Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Background: Fetal head 2attitude3 (relationship of fetal head to spine) in the first stage of labor may have a substantial impact on labor outcome. The diagnosis of fetal head deflexion traditionally is based on digital examination in labor, although the use of ultrasound to support clinical diagnosis has been recently reported. Objectives: The aims of this study were: (1)To quantify the degree of fetal head deflection via the use of ultrasound during the first stage of labor. (2) To determine whether a parameter derived from ultrasound examination (the occiput-spine angle) has a relationship with the course and outcome of labor. Study design This was a prospective study conducted at Kasr Alainy Hospital from July 2016 to January 2017. A nonconsecutive series of women with uncomplicated singleton pregnancies at term gestation (37 weeks or more) were submitted to trans abdominal ultrasound during the first stage of labor. Fetal position was occiput anterior and the angle between the fetal occiput and the cervical spine (the occiput-spine angle) was sonographically obtained on the sagittal plane. The measurements of the occiput spine-angle were performed offline by an operator who was blinded to the labor outcome. The intra- and inter observer reproducibility and the correlation between the occiput-spine angle and the mode of delivery were evaluated. Results: A total of 400 pregnant women were recruited, 350 of which underwent a spontaneous vaginal delivery and 50 were submitted to cesarean delivery

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