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Related Experiment Video

Updated: Jan 5, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
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Can the Progression Angle before Labor Help to Predict Cesarean Section?

Irune Alzola1, Emerson Murua2, Javier Rodríguez2

  • 1Clínica Zuatzu, San Sebastián, Spain, ialzola@clinicazuatzu.com.

Fetal Diagnosis and Therapy
|October 24, 2019
PubMed
Summary

Maternal history and ultrasound markers, including cervical length and estimated fetal weight, can predict cesarean sections in labor. This approach better predicts cesarean birth for maternal indications than fetal ones.

Keywords:
Cervical length measurementCesarean sectionLaborMaternal historyProgression angleRisk assessmentUltrasonography

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Area of Science:

  • Maternal-fetal medicine
  • Diagnostic imaging in obstetrics

Background:

  • Cesarean section rates remain high globally.
  • Predictive models for cesarean section are crucial for optimizing intrapartum management and resource allocation.

Purpose of the Study:

  • To predict cesarean section risk in singleton term pregnancies using a single visit assessment.
  • To evaluate the utility of maternal history and novel ultrasound markers, including progression angle, for predicting cesarean delivery.

Main Methods:

  • Prospective observational cohort study of 575 women with singleton term pregnancies.
  • Maternal history and ultrasound markers (cervical length, estimated fetal weight, progression angle) collected at 37-38 weeks' gestation.
  • Multivariable logistic regression analysis to predict cesarean section.

Main Results:

  • Cesarean section was performed in 18% of women.
  • Risk factors for cesarean section included previous cesarean, assisted reproduction, higher estimated fetal weight, and longer cervical length.
  • Protective factors included greater maternal height, multiparity, and wider progression angle.
  • The model achieved a detection rate of 69.9% for all cesarean sections at a 20% false positive rate.

Conclusions:

  • Combining maternal history with ultrasound markers (cervical length, estimated fetal weight, progression angle) at 37-38 weeks can predict labor cesarean sections.
  • Cesarean sections for maternal indications were more accurately predicted than those for fetal indications.