Sagittal suture overlap in cephalopelvic disproportion: Blinded and non‐participant assessment

Abstract

Assessment of sagittal suture overlap, but not lambdoid suture overlap, is useful for prediction of CPD. Knowledge of sagittal suture overlap may assist in decisions on clinical management where there is poor progress in a trial of labor.

Inconsistent definitions of prolonged labor in international literature: a scoping review

“…We identified 43 studies that focused on defining a prolonged first and/or second stage of labor as primary outcome. 14 , 17 , 31 , 35 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 All of these studies, except four, originated from North America or Europe. 44 , 72 , 73 , 77 The majority were observational studies (35, 81.4%).…”

“… 14 , 17 , 31 , 35 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 All of these studies, except four, originated from North America or Europe. 44 , 72 , 73 , 77 The majority were observational studies (35, 81.4%). Table 2 (page 41) is an overview of all definitions provided by these “defining” studies.…”

Letters and emails

“…We agree that moulding is a complex process and feel it important to emphasise that sagittal suture overlap has been shown to be a better predictor of cephalopelvic disproportion than lambdoidal overlap, which may be difficult to assess when the head is deflexed 1 …”

Asynclitism and Its Ultrasonographic Rediscovery in Labor Room to Date: A Systematic Review

“…This scientific evidence was then confirmed by further studies, published in the first decade of the 2000s, which investigated the fetal head attitude assessment during labor, without specific mention of asynclitism [ 41 , 42 , 43 , 44 , 45 ]. Buchmann et al, in 2008, were the first to describe a cluster of ultrasound parameters useful for ultrasound evaluation explicitly for asynclitic head during labor [ 6 ]. Asynclitism was not yet considered an entity of its own, instead seen as belonging to a group of unfavorable fetal head attitudes, according to the wider concept of cephalopelvic disproportion.…”

“…On the other hand, the positive predictive values of lamboid suture overlap are 25.2% and 23.4% for grade 2 and grade 1, CPD respectively. The absence of a sagittal or a lamboid suture overlap had 87.2% (211/242) and 90.9% negative predictive values for CPD, respectively [ 6 ]. According to the literature, compared to the vaginal digital examination (VDE), ultrasound (US) is associated with an earlier, more reliable, and more accurate diagnosis of asynclitism, especially in misleading cases, such as caput succedaneum, which is often observed in labor dystocia [ 24 ].…”