Intrapartum Ultrasound Measurement of Fetal Head Circumference for Prediction of Prolonged Second Stage of Labor

Abstract

Background: Fetal head circumference was suggested to play a role in determination of the mode of delivery in nulliparous women. Aim of the work: To determine the capability of intrapartum ultrasound measurement of head circumference to monitor second stage of labor progress in an accurate and objective manner as well as its role as a predictor of successful normal vaginal birth. Patients and Methods:130 females who attended to the labor room and fulfil the inclusion criteria underwent ultrasonographic examination prior to the start of labor, and then followed up until delivery. Every woman was followed up by cervical dilatation, and head station every 4 hours. Woman was transferred to operating room when the cervix is fully dilated and head is engaged to determinate the duration of second stage. Fetal heart sounds were auscultated every 30 minutes and plotted on partogram. Shifting to cesarean section was considered when delivery failed to progress, delayed second stage or fetal bradycardia. Results: By using value of 37.0 for Intrapartum head circumference as a cut-off point, we observed a significant difference between both groups [smaller or larger than 37.0] regarding duration of the 2nd stage of labor [P=0.00] & Mode of delivery [P=0.00]. No statistical difference was observed regarding Maternal morbidity [P=0.374] or Neonatal outcome [P=0.412]. Conclusion: There was significant relation between intrapartum head circumference and length of second stage. Intrapartum fetal head circumference is a useful tool to expect the progress of delivery.

Keywords

• intrapartum head circumference
• mode of delivery
• second stage of labor
• nullipara
• ultrasound