95% CI, 0.64–0.94), positive likelihood ratio of 1.64 (95% CI, 1.18–2.29) and negative likelihood ratio of 0.36 (95% CI, 0.15–0.83). Conclusions Our data ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1002/uog.27461 |
| الإتاحة: |
https://doi.org/10.1002/uog.27461Test |
| حقوق: |
http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.EEB278D8 |
| قاعدة البيانات: |
BASE |
