Cargando…

The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor

Objective: Our objective was to demonstrate the role of the clinical determination of fetal head station (FHS) at term to predict the delivery mode in primiparous women before the onset of labor. Methods: This prospective study included unselected primiparous women at term who presented at our terti...

Descripción completa

Detalles Bibliográficos
Autores principales: Dîră, Laurențiu Mihai, Cara, Monica-Laura, Drăgușin, Roxana Cristina, Nagy, Rodica Daniela, Iliescu, Dominic Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225040/
https://www.ncbi.nlm.nih.gov/pubmed/35743345
http://dx.doi.org/10.3390/jcm11123274
_version_ 1784733521268441088
author Dîră, Laurențiu Mihai
Cara, Monica-Laura
Drăgușin, Roxana Cristina
Nagy, Rodica Daniela
Iliescu, Dominic Gabriel
author_facet Dîră, Laurențiu Mihai
Cara, Monica-Laura
Drăgușin, Roxana Cristina
Nagy, Rodica Daniela
Iliescu, Dominic Gabriel
author_sort Dîră, Laurențiu Mihai
collection PubMed
description Objective: Our objective was to demonstrate the role of the clinical determination of fetal head station (FHS) at term to predict the delivery mode in primiparous women before the onset of labor. Methods: This prospective study included unselected primiparous women at term who presented at our tertiary maternity. We excluded multiparous patients, pregnancies with a planned Cesarean section, non-cephalic presentations, and multiple pregnancies. The protocol included weekly clinical examinations to assess the FHS. The results were used to describe the clinical fetal head descent at term. We correlated the fetal head station determinations at each week with labor outcome, including the evaluations performed within the week before delivery. Results: The data show no significant differences between vaginal (VD) and Cesarean section delivery (CS) cases regarding FHS determined at each week at term. The median determinations at the gestational ages (GW) from 37 to 41 were −2 and −3, similar between the two groups, with a more consistent difference at 41 GW: station -1 for VD compared to −3 for CS. There were significant differences between the “week before delivery” evaluations of the two groups. The determinations showed for both groups similar minimum (−5), maximum (+1), and median (−2) FHS values. Most vaginal deliveries cases presented at weekly examinations with increasing rates toward more advanced stations: from 10% at station −4 to 35% at station −1. Although we investigated a low-risk group, we found significant differences between the vaginal and Cesarean groups in terms of age, weight, and BMI. We provided a multiple logistic regression equation that considered the predictive clinical variables at term: the fetal head situation, age, weight, height, and BMI. Conclusion: The clinical evaluation of fetal head station in primiparous before labor onset has a limited value regarding the prediction of the delivery mode. There is a potential benefit for the determinations performed within the week before delivery, but such a policy would require weekly assessments of the FHS at term, which is unlikely to be implemented. Another potential benefit would involve estimating labor outcomes in late-term or prolonged pregnancy. The fine tuning of the logistic prediction should be achieved by increasing the studied population and the number of centers involved before counseling primiparous women at term based on the clinical fetal engagement data.
format Online
Article
Text
id pubmed-9225040
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-92250402022-06-24 The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor Dîră, Laurențiu Mihai Cara, Monica-Laura Drăgușin, Roxana Cristina Nagy, Rodica Daniela Iliescu, Dominic Gabriel J Clin Med Article Objective: Our objective was to demonstrate the role of the clinical determination of fetal head station (FHS) at term to predict the delivery mode in primiparous women before the onset of labor. Methods: This prospective study included unselected primiparous women at term who presented at our tertiary maternity. We excluded multiparous patients, pregnancies with a planned Cesarean section, non-cephalic presentations, and multiple pregnancies. The protocol included weekly clinical examinations to assess the FHS. The results were used to describe the clinical fetal head descent at term. We correlated the fetal head station determinations at each week with labor outcome, including the evaluations performed within the week before delivery. Results: The data show no significant differences between vaginal (VD) and Cesarean section delivery (CS) cases regarding FHS determined at each week at term. The median determinations at the gestational ages (GW) from 37 to 41 were −2 and −3, similar between the two groups, with a more consistent difference at 41 GW: station -1 for VD compared to −3 for CS. There were significant differences between the “week before delivery” evaluations of the two groups. The determinations showed for both groups similar minimum (−5), maximum (+1), and median (−2) FHS values. Most vaginal deliveries cases presented at weekly examinations with increasing rates toward more advanced stations: from 10% at station −4 to 35% at station −1. Although we investigated a low-risk group, we found significant differences between the vaginal and Cesarean groups in terms of age, weight, and BMI. We provided a multiple logistic regression equation that considered the predictive clinical variables at term: the fetal head situation, age, weight, height, and BMI. Conclusion: The clinical evaluation of fetal head station in primiparous before labor onset has a limited value regarding the prediction of the delivery mode. There is a potential benefit for the determinations performed within the week before delivery, but such a policy would require weekly assessments of the FHS at term, which is unlikely to be implemented. Another potential benefit would involve estimating labor outcomes in late-term or prolonged pregnancy. The fine tuning of the logistic prediction should be achieved by increasing the studied population and the number of centers involved before counseling primiparous women at term based on the clinical fetal engagement data. MDPI 2022-06-08 /pmc/articles/PMC9225040/ /pubmed/35743345 http://dx.doi.org/10.3390/jcm11123274 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dîră, Laurențiu Mihai
Cara, Monica-Laura
Drăgușin, Roxana Cristina
Nagy, Rodica Daniela
Iliescu, Dominic Gabriel
The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title_full The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title_fullStr The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title_full_unstemmed The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title_short The Value of Fetal Head Station as a Delivery Mode Predictor in Primiparous Women at Term before the Onset of Labor
title_sort value of fetal head station as a delivery mode predictor in primiparous women at term before the onset of labor
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225040/
https://www.ncbi.nlm.nih.gov/pubmed/35743345
http://dx.doi.org/10.3390/jcm11123274
work_keys_str_mv AT diralaurentiumihai thevalueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT caramonicalaura thevalueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT dragusinroxanacristina thevalueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT nagyrodicadaniela thevalueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT iliescudominicgabriel thevalueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT diralaurentiumihai valueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT caramonicalaura valueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT dragusinroxanacristina valueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT nagyrodicadaniela valueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor
AT iliescudominicgabriel valueoffetalheadstationasadeliverymodepredictorinprimiparouswomenattermbeforetheonsetoflabor