title: Subpubic Arch Angle and Mode of Delivery in Low-Risk Nulliparous Women.
abstract: OBJECTIVE
  To assess whether subpubic arch angle (SPA) measurement before labor onset can predict labor outcome among low-risk pregnant women.
  
  
  METHODS
  3D ultrasound volume was transperineally acquired from a series of nulliparous women with uncomplicated pregnancy at term before the onset of labor. SPA was measured offline using Oblique View Extended Imaging (OVIX) on each volume performed by an investigator not involved in the clinical management. Labor outcome was prospectively investigated in the whole study group.
  
  
  RESULTS
  Overall, 145 women were enrolled in the study. Of these, 83 underwent spontaneous vaginal delivery, whereas obstetric intervention was performed in 62 cases (Cesarean section in 40 and vacuum extraction in 22). The SPA appeared to be significantly narrower in the women submitted to obstetric intervention compared with those undergoing spontaneous vaginal delivery (116.8 ± 10.3° vs. 123.7 ± 9.6°, p < 0.01). At multivariate analysis SPA and maternal age were identified as independent predictors of the mode of delivery. On the other hand, the duration of labor did not show a significant relationship with SPA.
  
  
  CONCLUSIONS
  In low-risk nulliparous women at term gestation, SPA measurement obtained by 3D ultrasound before the onset of labor seems to predict the likelihood of an obstetric intervention but not the duration of labor.
authors.affiliation: Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Aly
authors.initials: A
authors.lastname: Youssef
authors.forename: Tullio
authors.initials: T
authors.lastname: Ghi
authors.forename: Federica
authors.initials: F
authors.lastname: Martelli
authors.forename: Elisa
authors.initials: E
authors.lastname: Montaguti
authors.forename: Ginevra
authors.initials: G
authors.lastname: Salsi
authors.forename: Federica
authors.initials: F
authors.lastname: Bellussi
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Pilu
authors.forename: Nicola
authors.initials: N
authors.lastname: Rizzo
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007743:Labor, Obstetric; D015999:Multivariate Analysis; D010388:Pelvis / Q000033:anatomy & histology*; D011247:Pregnancy; D012372:ROC Curve; D012307:Risk Factors; D013997:Time Factors; D016216:Ultrasonography, Prenatal / Q000295:instrumentation / Q000379:methods*