Is Ultrasound Measured Fetal Biometry Predictive of Intrapartum Cesarean Section for Failure to Progress?

AbstractHuman birth represents a critical and life-threatening event in the life of mother and child and is therefore of special importance for anthropological as well as public health research.Study aims: to analyze the association patterns between fetal biometry and delivery modes from the first trimester onwards.In this electronic medical record-based study, a dataset of 3408 singleton term birth taking place at the Viennese Danube hospital in Austria. was analyzed. Fetal biometry was reconstructed by the results of three ultrasound examinations carried out at the 11th/12th, 20th/21th and 32th/33thweek of gestation. In detail, crown-rump length, biparietal diameter, fronto-occipital diameter, head circumference, abdominal trans-verse diameter, abdominal sagittal diameter, abdominal circumference, and femur length were determined. Birth weight, birth length and head circumference were measured immediately after birth. Four delivery modes were compared: spontaneous vaginal birth, instrumental vaginal birth, planned cesarean section and emergency cesarean section.The total cesarean section rate was 10.2%. Fetal biometry and newborn size differed significantly between the four delivery modes. From the second trimester onward, head circumferences were significantly larger (p=0.005) among fetuses delivered by instrumental delivery or emergency cesarean section than among fetuses delivered by spontaneous vaginal birth. The fetal abdominal dimensions during the third trimester were significantly largest (p=0.001) among fetuses delivered by emergency cesarean section. In comparison to spontaneous vaginal delivery the risk to require instrumental delivery increased significantly with increasing fetal head dimensions at the second (p=0.019) and third trimester(p=0.032) independent of maternal somatic factors. The risk of emergency CS increased significantly with increasing head dimensions (p=0.030) as well as abdominal dimensions (p=0.001) at the third trimester and newborn size (p=0.002), also independently of maternal somatic factors.In general, larger fetuses are on an increased risk of experiencing instrumental delivery or emergency caesarean section. This association between fetal size and delivery mode is detectable from the second trimester onwards.

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KANET Diagnosis of Fetal Akinesia Deformation Sequence at 30 Weeks

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1324 ◽

2013 ◽

Vol 7 (4) ◽

pp. 500-505 ◽

Cited By ~ 1

Author(s):

Ulrich Honemeyer ◽

Afshin Pour-Mirza ◽

Jennifer Kasirsky

Keyword(s):

Cesarean Section ◽

Obstet Gynecol ◽

Complete Loss ◽

Lower Segment ◽

Normal Morphology ◽

Fetal Biometry ◽

Lower Segment Cesarean Section ◽

Fetal Movements

ABSTRACT We are reporting the case of a 40 years old 2nd gravida, 1 para. At 26 weeks of the reported pregnancy, fetal movements stopped suddenly and almost completely within 24 hours. At 30w2d she was referred for Doppler scan and fetal biometry. In ultrasonography (US) normal morphology was seen. Biometry corresponded to 28w1d. Outstanding observation was the permanent immobility of the entire fetus in four-dimensional ultrasound (4D-US). We found during two US examinations an abnormal KANET test, the first at 30w2d with a score of 3 points, and the second at 31w4d, with a score of 4 points. Cardiotocography (CTG) demonstrated complete loss of variability and accelerations. The patient developed severe polyhydramnios at 33 weeks. After lower segment cesarean section (LSCS) because of breech position, the newborn required ventilation, and passed away after 5 days. How to cite this article Honemeyer U, Kasirsky J, Pour-Mirza A, Kurjak A. KANET Diagnosis of Fetal Akinesia Deformation Sequence at 30 Weeks. Donald School J Ultrasound Obstet Gynecol 2013;7(4):500-505.

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Intrapartum Intrauterine Fetal Demise with Normal Umbilical Cord Blood Gas Values at Birth

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/318350 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Michael D. Benson

Keyword(s):

Heart Rate ◽

Cesarean Section ◽

Future Research ◽

Blood Gas ◽

Fetal Demise ◽

Apgar Scores ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Intrauterine Fetal Demise ◽

Failure To Progress

A case is presented in which a fetus was delivered by cesarean section for failure to progress and a “nonreassuring heart rate tracing” in which the Apgar scores were unexpectedly 0 at 1, 5, and 10 minutes. Resuscitation was unsuccessful after 30 minutes. The venous cord gas was normal and the arterial blood gas was not consistent with intrapartum asphyxia. At the time of surgery, the placenta appeared grossly normal. The autopsy was entirely normal. This case raises questions about our understanding of intrauterine fetal demise and suggests an approach to future research.

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The Outpatient Management of a Brain Dead Child

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180100004370 ◽

1993 ◽

Vol 2 (3) ◽

pp. 359-370

Author(s):

Gregory L. Stidham ◽

Amnon Goldworth ◽

Gail Joralemon ◽

David A. Bennahum ◽

Alexander Ivanjushkin

Keyword(s):

Respiratory Failure ◽

Cesarean Section ◽

Acute Respiratory Failure ◽

Respiratory Arrest ◽

Outpatient Management ◽

Ventilator Support ◽

Dead Child ◽

Brain Dead ◽

Failure To Progress

The patient, a 27-month-old girl, presented to Hospital B by ambulance in acute respiratory failure due to bilateral pneumothoraces.At 41 weeks, the patient had been delivered by Cesarean section for failure to progress at Hospital A in the same city. Three days after birth she suffered a respiratory arrest. Resuscitation and ventilator support were initiated promptly but the child did poorly, and shortly after this first arrest, the parents were told by the child's physician that she had no chance of recovery. Nevertheless, the mother continued to insist that the child be kept on a respirator and aggressive support be maintained.

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A uterus didelphys with a spontaneous labor at term of pregnancy: a rare case and a review of the literature

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2018-0001 ◽

2018 ◽

Vol 7 (2) ◽

Author(s):

Paola Algeri ◽

Sonia M. Rota ◽

Elena Nicoli ◽

Orlando Caruso ◽

Giovanna Spinetti ◽

...

Keyword(s):

Cesarean Section ◽

Preterm Delivery ◽

Rare Case ◽

Review Of The Literature ◽

Uterus Didelphys ◽

Spontaneous Pregnancy ◽

Uterine Anomalies ◽

Delivery Route ◽

The Right ◽

Failure To Progress

Abstract Uterus didelphys accounts for 13% of uterine anomalies and has been correlated with preterm delivery and fetal malpresentation at delivery. A 37-year-old pregnant woman reported a spontaneous pregnancy in the right horn of a uterus didelphys. The course of the pregnancy was complicated by gestational diabetes, but no miscarriage threat or preterm delivery threat was reported during this pregnancy. She arrived at our division, in labor, at 39.2 gestational weeks’. She delivered by cesarean section due to failure to progress at 5 cm. Her post-operative course was uneventful. Vaginal delivery could be a safe option and the induction of labor or the use of oxytocin could be helpful in such cases, but recommended doses and labor time should be evaluated, so cesarean section is to date the most frequent delivery route in uterus didelphys at term.

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