Abstract
Objectives
Aim of the study was to analyze the impact of head circumference (HC) and birth weight (BW) on the delivery mode and delivery outcomes.
Methods
Study population consisted of pregnancy, delivery and newborn data from 1,762 women, who delivered between 2004 and 2016 at University Hospital of Zurich (UHZ). Odds ratio (OR) with 95% confidence intervals (CI) were calculated for mode of delivery. Newborns were sorted into four groups according HC or BW. To evaluate the association between HC and delivery outcome, a descriptive analysis was performed. In addition reference charts of newborn HC at term were constructed.
Results
OR for instrumental delivery (ID) was 2.37 (CI 95%, 1.63–3.46), for C-Section (CS) 3.74 (CI 95%, 1.49–9.37) when HC >36 cm. OR for ID was 1.59 (CI 95%, 1.02–2.50), for CS 3.18 (CI 95% 1.08–9.350) when BW was >4,000 g. OR for ID was 2.15 (95% CI, 1.69–2.73), for CS 1.93 (95% CI, 0.89–4.18) when HC ≥36 cm and BW <4000 g. OR for ID was 2.23 (95% CI, 1.35–3.67), for CS 4.39 (95% CI, 1.48–12.99) when HC ≥36 cm and BW ≥4,000 g. HC ≥36 cm was defined as large in our study. Mothers with higher age and body mass index delivered babies with larger HC (p<0.05). Blood loss and duration of expulsion period and BW was associated with larger HC (p<0.05).
Conclusions
The rate of ID and CS increased in case of a larger HC and greater BW. However, the main prognostic factor for ID was size of HC: ≥36 cm, but not macrosomia.
Funding source: No funding
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The Ethics Committee of the Kanton Zürich approved the study (BASEC Nr. 2016-01580 07.02.2017).
References
1. Turner, MJ, Rasmussen, MJ, Turner, JE, Boylan, PC, MacDonald, D, Stronge, JM. The influence of birth weight on labour in nulliparas. Obstet Gynecol 1990;76:159–63.Search in Google Scholar
2. Walsh, JM, Hehir, MP, Robson, MS, Mahony, RM. Mode of delivery and outcomes by birth weight among spontaneous and induced singleton cephalic nulliparous labors. Int J Gynecol Obstet 2015;129:22–5. https://doi.org/10.1016/j.ijgo.2014.10.029.Search in Google Scholar PubMed
3. Zhang, X, Decker, A, Platt, RW, Kramer, MS. How big is too big? The perinatal consequences of fetal macrosomia. Am J Obstet Gynecol 2008;198:517:e1–6. https://doi.org/10.1016/j.ajog.2007.12.005.Search in Google Scholar PubMed
4. Boulet, SL, Alexander, GR, Salihu, HM, Pass, M. Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk. Am J Obstet Gynecol 2008;188:1372–8.10.1067/mob.2003.302Search in Google Scholar PubMed
5. Elvander, C, Hogberg, U, Ekeus, C. The influence of fetal head circumference on labor outcome: a population-based register study. Acta Obstet Gynecol Scand 2012;91:470–5. https://doi.org/10.1111/j.1600-0412.2012.01358.x.Search in Google Scholar PubMed
6. Lipschuetz, M, Cohen, SM, Ein-Mor, E, Sapir, H, Hochner-Celnikier, D, Porat, S, et al. A large head circumference is more strongly associated with unplanned cesarean or instrumental delivery and neonatal complications than high birthweight. Am J Obstet Gynecol 2015;213:833:e1–12. https://doi.org/10.1016/j.ajog.2015.07.045.Search in Google Scholar PubMed
7. Burke, N, Burke, G, Breathnach, F, McAuliffe, F, Morrison, JJ, Turner, M, et al. Prediction of cesarean delivery in the term nulliparous woman: results from the prospective, multicenter Genesis study. Am J Obstet Gynecol 2017;216:598:e1–11. https://doi.org/10.1016/j.ajog.2017.02.017.Search in Google Scholar PubMed
8. Ayinde, OA, Omigbodun, AO. Head circumference at the time of birth: a possible predictor of labour outcome in singleton cephalic deliveries at term? Ann Afr Med 2004;3:126–9.Search in Google Scholar
