Fetal occiput-spine angle during the first stage of labour for predictor of progress and outcome of labour at Tanta university hospital

Abstract

Background: Labor dystocia (LD) is defined by the slow and abnormal progress of labor. Failure to progress in labor is the leading indication for 1ry cesarean delivery approximately 80% of American women will eventually have at least one child, and the majority of these women will undergo labor. “Labor dystocia” encompasses a variety of concepts, ranging from “abnormally” slow dilation of the cervix or descent of the fetus during active labor to entrapment of the fetal shoulders after delivery of the head.Aim and objectives: To assess the relation between the fetal occiput-spine angle measured through transabdominal ultrasound during 1st stage, progress and outcome of labor.Subjects and methods: This cross sectional study was carried out on 150 pregnant ladies. who were recruited from the labor and delivery ward at Tanta University Hospitals and Desouq general Hospital during the period of research from August 2021 to August 2022.Result: As regard cut off value of angle to predict complication in predicting labour outcome either NVD or CS at an angle ≤133 the sensitivity specificity, PPV, NPV of angle to predict complication were 66.67%, 56.59%, 20%, 91.2% respectively. There was significant relation between angle ≤126 or >126 regarding Cervix position, Head station, Mode of delivery, Fetal and maternal complications.Conclusion: Occiput –spinal angle is a good predictor of operative delivery. Fetuses with a smaller occiput-spine angle (<126°) have a higher risk of cesarean delivery. We also found that the best OSA is 133 and below this angle the complication increased.