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Indian Journal of Obstetrics and Gynecology

Volume  7, Issue 1, Jan-Mar 2019, Pages 72-79
 

Original Article

The Occiput-Spine Angle and Fetal Head Deflexion During the First Stage of Labor

Anjani Shrivastava1, Kedar Ajay Trivedi2, Ronak V. Makwana3

1Associate Professor 2Assistant Professor 33rd Year Resident, Dept of Obstetrics and Gynecology, Government Medical College, Surat, Gujarat 395001, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7119.13

Abstract

Introduction: Cephalopelvic disproportion/deflexed head increases the hazard of vaginal delivery both for the mother and for the child. Protracted labour is more common in primigravid women than in multipara. Initially it was X-ray pelvimetry which was used but now a days due to advanced technology it is ultrasound which has replaced X-ray pelvimetry and it is more informative and more accurate. Aims and Objectives: (1) To quantify the degree of fetal head deflection (2) To determine whether a parameter derived from ultrasound examination has a relationship with the course and outcome of labor. Subjects and Methods: The primigravidas with 1. Low risk pregnant women at or beyond 37 weeks of gestation in the 1st stage of labour with vertex presentation with 2. Cervical Dilatation 3-6 cms and 3. The station above the ischial spine with regular contractions. Methods: From the Eligible patients, informed consent was taken. Measurement of occipitospinal angle using abdominal probe of the USG machine and readings were noted. Summary: Age of the patient, Gestational age and weight of the baby are not found to have any significant association with the outcome of the labour. patients with lower occipitospinal angle (<120°) had undergone caesarean section majority of the time (11 patients) and those with occipitospinal angle >120° had spontaneous vaginal delivery (86 patients). Conclusion: The degree of fetal head deflexion in the first stage of labour may be quantified accurately by means of transabdominal ultrasound. The occiput-spine angle width seems significantly related to the fetal head station and to the risk of obstetric intervention.

Keywords: Primigravida with Vertex Presentation; OcciputSpinal Angle and Outcome of the Labour (Lscs or Normal Vaginal Delivery).


Corresponding Author : Kedar Ajay Trivedi, Assistant Professor, Dept of Obstetrics and Gynecology, Government Medical College, Surat, Gujarat 395001, India.