Sonographic parameters for diagnosing fetal head engagement during labour

Journal article


Wiafe, Y.A., Whitehead, B., Venables, H. and Odoi, A.T. 2018. Sonographic parameters for diagnosing fetal head engagement during labour. Ultrasound. https://doi.org/10.1177/1742271x18755080
AuthorsWiafe, Y.A., Whitehead, B., Venables, H. and Odoi, A.T.
Abstract

The purpose of this study was to investigate the diagnostic performance of the head–perineum distance, angle of progression, and the head–symphysis distance as intrapartum ultrasound parameters in the determination of an engaged fetal head. Two hundred and one women in labour underwent both ultrasound and digital vaginal examination in the estimation of fetal head station. The transperineal ultrasound measured head–perineum distance, angle of progression, and head–symphysis distance for values correlating with digital vaginal examination head station. Using station 0 as the minimum level of head engagement, correlating cutoff values for head–perineum distance, angle of progression, and head–symphysis distance were obtained. Receiver operating characteristics were used in determining the diagnostic performance of these cut-off values for the detection of fetal head engagement. With head–perineum distance of 3.6 cm the sensitivity and specificity of sonographic determination of engaged fetal head were 78.7 and 72.3%, respectively. A head–symphysis distance of 2.8 cm also had sensitivity and specificity of 74.5 and 70.8%, respectively, in determining engagement, whilst an angle of progression of 101 was consistent with engagement by digital vaginal examination with 68.1% sensitivity and 68.2% specificity. Ultrasound shows high diagnostic performance in determining engaged fetal head at a head–perineum distance of 3.6 cm, head–symphysis distance of 2.8 cm, and angle of progression of 101.

The purpose of this study was to investigate the diagnostic performance of the head–perineum distance, angle of progression, and the head–symphysis distance as intrapartum ultrasound parameters in the determination of an engaged fetal head. Two hundred and one women in labour underwent both ultrasound and digital vaginal examination in the estimation of fetal head station. The transperineal ultrasound measured head–perineum distance, angle of progression, and head–symphysis distance for values correlating with digital vaginal examination head station. Using station 0 as the minimum level of head engagement, correlating cutoff values for head–perineum distance, angle of progression, and head–symphysis distance were obtained.
Receiver operating characteristics were used in determining the diagnostic performance of these cut-off values for the detection of fetal head engagement. With head–perineum distance of 3.6 cm the sensitivity and specificity of sonographic determination of engaged fetal head were 78.7 and 72.3%, respectively. A head–symphysis distance of 2.8 cm also had sensitivity and specificity of 74.5 and 70.8%, respectively, in determining
engagement, whilst an angle of progression of 101 was consistent with engagement by digital vaginal examination with 68.1% sensitivity and 68.2% specificity. Ultrasound shows high diagnostic performance in determining engaged fetal head at a head–perineum distance of 3.6 cm, head–symphysis distance of 2.8 cm, and
angle of progression of 101.

KeywordsAngle of progression; Head–perineum distance; Head–symphysis distance; Engaged fetal head; Child labour; Birth
Year2018
JournalUltrasound
PublisherSage
ISSN1742271X
17431344
Digital Object Identifier (DOI)https://doi.org/10.1177/1742271x18755080
Web address (URL)http://www.scopus.com/inward/record.url?eid=2-s2.0-85041711977&partnerID=MN8TOARS
Publication dates2018
Publication process dates
Deposited09 Feb 2018, 16:24
Accepted10 Nov 2017
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ContributorsUniversity of Derby, Kwame Nkrumah University of Science and Technolog, Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK, Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK, Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK and Department of Obstetrics and Gynaecology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana
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