Ultrasound in labor admission to predict need for emergency cesarean section: a prospective, blinded cohort study

Karaaslan, Onur
Islamova, Gunel
Soylemez, Feride
Kalafat, Erkan
Objective: To assess whether assessment with ultrasound could improve the detection of emergency cesarean section (ECS) in laboring women. Methods: Women who presented with symptoms of active labor or women in need of labor induction were invited to participate in the study. Women included in the study were evaluated with ultrasonography for fetal biometry and vaginal examinations for Bishop score assessment. The main aim in this study was determining factors associated with ECS due to fetal distress and obstructed labor. Results: No fetal biometry variable was associated with ECS due to any indication (fetal distress and obstructed labor combined) in the univariate analysis. In multivariate analyses, biometry variables were adjusted for Bishop score at admission and only abdominal circumference percentile showed a significant association with the odds of ECS due to any indication (OR:1.02, 95% CI: 1.01-1.03). Biparietal diameter and abdominal circumference variables were associated with the odds of ECS due to obstructed labor in both univariate and multivariate analyses (p < .05 for all). However, the predictive accuracy of biparietal diameter percentile (area under the curve (AUC): 0.55, 95% CI: 0.46-0.63) and abdominal circumference percentile (AUC: 0.56, 95% CI: 0.48-0.64) without adjunct variables were poor. Moreover, the addition of fetal biometry parameters to Bishop score did not improve the predictive accuracy of Bishop score. Conclusion: Ultrasound assessment at admission, in addition to Bishop score assessment, did not significantly improve the prediction of ECS. Also, the fetal biometry alone had poor predictive capability for ECS. Routine ultrasound assessment at labor admission appears to be ineffective for predicting ECS. Precis Fetal biparietal diameter and abdominal circumference showed an association with emergency cesarean due to obstructed labor but the predictive accuracy of fetal biometry was low. Routine ultrasound examination at admission, in addition to Bishop score assessment, may not useful for assessing the risk of emergency section in unselected populations.


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Objective: The objective of this study is to evaluate diagnostic accuracy of transperineal ultrasound assessment compared to speculum examination by using placental alfa-microglobulin (PAMG)-1 tests as reference.Methods: This was a prospective observational study conducted in Ankara University Hospital. Women with early and late preterm pregnancies with suspected rupture of membranes, i.e. women with a complaint of fluid leakage (105 in total) were enrolled. Prior to speculum examination, sagittal and trans...
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Kalafat, Erkan; Kalaylioglu, Zeynep; Thilaganathan, Basky; Khalil, Asma (Elsevier BV, 2020-09-01)
Objective A secondary analysis of the trial of randomized umbilical and fetal flow in Europe suggested that the umbilicocerebral ratio (UCR) provides better differentiation of neurodevelopmental outcome in the abnormal range compared with that of the cerebroplacental ratio (CPR).1 However, the reported superiority of UCR is controversial.2 This study aimed to compare the CPR and the UCR for predicting operative delivery for presumed fetal compromise and prolonged neonatal unit (NNU) admission in term fetus...
Computerized prediction system for the route of delivery (vaginal birth versus cesarean section)
BEKSAÇ, MEHMET SİNAN; TANAÇAN, ATAKAN; Bacak, Hikmet Ozge; Leblebicioğlu, Mehmet Kemal (Walter de Gruyter GmbH, 2018-11-01)
Aim: To develop a supportive computerized prediction system for the route of delivery.
Citation Formats
O. Karaaslan, G. Islamova, F. Soylemez, and E. Kalafat, “Ultrasound in labor admission to predict need for emergency cesarean section: a prospective, blinded cohort study,” JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, pp. 0–0, 2019, Accessed: 00, 2020. [Online]. Available: https://hdl.handle.net/11511/67413.