title: Occiput-spine relationship: shoulders are more important than head.
abstract: To understand the role of fetal spine position in determining a fetal head position at the time of birth and modality of delivery.
  
  
  
  This was a multicenter prospective observational study. Fetal occiput and spine position were evaluated by intrapartum ultrasound. Eighty-six women were eligible for inclusion in the study. Occiput rotational movements and modality of delivery in relation to the fetal spine position were investigated.
  
  
  
  At the beginning of labor, fetal occiput was in a posterior position in 52.3% of cases and, in 81.5% of cases the spine was in an anterior transverse position. At birth, occiput and spine were both in an anterior position in 90.4% of cases. The rate of cesarean sections in the SP group was significantly higher than the rate in the SAT group (50% vs. 8%, p < 0.0007). Instead, the rate of vaginal deliveries without intervention in the SP group was significantly lower than the rate in the SA group (14% vs. 71%, p < 0.0001).
  
  
  
  Fetal spine position could have an important role in determining fetal occiput position at birth. Spine position might play a crucial role in the outcome of delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy. alessandrosvelato@virgilio.it.
authors.forename: A
authors.initials: A
authors.lastname: Svelato
authors.forename: A
authors.initials: A
authors.lastname: Ragusa
authors.forename: P
authors.initials: P
authors.lastname: Alimondi
authors.forename: M
authors.initials: M
authors.lastname: Di Tommaso
authors.forename: R
authors.initials: R
authors.lastname: Marci
authors.forename: V
authors.initials: V
authors.lastname: Barbagallo
authors.forename: R D F
authors.initials: RD
authors.lastname: Alampi
authors.forename: G
authors.initials: G
authors.lastname: Calagna
authors.forename: A
authors.initials: A
authors.lastname: Perino
mesh_terms: D005260:Female; D005333:Fetus; D006257:Head; D006801:Humans; D007746:Labor Presentation; D011247:Pregnancy; D011446:Prospective Studies; D012782:Shoulder; D013131:Spine; D016216:Ultrasonography, Prenatal