9. Mujugira, A, Osoti, A, Deya, R, Hawes, SE, Phipps, AI. Fetal head circumference, operative delivery, and fetal outcomes: a multi-ethnic population-based cohort study. BMC Pregnancy Childbirth 2013;13:106. https://doi.org/10.1186/1471-2393-13-106.Search in Google Scholar PubMed PubMed Central
10. Aviram, A, Yogev, Y, Bardin, R, Hiersch, L, Wiznitzer, A, Hadar, E. Association between sonographic measurement of fetal head circumference and labor outcome. Int J Gynaecol Obstet 2016;132:72–6. https://doi.org/10.1016/j.ijgo.2015.06.043.Search in Google Scholar PubMed
11. Valsky, DV, Lipschuetz, M, Bord, A, Eldar, I, Messing, B, Hochner-Celnikier, D, et al. Fetal head circumference and length of second stage of labor are risk factors for levator ani muscle injury, diagnosed by 3-dimensional transperineal ultrasound in primiparous women. Am J Obstet Gynecol 2009;201:91:e1–7. https://doi.org/10.1016/j.ajog.2009.03.028.Search in Google Scholar PubMed
12. Kennelly, MM, Anjum, R, Lyons, S, Burke, G. Postpartum fetal head circumference and its influence on labour duration in nullipara. J Obstet Gynaecol 2003;23:496–9. https://doi.org/10.1080/0144361031000153701.Search in Google Scholar PubMed
13. Ooi, PV, Ramphul, M, Said, S, Burke, G, Kennelly, MM, Murphy, DJ. Ultrasound assessment of fetal head circumference at the onset of labor as a predictor of operative delivery. J Matern Fetal Neonatal Med 2015;28:2182–6. https://doi.org/10.3109/14767058.2014.980810.Search in Google Scholar PubMed
14. Bamberg, C, Deprest, J, Sindhwani, N, Teichgräberg, U, Güttler, F, Dudenhausen, JW, et al. Evaluating fetal head dimension changes during labor using open magnetic resonance imaging. J Perinat Med 2016;45:305–8.10.1515/jpm-2016-0005Search in Google Scholar PubMed
15. Melamed, N, Yogev, Y, Danon, D, Mashiach, R, Meizner, I, Ben-Haroush, A. Sonographic estimation of fetal head circumference: how accurate are we?Ultrasound Obstet Gynecol 2011;37:65–71. https://doi.org/10.1002/uog.7760.Search in Google Scholar PubMed
16. Royston, P, Wright, EM. How to construct ‘normal ranges’ for fetal variables. Ultrasound Obstet Gynecol 1998;11:30–8. https://doi.org/10.1046/j.1469-0705.1998.11010030.x.Search in Google Scholar PubMed
17. Lipschuetz, M, Cohen, SM, Israel, A, Baron, J, Porat, S, Valsky, DV, et al. Sonographic large fetal head circumference and risk of cesarean delivery. Am J Obstet Gynecol 2018;218:e1–7. https://doi.org/10.1016/j.ajog.2017.12.230.Search in Google Scholar PubMed
18. Yagel, O, Cohen, SM, Lipschuetz, M, Bdolah-Abram, T, Amsalem, H, Kabiri, D, et al. Higher rates of operative delivery and maternal and neonatal complications in persistent occiput posterior position with a large head circumference: a retrospective cohort study. Fetal Diagn Ther 2018;44:51–8. https://doi.org/10.1159/000478010.Search in Google Scholar PubMed
19. Pretscher, J, Schwenke, E, Baier, F, Kehl, S, Schneider, M, Stumpfe, FM, et al.Can sonographic fetal biometry predict adverse perinatal outcome? Ultraschall Med 2019;40:230–6. https://doi.org/10.1055/a-0576-0143.Search in Google Scholar PubMed
20. Balsyte, D, Schaffer, L, Burkhardt, T, Wisser, J, Zimmermann, R, Kurmanavicius, J. Continuous independent quality control for fetal ultrasound biometry provided by the cumulative summation technique. Ultrasound Obstet Gynecol 2010;35:449–55. https://doi.org/10.1002/uog.7545.Search in Google Scholar PubMed
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant
Articles in the same Issue
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant