|
[9000435.] رقم البحث : 9000435 - |
|
SONOGRAPHIC PARAMETERS PREDICTORS FOR / |
| |
قطاع الدراسات الطبية / نساء وتوليد |
| تخصص البحث : نساء وتوليد |
| |
Menoufia Medical Journal / / Vol. 25, No. 1 - Janury 2012 |
| |
Shahinaz H. EL-Shourbagy |
| |
Sonographic parameters, AD-BPD difference, chest- BPD,
Humerospinous distance |
| |
Background: Shoulder dystocia followed by permanent brachial
plexus injury or mental impairment is one of the leading causes of
malpractice allegations. Prompt assessment and management of
shoulder dystocia and preparation to maximize the efficiency of
shoulder dystocia maneuvers are critical. Study design:
Prospective cross sectional study of a reference group of healthy
pregnant women and a test group of women with risk factors for
shoulder dystocia. Outcome measures were difficulties with delivery
of shoulders and correlation with maternal body weight and birth
weight. Objectives: To determine the best Sonographic parameters
in prediction of shoulder dystocia in delivery at term. Patients and
Methods: The study included 60 selected pregnant women within
two weeks of delivery at Tanta University hospital. The chosen cases
were divided into two groups. The first ”reference” group (GI)
composed of 20 women with singleton normal pregnancy at 38-42
weeks. The second test group (GII) composed of 40 women at risk.
Risk factors include maternal obesity (Body mass index ’BMI’ > 30),
excessive prenatal weight gain (weight gain > 20 kg), previous
macrocosmic baby, history of difficult delivery, clinical suspicion of
large baby and diabetic women. Three ultrasonic parameters were
used for comparison between the two groups.
1. Difference between the abdominal diameter and biparietal
diameter (AD-BPD difference).
2. Difference between chest diameter - biparietal diameter (chest-
BPD difference).
3. Humerospinous distance measurement.
Results: During the study period, 45 women were admitted to
spontaneous labor, 10 underwent an induction of labor, and 5 had an
elective cesarean section. All cases of shoulder dystocia (n=10)
occurred among women who delivered vaginally with significant ADBPD
difference (P>0.05). Comparing the groups with and without
shoulder dystocia, significant differences were found in maternal
weight, weight gain, birth weight and AD-BPD difference, while in
other sonographic parameters measured (chest- BPD,
Humerospinous distance) the significant difference was only
detected at a cutoff value 2.6cm for AD-BPD difference (AD-BPD
difference> 2.6). Conclusion: Since some of these risk factors are
known prior to delivery, each woman especially those at high risk,
with significant AD-BPD difference should be counseled on her
individual risk of severe perinatal morbidity before a decision on the
mode of delivery is taken. |
| |
 Download Paper |
تسجيل دخول 
