VP45.05: The ratio between fetal head circumference and maternal mid pelvic circumference: a simple index for cephalopelvic disproportion evaluation

Introduction: Cephalo-pelvic-disproportion (CPD) is one of the most common obstetric complications. Since CPD is the disproportion between the fetal head and maternal bony pelvis, evaluation of the head-circumference (HC) relative to maternal bony pelvis may be a useful adjunct to pre-labor CPD evaluation. The aim of the present study was a proof-of-concept evaluation of the ratio between HC to pelvic circumference (PC) as a predictor of CPD. Methods: Of 11,822 deliveries, 104 cases that underwent an abdomino-pelvic CT for any medical indication and who underwent normal vaginal deliveries (NVD) (n=84) or cesarean deliveries (CD) due to CPD (n=20) were included retrospectively. Maternal pelvis dimensions were reconstructed and neonatal HC, as a proxy for fetal HC, were measured. The correlation between cases of CPD and Cephalo-Pelvic Circumference Index (CPCI), which represents the ratio between the HC and PC in percent (HC/PC *100) was evaluated. Results: The mid-pelvis cephalo-pelvic circumference index (MP-CPCI) was larger in CD groups as compared to the NVD group: 103±11 vs. 97±8% respectively (p=0.0003). In logistic regression analysis, the MP-CPCI was found to be independently associated with CD due to CPD: each 1% increase in MP-CPCI increased the likelihood of CD for CPD by 11% (aOR 1.11, CI 95% 1.03-1.19, p=0.004). The adjusted odds ratio for CD due to CPD increased incrementally as the MP-CPCI increased, from 3.56 (95%CI, 1.01-12.6) at MP-CPCI of 100, to 5.6 (95%CI, 1.63-19.45) at 105, 21.44 (95%CI, 3.05-150.84) at 110, and 28.88 (95%CI, 2.3-362.27) at MP-CPCI of 115 Conclusions: The MP-CPCI, representing the relative dimensions of the fetal HC and maternal PC, is a simple tool that can potentially distinguish between parturients at lower and higher risk of CPD. Prospective randomized studies are required to evaluate the feasibility of prenatal pelvimetry and MP-CPCI to predict the risk of CPD during labor.

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Pregnancy outcomes in women with preexisting thyroid diseases: a French cohort study

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420001051 ◽

2020 ◽

pp. 1-10

Author(s):

Marion Lecorguillé ◽

Juliane Léger ◽

Anne Forhan ◽

Marie Cheminat ◽

Marie-Noëlle Dufourg ◽

...

Keyword(s):

Thyroid Hormone ◽

Gestational Diabetes ◽

Head Circumference ◽

Thyroid Diseases ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Fetal Head ◽

History Of ◽

Multivariable Regression ◽

Multivariable Regression Models

Abstract Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.

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Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

Environmental Health ◽

10.1186/s12940-021-00747-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Chalana M. Sol ◽

Charissa van Zwol - Janssens ◽

Elise M. Philips ◽

Alexandros G. Asimakopoulos ◽

Maria-Pilar Martinez-Moral ◽

...

Keyword(s):

Birth Outcomes ◽

Fetal Growth ◽

Head Circumference ◽

Lower Risk ◽

First Trimester ◽

Population Based ◽

Third Trimester ◽

Bisphenol S ◽

Fetal Head ◽

Urine Concentrations

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.

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Prenatal Sonographic Head Circumference and Cerebral Ventricle Width Measurements Before and After Open Fetal Myelomeningocele Repair – Prediction of Shunting During the First Year of Life

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0756-8417 ◽

2018 ◽

Vol 41 (05) ◽

pp. 544-549 ◽

Cited By ~ 2

Author(s):

Ladina Vonzun ◽

Franziska Maria Winder ◽

Martin Meuli ◽

Ueli Moerlen ◽

Luca Mazzone ◽

...

Keyword(s):

