Pregnancy Clinical Trial
Official title:
Prediction of Labor and Delivery With the Use of Ultrasound in Pregnancies With Induced Labor
The aim of the study was to evaluate any possible associations between engagement and position of the fetal head and the outcome of labor in women with induced labor, and to compare the value of ultrasound measurements in predicting the time from induction to delivery and operative deliveries.
Fetal head engagement measured by ultrasound as a predictive factor of labor outcome in
women with induced labor
T. EGGEBØ, L. K. GJESSING, I. ØKLAND, C. HEIEN, P. ROMUNDSTAD*, K. Å. SALVESEN** Department
of Obstetrics and Gynaecology, Stavanger University Hospital, Norway * Department of Public
Health, NTNU, Norway, St Olavs Hospital, Trondheim University Hospital
** National Center for Fetal Medicine, Department of Obstetrics and Gynaecology, Trondheim
University Hospital (St. Olav's Hospital) and Department of Laboratory Medicine, Children's
and Women's Health, Norwegian University of Science and Technology
KEYWORDS:
Ultrasound, induced labor, cervical length, engagement of fetal head, occiput posterior,
Bishop score, outcome of labor
Objective The aim of the study is to evaluate any possible associations between engagement
of the fetal head, the cervical status or occiput posterior position and the outcome of
labor in women with induced labor, and to compare the value of ultrasound measurements with
Bishop score in predicting operative deliveries.
Methods The ultrasound examinations will be carried out in 250 women immediately before
induction of labor. A transabdominal scan will be performed to determine the position of the
fetal occiput, a transperineal scan with transverse view to determine the degree of
engagement and a transvaginal examination to evaluate the cervical length and the cervical
angle.. The Bishop score will be performed by another examinator who is blinded to the
results of the ultrasound examinations. The time from induction to delivery will be tested
in a Cox regression analysis with fetal head engagement, cervical length and parity as
possible predictive factors and maternal age, BMI, gestational age, birth weight and head
circumference as possible confounders.
Inclusion and exclusion criteria:
Women were eligible for the study if they had a live singleton pregnancy with cephalic
presentation and a gestational age of more than 37 completed pregnancy weeks according to a
mid-trimester scan.
Statistical analysis Appropriate statistical tests for comparisons, such as Mann Whitney U
test, chi-square test, Fisher`s exact test, Pearson correlation, Kaplan Meier survival
analysis and Cox regression analysis will be used. For receiver-operating characteristics
(ROC) curves, the area under the curve will be used as discriminator. P-values < 0.05 will
be considered significant.
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Observational Model: Case-Only, Time Perspective: Prospective
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