Imperial College London
Alternate

Dr Sana Usman

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Lecturer
 
 
 
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s.usman

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kahrs:2017:10.1016/j.ajog.2017.03.009,
author = {Kahrs, BH and Usman, S and Ghi, T and Youssef, A and Torkildsen, EA and Lindtjorn, E and Ostborg, TB and Benediktsdottir, S and Brooks, L and Harmsen, L and Romundstad, PR and Salvesen, KA and Lees, CC and Eggebo, TM},
doi = {10.1016/j.ajog.2017.03.009},
journal = {American Journal of Obstetrics and Gynecology},
title = {Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study},
url = {http://dx.doi.org/10.1016/j.ajog.2017.03.009},
volume = {217},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundSafe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions should be focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery. Prolonged attempts at vacuum delivery are associated with neonatal morbidity and maternal trauma, especially so if the procedure is unsuccessful and a cesarean is performed.ObjectiveThe aim of the study was to assess if ultrasound measurements of fetal position and station can predict duration of vacuum extractions, mode of delivery, and fetal outcome in nulliparous women with prolonged second stage of labor.Study DesignWe performed a prospective cohort study in nulliparous women at term with prolonged second stage of labor in 7 European maternity units from 2013 through 2016. Fetal head position and station were determined using transabdominal and transperineal ultrasound, respectively. Our preliminary clinical experience assessing head-perineum distance prior to vacuum delivery suggested that we should set 25 mm for the power calculation, a level corresponding roughly to +2 below the ischial spines. The main outcome was duration of vacuum extraction in relation to ultrasound measured head-perineum distance with a predefined cut-off of 25 mm, and 220 women were needed to discriminate between groups using a hazard ratio of 1.5 with 80% power and alpha 5%. Secondary outcomes were delivery mode and umbilical artery cord blood samples after birth. The time interval was evaluated using survival analyses, and the outcomes of delivery were evaluated using receiver operating characteristic curves and descriptive st
AU  - Kahrs,BH
AU  - Usman,S
AU  - Ghi,T
AU  - Youssef,A
AU  - Torkildsen,EA
AU  - Lindtjorn,E
AU  - Ostborg,TB
AU  - Benediktsdottir,S
AU  - Brooks,L
AU  - Harmsen,L
AU  - Romundstad,PR
AU  - Salvesen,KA
AU  - Lees,CC
AU  - Eggebo,TM
DO  - 10.1016/j.ajog.2017.03.009
PY  - 2017///
SN  - 0002-9378
TI  - Sonographic prediction of outcome of vacuum deliveries: a multicenter, prospective cohort study
T2  - American Journal of Obstetrics and Gynecology
UR  - http://dx.doi.org/10.1016/j.ajog.2017.03.009
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000405276800019&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/50683
VL  - 217
ER  -
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