The  Effect Of Sonographic Head Circumference On Delivery Mode And Perineal Laceration: Head Circumference, Delivery Mode and Perineal Lacerations

BURCU DİNCGEZ; Gülten Özgen; Levent Özgen; Ayse Ulku  Turker Aras

doi:10.5281/zenodo.14032629

Authors

BURCU DİNCGEZ Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum ABD
Gülten Özgen Bursa Yüksek İhtisas Training and Research Hospital, Department of Obstetrics and Gynaecology https://orcid.org/0000-0002-7888-7583
Levent Özgen Uludag University, Medicine Faculty, Department of Obstetrics and Gynecology, Bursa, Turkey https://orcid.org/0000-0003-0070-2646
Ayse Ulku Turker Aras Kafkas University, Medicine Faculty, Department of Obstetrics and Gynecology, Kars, Turkey https://orcid.org/0000-0002-3393-6310

DOI:

https://doi.org/10.5281/zenodo.14032629

Keywords:

cesarean section estimated fetal weight, head circumference, perineal tear, vaginal delivery

Abstract

Aim:The present study aimed to determine the role of head circumference for delivery mode and perineal laceration both in primiparous and multiparous patients and compare this role with estimated fetal weight.

Material and Methods:A total of 866 patients, who delivered in our clinic were divided into two groups: vaginal delivery (n=604) and cesarean section (n=262). Demographic characteristics, sonographic head circumference, estimated fetal weight, birth week and weight, presence of severe perineal laceration, gender, neoatal head circumference, Apgar scores were compared between groups.

Results:The median head circumference was 339 (302-384) milimeter in vaginal delivery and 347 (314-384) milimeter in cesarean section (p<0.001). Sonographic head circumference was positively correlated with estimated fetal weight (r=0.561,p<0.001), birth weight (r=0.446,p<0.001) and neonatal head circumference (r=0.396,p<0.001). Head circumference >35.4 predicted cesarean section with 36.3% sensitivity and 84.8% specificity (AUC=0.637,p<0.001) and >35.2 predicted perineal laceration with 78.6% sensitivity and 85.4% specificity (AUC=0.853,p<0.001). Head circumference was superior for cesarean section as compared to estimated fetal weight (p=0.003) whereas no difference was found for perineal laceration (p=0.64).Head circumference >34.9 predicted cesarean section with 60% sensitivity and 73.8% specificity (AUC=0.692,p<0.001) in primiparous while >35.4 predicted cesarean section with 34.3% sensitivity and 84.5% specificity in multiparous women (AUC=0.624,p<0.001).

Conclusion:Considering large head circumference was more strongly associated with cesarean delivery and perineal lacerations than estimated fetal weight, we suggest that measuring head circumference would be an appropriate approach for determining delivery mode and complications.

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