by measuring the distance from outer skin edge to rib margin at the level of the ... weight, maternal pre- and post-delivery weight, maternal weight change, route ...
21st World Congress on Ultrasound in Obstetrics and Gynecology Conclusions: Narrow ‘‘angel of progression’’ (< 95◦ ) in non laboring nulliparous women at term seems to be associated with a high rate of cesarean section due to arrest disorders.
OP22.05 Correlation of intrapartum ultrasonic fetal abdominal subcutaneous and skin thickness with birthweight and delivery indices
Oral poster abstracts
mode of delivery the only significant difference was found between interspinous diameter measurements and mode of delivery (P < 0.01) (Table 1). Conclusions: The pelvic parameter that significantly differed between modes of delivery was the interspinous diameter. The transverse inlet diameter did not reach a statistical significance, probably due to the exclusion of cases with non reassuring fetal monitoring. OP22.06: Table 1. Sonopelvimetry and modes of delivery
A. Fong, S. Rad, D. Finke, D. Ogunyemi Cedars-Sinai Medical Center, Los Angeles, CA, USA Objectives: To correlate fetal abdominal subcutaneous and skin thickness with birthweight and delivery indices. Methods: 65 patients were recruited during labor. The fetal abdominal subcutaneous and skin thickness (FASST) was assessed by measuring the distance from outer skin edge to rib margin at the level of the abdominal circumference. FASST was compared to birth weight, maternal pre- and post-delivery weight, maternal weight change, route of delivery, gender, maternal age, and gestational age. Results: Gestational age at recruitment was 39.61 ± 1.24 weeks (mean ± standard deviation). The interval from FASST measurement to delivery ranged from 1 to 34 hours. FASST measurements correlated strongly with birth weight (r = 0.643, P < .001). There were weak correlations with gestational age (r = 0.287, P = 0.021), maternal weight at delivery (r = 0.270, P = 0.032), and maternal weight gain during pregnancy (r = 0.345, P = 0.007). There was no difference in cesarean section resulting from arrest of labor. Macrosomic fetuses had thicker FASST (55.03 ± 9.05 mm) compared to others (43.45 ± 7.33 mm) (P = 0.01). Females had thicker FASST (45.92 ± 7.49 mm) compared to males (42.12 ± 7.61 mm) (P = 0.047). Conclusions: FASST measurements positively correlate with birthweight, maternal weight & female gender. These preliminary findings demonstrate FASST as a potentially promising tool for assessing intrapartum fetal weight. Supporting information can be found in the online version of this abstract.
OP22.06 Pelvimetry by LaborPro system for the diagnosis of dystocia Y. Gilboa2 , E. Bertucci1 , C. Cani1 , J. Haas2 , V. Mazza1 , R. Achiron2 1 Prenatal Medicine Unit, Modena and Reggio Emilia University, Modena, Italy; 2 Obsterics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
Objectives: To test the clinical value of the LaborPro system pelvimetry for the diagnosis of cephalopelvic dysproportion. Methods: Bi-national prospective study; Sheba Medical Center Israel and Policlinico of Modena Italy. Nulliparous women scheduled for vaginal delivery at > 39 weeks and consented participate in the study were evaluated by using the LaborPro system. The data observed was not revealed to the staff nor influenced the clinical management. The pelvic inlet dimensions evaluated by extrapolating the transverse diameter and obstetric conjugate. Interspinous diameter measured for the mid pelvis and the pelvic outlet evaluated by measuring pubic arch angle. Results: 79 nuliparous from 39 weeks of gestation recruited. 17 were excluded due to cesarean section or operative delivery indicated by non reassuring fetal heart rate monitoring. Of the 62 deliveries included, 47 delivered by vaginal delivery 7 Cesarean section and 8 operative deliveries. None of the general characteristics evaluated, maternal age, BMI, maternal height and fetal body weight differed between modes of delivery. Comparing pelvic dimensions with
120
Cases
Transverse diameter (cm) NS Obstetric coniugate (cm) NS Pubich arch angle (◦ ) NS Interspinous diameter (cm) 0.001
Operative delivery n=8 13.6 12.0 94 8.5
± ± ± ±
1.6 1.6 14.9 1.4
Cesarean section n=7 12.6 12.3 118.5 8.3
± ± ± ±
1.4 71.3 18 1.6
Spontaneous vaginal delivery n = 47 13.4 12.4 116.5 9.7
± ± ± ±
0.9 1.7 9.0 1.1
OP22.07 A study about sonographic parameters to assess labor progression use three-dimensional transperineal ultrasound Q. Q. Wu1 , Y. An1 , H. Cao2 , T. Zhong2 1 The Ultrasound Department, Beijing Obs/Gyn. Hospital of Capital University, Beijing, China; 2 GE Healthcare company, Beijing, China
Objectives: To analysis the difference of progression angle and the progression distance by three-dimensional transperineal ultrasound (TPU) imaging during labor between the patients who result in vaginal delivery and those who will require caesarean section because of protracted active phase, and provide reference for clinic treatment. Methods: 100 patients with live singleton fetus, head presentation, primipara, the gestational age ≥ 37 weeks, no cephalopelvic disproportion in prenatal evaluation. Use Voluson-i three-dimensional probe to collect volume date, and analysis the sonographic data with sono-VCAD software. Measure the progression angel and the progression distance. Compare to the digital examination and use SSPS 13.0 to analysis. Results: In the 100 patients, the average pregnancy weeks is 39.4, the average birth weight is 3380 g. 81 patients result in vaginal delivery and 19 patients result in caesarean section for protracted active phases. The mean progression speed of progression angle and the progression distance were 19.3 ± 15.4◦ , 14.6 ± 12.2 cm per hour in whom result in vaginal delivery; the mean progression speed of the progression angle and the progression distance were 2.4 ± 4.8◦ , 2.7 ± 4.7 cm per hour in caesarean section. The two parameters of vaginal delivery patients were obviously smaller than the caesarean section patients (P < 0.001). There was a significant linear correlation between the progression distance measured on TPU and the clinical station assessed by digital examination (R2 = 0.778 P = 0.000 < 0.001). Conclusions: The progression angle and the progression distance measured by three-dimensional TPU during labor provide objective and reproducible assessment parameters. They provide objective evidence to the following clinical treatment for the patients who result in arrested labor.
Ultrasound in Obstetrics & Gynecology 2011; 38 (Suppl. 1): 56–167
