Fetal cheek-to-cheek diameter in the prediction of mode of delivery.
OBJECTIVE
The purpose of this study was to assess sonographic fetal cheek-to-cheek diameter (CCD) in predicting mode of delivery.


METHODS
Two hundred sixty-four patients were considered in 2 parts. First, a retrospective analysis of 214 patients entered into a birth weight (BW) study. Measurements of the CCD, biparietal diameter (BPD), and BW, as well as labor data, were collected. Then a prospective study of patients at > or =38 weeks gestational age was conducted. Fetal weight (EFW) was estimated by routine measurements. Information regarding CCD was withheld from the delivering caregiver. Labor records were reviewed for BW and complications, defined as: instrumental delivery, cesarean section (C/S) for nonprogress of labor or "CPD," and "difficult" vaginal delivery. The CCD, BW (both parts), or EFW (prospective part) and mode of delivery were compared.


RESULTS
Abnormal CCD (>2SD above previously published norms for each GA) was closely associated with cesarean delivery, regardless of EFW. At term, risk of C/S with a CCD >7.9 cm was 94%.


CONCLUSIONS
Within limits, EFW alone has weak correlation with cesarean delivery. CCD, as a reflector of fetal adipose tissue, performs as well as actual BW and demonstrates good prediction for delivery by C/S.
Abramowicz
Jacques S
JS
Department of Obstetrics and Gynecology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA. Jacques_abramowicz@rush.edu
Rana
Sarosh
S
Abramowicz
Shelly
S
D000328:Adult; D002610:Cheek / Q000000981:diagnostic imaging / Q000196:embryology*; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000379:methods*; D004420:Dystocia / Q000000981:diagnostic imaging; D005260:Female; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011336:Probability; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal