Measurement of the fetal occiput-spine angle during the first stage of labor as predictor of the progress and outcome of labor

Abstract

There was a significantly longer duration of both first and second stages of labor with higher rates of CS and maternal and fetal complications in women with OSA <126.

Sonographic assessment of fetal head deflexion using occiput: spine angle measured during first stage of labour and its role in predicting the mode of delivery among nulliparous women

“…This cutoff is similar, but slight lower, that that reported by Maged et al, who reported a cut-off value of 126°. 5 Ghi et al reported a cut-off of 125°, which is again greater than the value obtained in our study. 4 The differences between our study and those of Maged et al and Ghi et al may be attributed to the differences in the study populations of the studies.…”

“…4 The differences between our study and those of Maged et al and Ghi et al may be attributed to the differences in the study populations of the studies. 4,5 Both studies were inclusive of both multiparas as well as nulliparas, whereas ours was restricted to nulliparas since they were the focus group of the current study.…”

“…The sensitivity and specificity of the cut-off of 126° reported by Maged et al was 78.4% and 93.79, respectively, while that of ours for a cut-off of 121° was 80.5% and 87.5%, implying that our cut-off had greater sensitivity, while theirs had better specificity. 5 Therefore, accounting for the risk of Cesarean delivery in nulliparas if the OSA is between 121° and 126° could be considered as a reasonable guideline for clinicians.…”

“…Studies have shown an association between the value of OSA and the need for intervention, including cesarean section or instrumentation. 4,5 However, there still remains some ambiguity regarding the manner in which the OSA influences the progress and outcome of delivery.…”

Accuracy of non-invasive methods for assessing the progress of labor in the first stage: a systematic review and meta-analysis

“…When combining both HPD and AOP for the prediction of the mode of birth, the assessment of both parameters has a high sensitivity of 97.7% and a high positive predictive value of 86.63% 6 Mukdee, Suntharasaj [ 28 ] 2021 Thailand 330 2D transabdominal ultrasound Active phase The sensitivity of an OSA ≥ 100 degrees for predicting vaginal birth is 83.7%, but its specificity is only 17.1%. The combination of an OSA ≥ 100 degrees with multiparity and no induction of labor can predict vaginal birth with a positive likelihood ratio of 3.6 7 Fahmy, Elhalaby [ 29 ] 2020 Egypt 70 nulliparous 2D Transperineal ultrasound Active phase VE, HPD [≥ 120 degrees] and AOP [≤ 45 mm] are significantly correlated with one another and prediction of the occurrence of normal vaginal birth 8 Kandil, Elhalaby [ 30 ] 2020 Egypt 80 2D Transperineal ultrasound Active phase The sensitivity of an AOP > 104 degrees for predicting vaginal delivery is 90%, and the specificity is 86% 9 Solaiman, Atwa [ 31 ] 2020 Egypt 28 2D Transperineal ultrasound Prolonged active phase of first or second stage s of labor Using a cut off value of 115 degrees for the AOP, the positive predictive value [PPV] of vaginal birth is 87%; using a cut off value of 42 mm for HPD results in a PPV for vaginal birth of 85% 10 Maged, Soliman [ 14 ] 2019 Egypt 400 2D Transabdominal ultrasound Active phase An OSA < 126 degrees has a sensitivity, specificity, and accuracy of 82%, 64.6%, and 92% in the prediction of the mode of birth, respectively …”