Neonatal head circumference as a risk factor for obstetric anal sphincter injuries: a systematic review and meta-analysis

Mohd Raihan, Fatimah Sarah; Kusuma, Julianty; Nasution, Ahmad Azmi

doi:10.1016/j.ajogmf.2023.101047

Cited by 2 publications

(2 citation statements)

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“…There is an association between a HC >95th centile and higher risk of unplanned cesarean delivery, instrumental delivery 57 and obstetric anal sphincter injury (OASI) 58 . Therefore, in fetuses with macrocephaly with a HC >95th centile at term when pelvic‐cephalic disproportion is likely during labor, a planned cesarean delivery should be considered.…”

Section: Obstetric Managementmentioning

confidence: 99%

“…There is an association between a HC >95th centile and higher risk of unplanned cesarean delivery, instrumental delivery 57 and obstetric anal sphincter injury (OASI). 58 Therefore, in fetuses with macrocephaly with a HC >95th centile at term when pelvic-cephalic disproportion is likely during labor, a planned cesarean delivery should be considered. In cases in which macrocephaly is the result of hydrocephalus and the prognosis is grim, pre-labor cephalocentesis can be considered to facilitate vaginal delivery.…”

Section: Obstetric Managementmentioning

confidence: 99%

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Fetal macrocephaly: Pathophysiology, prenatal diagnosis and management

Shinar,

Chitayat,

Shannon

et al. 2023

Prenatal Diagnosis

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Macrocephaly means a large head and is defined as a head circumference (HC) above the 98th percentile or greater than +2SD above the mean for gestational age. Macrocephaly can be primary and due to increased brain tissue (megalocephaly), which in most cases is familial and benign or secondary. The latter may be due to various causes, including but not limited to communicating or non‐communicating hydrocephalus, cerebral edema, focal and pericerebral increased fluid collections, thickened calvarium and brain tumors. Megalocephaly can be syndromic or non‐syndromic. In the former, gyral and structural CNS anomalies are common. It is important to exercise caution when considering a diagnosis of megalocephaly due to limitations in the accuracy of HC measurement, lack of nomograms for specific populations, inconsistencies between prenatal and postnatal HC growth curves and progression over time. The degree of macrocephaly is important, with mild macrocephaly ≤2.5SD carrying a good prognosis, especially when one of the parents has macrocephaly and normal development. Cases in which the patient history and/or physical exam are positive or when parental HC are normal are more worrisome and warrant a neurosonogram, fetal MRI and genetic testing to better delineate the underlying etiology and provide appropriate counseling.

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Section: Obstetric Managementmentioning

confidence: 99%

Section: Obstetric Managementmentioning

confidence: 99%