Abstract
Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM (Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.
Highlights
Labour is considered obstructed when the presenting part of the fetus cannot progress into the birth canal, despite strong uterine contractions [1] [2]
The aim of the present study is to evaluate the ability and feasibility—the laborProTM (Trig Medical Inc., Yoqneam Ilit, Israel), to evaluate maternal pelvic diameters and fetal head station—sonopelvimetry, in women who have reached term prior to labour, and examine prospectively its effectiveness in evaluating the risk assessment of obstructed labour
In the obstructed labour group, caesarean delivery (CD) was performed on 16 patients in the first stage and 14 in the second stage of labour
Summary
Labour is considered obstructed when the presenting part of the fetus cannot progress into the birth canal, despite strong uterine contractions [1] [2]. The diagnosis of obstructed labour has been made only during labour, based on clinical and manual evaluation of the foetal station and the maternal pelvic dimensions. Clinical pelvimetry was introduced over 200 years ago, based on the seminal work of William Smellie (1697-1763) and Jean-Louis Baudelocque (17461810), who developed internal and external callipers for measuring maternal pelvic diameter [13]. MRI, which does not involve radiation, has made it possible to assess the relationship between maternal pelvic diameter and head dimensions and estimate pelvic capacity [17]. One of the capabilities of the system is to determine the spatial position of the pelvic inlet plane, as well as measuring diameters of the pelvis. The system calculates the interspinous diameter (ISD) measured directly in a ruler-like manner, while the transverse pelvic inlet diameter and anterior posterior pelvic diameter (obstetric conjugate) are calculated based on a computerised pelvic model
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