Head Circumference ◽

Predictive Accuracy ◽

False Positive Rate ◽

Roc Curves ◽

First Year ◽

Fetal Head ◽

Fetal Diagnosis ◽

Before And After ◽

Width Measurements ◽

First Year Of Life

Abstract Purpose The aim of this study was to describe the sonographic evolution of fetal head circumference (HC) and width of the posterior horn of the lateral ventricle (Vp) after open fetal myelomeningocele (fMMC) repair and to assess whether pre- or postoperative measurements are helpful to predict the need for shunting during the first year of life. Patients & Methods All 30 children older than one year by January 2017 who previously had fMMC repair at the Zurich Center for Fetal Diagnosis and Therapy were included. Sonographic evolution of fetal HC and Vp before and after fMMC repair was assessed and compared between the non-shunted (N = 16) and the shunted group (N = 14). ROC curves were generated for the fetal HC Z-score and Vp in order to show their predictive accuracy for the need for shunting until 1 year of age. Results HC was not an independent factor for predicting shunting. However, the need for shunting was directly dependent on the preoperative Vp as well as the Vp before delivery. A Vp > 10 mm at evaluation for fMMC repair or > 15 mm before delivery identifies 100 % of the infants needing shunt placement at a false-positive rate of 44 % and 25 %, respectively. All fetuses with a Vp > 15 mm at first evaluation received a shunt. Conclusion Fetuses demonstrating a Vp of > 15 mm before in utero MMC repair are extremely likely to develop hydrocephalus requiring a shunt during the first year of life. This compelling piece of evidence must be appropriately integrated into prenatal counseling.

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Sonographic large fetal head circumference and risk of cesarean delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.12.230 ◽

2018 ◽

Vol 218 (3) ◽

pp. 339.e1-339.e7 ◽

Cited By ~ 17

Author(s):

Michal Lipschuetz ◽

Sarah M. Cohen ◽

Ariel Israel ◽

Joel Baron ◽

Shay Porat ◽

...

Keyword(s):

Cesarean Delivery ◽

Head Circumference ◽

Fetal Head

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Accuracy of ultrasonic fetal weight estimation using head and abdominal circumference and femur length

Medicinski pregled ◽

10.2298/mpns0512548m ◽

2005 ◽

Vol 58 (11-12) ◽

pp. 548-552 ◽

Cited By ~ 1

Author(s):

Ljiljana Mladenovic-Segedi ◽

Dimitrije Segedi

Keyword(s):

Birth Weight ◽

Head Circumference ◽

Fetal Weight ◽

Abdominal Circumference ◽

Weight Estimation ◽

Fetal Head ◽

Total Body Mass ◽

Femur Length ◽

Fetal Weight Estimation ◽

Gynecology And Obstetrics

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.

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Fetal head circumference, operative delivery, and fetal outcomes: a multi-ethnic population-based cohort study

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-13-106 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 16

Author(s):

Andrew Mujugira ◽

Alfred Osoti ◽

Ruth Deya ◽

Stephen E Hawes ◽

Amanda I Phipps

Keyword(s):

Cohort Study ◽

Head Circumference ◽

Population Based ◽

Operative Delivery ◽

Ethnic Population ◽

Fetal Head ◽

Fetal Outcomes

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Fetal head circumference growth in children with specific language impairment

Archives of Disease in Childhood ◽

10.1136/adc.2009.180331 ◽

2010 ◽

Vol 97 (1) ◽

pp. 49-51 ◽

Cited By ~ 9

Author(s):

Andrew J O Whitehouse ◽

Stephen R Zubrick ◽

Eve Blair ◽

John P Newnham ◽

Martha Hickey

Keyword(s):

Language Impairment ◽

Head Circumference ◽

Specific Language Impairment ◽

Fetal Head ◽

Specific Language

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Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-9304201600s100002 ◽

2016 ◽

Vol 16 (suppl 1) ◽

pp. S7-S15 ◽

Cited By ~ 3

Author(s):

Alex Sandro Rolland Souza ◽

Ariani Impieri de Souza ◽

Silvia de Lourdes Loreto Faquin ◽

Orlando Gomes dos Santos Neto ◽

Emanuele Honorato ◽

...

Keyword(s):

Gestational Age ◽

Linear Form ◽

Head Circumference ◽

Perinatal Outcomes ◽

Ultrasound Diagnosis ◽

Random Regression ◽

Morphological Alteration ◽

Fetal Head ◽

Regression Effects ◽

Congenital Zika Syndrome

Abstract Objectives: to describe altered intrauterine ultrasound, analyze fetal head circumference (HC) growth and neonates' outcomes among presumed cases of congenital Zika syndrome in Brazil. Methods: 30 women were included in the study with suspected history of Zika virus (ZIKV) infection during pregnancy and fetal's brain altered on ultrasound diagnosis. Sociodemographic and obstetric characteristics, prenatal altered ultrasounds, HC and other perinatal outcomes have been described. The relation between HC and gestational age was analyzed by using random regression effects based on polynomials fractions. The Z test was calculated to determine an instant variant mean rate of the HC for each gestational age. Results: the mean gestational age of the ultrasound diagnosis was 33.3 + 4.7 weeks and HC at birth was 28.9 + 1.6 cm. The main altered brain ultrasound was microcephaly (96.7%). The analysis of the fetal head circumference showed an estimated increase of the average HC, as to gestational age, it did not occur in a linear form. The instant HC variation rate increased according to gestational age (p<0,001). Conclusions: Fetal's main morphological alteration was microcephaly, observing an increase in the head circumference according to gestational age in a non-linear form and the variation decreased with gestational age.

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