10.6084/m9.figshare.4857389.v1
Bellussi F.
Bellussi
F.
Ghi T.
Ghi
T.
Youssef A.
Youssef
A.
Cataneo I.
Cataneo
I.
Salsi G.
Salsi
G.
Simonazzi G.
Simonazzi
G.
Pilu G.
Pilu
G.
Supplementary Material for: Intrapartum Ultrasound to Differentiate Flexion and Deflexion in Occipitoposterior Rotation
Karger Publishers
2017
Labor
Dystocia
Malpresentation
Malposition
Occiput posterior position
Brow presentation
Sinciput presentation
Ultrasound
2017-04-11 13:33:11
Media
https://karger.figshare.com/articles/media/Supplementary_Material_for_Intrapartum_Ultrasound_to_Differentiate_Flexion_and_Deflexion_in_Occipitoposterior_Rotation/4857389
<p><b><i>Objective:</i></b> To evaluate the ability of intrapartum
ultrasound to differentiate occipitoposterior (OP) rotation with normal
flexion of the head from deflexion, to compare the accuracy of
ultrasound with the digital examination, and to assess the outcome of
labor according to the type of presentation. <b><i>Patients and Methods:</i></b>
A retrospective study of patients with abnormal labor because of either
prolongation and/or abnormal cardiotocography and OP rotation who
underwent intrapartum sonography. <b><i>Results:</i></b> Normal flexion
was inferred in 36/42 cases by a longitudinal sonographic view of the
fetal face demonstrating the chin approaching the chest. In the
remaining 6, deflexion was diagnosed by visualizing the chin separate
and distant from the chest. In 3 of these cases, the orbits were at the
same level of the pubis suggesting brow presentation. In the remaining 3
cases, the orbits were above the pubis, and sinciput presentation was
inferred. Head deflexion was diagnosed more accurately with ultrasound
than clinically and always required a cesarean section versus 36% of
cases with OP flexed presentation (<i>p</i> = 0.0052). <b><i>Conclusions:</i></b>
Fetuses with abnormal labor and OP rotation had deflexed presentations
in 14% of cases and were never delivered vaginally. Sonography was far
more accurate than the digital examination.</p>