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Factors Influencing the Accuracy of Digital Examination for Determining Fetal Head Position during the First Stage of Labor
Factors Influencing the Accuracy of Digital Examination for Determining Fetal Head Position during the First Stage of Labor
- Source :
- Journal of Nippon Medical School. 77:290-295
- Publication Year :
- 2010
- Publisher :
- Medical Association of Nippon Medical School, 2010.
-
Abstract
- Objective: The objective of this study was to explore factors influencing the accuracy of transvaginal digital examination for determining fetal head position during the first stage of labor. Materials and Methods: Fetal head position was assessed in 87 women in the first stage of labor at term with normal singleton cephalic presentation. Transvaginal digital examinations were performed by attending midwives and were followed immediately by transabdominal ultrasound assessments performed by a single sonographer. Accuracy was defined as agreement of the results of each examination. Multivariate logistic regression analysis was performed to determine the independent factors influencing accuracy. Results: In only 40.3% of patients (n = 35) were transvaginal digital examinations consistent with ultrasound assessments. Multivariate logistic regression analysis showed that the accuracy of digital examinations was significantly associated with cervical dilatation more than 7 cm (odds ratio, 3.01; 95% confidence interval [CI], 1.03-9.4), birth weight less than 2,500 g (odds ratio, 8.68; 95% CI, 1.08-86.28), and the anterior occiput position group (odds ratio, 4.73; 95% CI, 1.76-13.49). Conclusions: The present study demonstrates that transvaginal digital examination is less accurate than ultrasonography for determining fetal head position during the first stage of labor. The results suggest that ultrasound assessments should be routinely performed in patients with a cervical dilatation less than 7 cm, an estimated fetal body weight more than 2,500 g, the occiput posterior position, or the occiput transverse position.
- Subjects :
- medicine.medical_specialty
Birth weight
Logistic regression
Ultrasonography, Prenatal
Labor Presentation
Pregnancy
Humans
Medicine
Fetal head
Prospective Studies
Gynecology
business.industry
Obstetrics
Cephalic presentation
Fetal Body Weight
Occiput
General Medicine
Odds ratio
Confidence interval
Logistic Models
medicine.anatomical_structure
Vagina
Female
Labor Stage, First
business
Head
Subjects
Details
- ISSN :
- 13473409 and 13454676
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Journal of Nippon Medical School
- Accession number :
- edsair.doi.dedup.....4c770076bc2a4a1b903735ea7fa464c4
- Full Text :
- https://doi.org/10.1272/jnms.77.290