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Sonographic evaluation of fetal head extension and maternal pelvis in cases of breech presentation
1Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Background:
To investigate whether sonographic examination of the fetal head extension, pelvic adequacy and fetal position, could replace the traditional x-ray method in the evaluation of the breech in labor.
Methods:
Seventy-two parturients admitted in labor with a breech presentation were prospectively evaluated by a newly proposed ultrasonographic approach. The head extension, obstetric conjugate and fetal attitude obtained were further compared to the gold standard radiologic measurements.
Results:
A highly significant correlation between ultrasonic and x-ray measurements for the fetal head extension (r = 0.8696; p < 0.0001), obstetric conjugate (r = 0.8931; p < 0.0001), as well as high reliability (95.5%) in diagnosing the breech variant by ultrasound have been found.
Conclusions:
Ultrasonic evaluation of breech presentation, as performed by the proposed method, is simple, easy to perform and compares well with the standard radiologic studies. It is suggested that modern ultrasonic technique, which carries no risk of ionizing radiation, may replace traditional x-ray examination of the breech in labor.