{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:52:34Z","timestamp":1792785154083,"version":"4.5.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"NIHR Biomedical Research Centre Imperial College London","id":[{"id":"https:\/\/ror.org\/041kmwe10","id-type":"ROR","asserted-by":"crossref"}]},{"name":"British Medical Association","award":["Helen Lawson Grant"],"award-info":[{"award-number":["Helen Lawson Grant"]}],"id":[{"id":"https:\/\/ror.org\/02caz1f24","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Imperial College Healthcare NHS Trust","id":[{"id":"https:\/\/ror.org\/056ffv270","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Imperial College Healthcare Charity","id":[{"id":"https:\/\/ror.org\/025zmdz23","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Research Foundation","award":["Flanders (FWO) grant G0B4716N"],"award-info":[{"award-number":["Flanders (FWO) grant G0B4716N"]}]},{"name":"KU Leuven","award":["C24\/15\/037"],"award-info":[{"award-number":["C24\/15\/037"]}],"id":[{"id":"https:\/\/ror.org\/05f950310","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Imperial Confidence in Concept"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Purpose Ultrasound offers an objective method of assessing the progress of labor. We sought to examine whether repeat clinical and ultrasound assessments during labor were prognostic of the mode of delivery.<\/jats:p>\n                  <jats:p>Materials and Methods Term nulliparous women underwent ultrasound assessment of fetal head position, head descent measured as head\u2013perineum distance, caput succedaneum, molding, umbilical, and middle cerebral artery Doppler, as well as assessment of cervical dilatation by digital vaginal examination. Univariable and multivariable logistic regression analyses were used to investigate a prognostic model for intrapartum cesarean delivery.<\/jats:p>\n                  <jats:p>Results Of 270 participants, 269 were able to be evaluated. Two hundred nineteen (81%) had repeat ultrasound and clinical assessments; intrapartum cesarean delivery was required in 79 (29%). The most important parameters to determine the likelihood of intrapartum cesarean delivery from the initial assessment were head station (adjusted odds ratio [AOR] 1.08 per mm, 95% CI 1.04\u20131.13, p &lt; 0.0001) and cervical dilatation (AOR, 0.78 per cm, (95% CI 0.66\u20130.92, p = 0.0025). For repeat assessments, change in cervical dilatation per hour was the most important (AOR, 0.10 per cm, [95% CI 0.03\u20130.26, p &lt; 0.0001]). Multivariable analysis of the initial assessment including gestational age, head descent, cervical dilatation, and caput succedaneum gave an area under the curve of 0.72 and 0.78 when cervical dilatation and caput succedaneum were included.<\/jats:p>\n                  <jats:p>Conclusion This study identifies the key parameters associated with mode of delivery during labor. Clinical assessment of cervical dilatation and ultrasound measurement of head station at the initial assessment are the most promising prognostic parameters for intrapartum cesarean delivery. Repeat assessment including change in cervical dilatation improved the prediction to a level that is potentially clinically useful.<\/jats:p>","DOI":"10.1055\/a-2915-9365","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:01:46Z","timestamp":1788994906000},"source":"Crossref","is-referenced-by-count":0,"title":["Digital Vaginal and Ultrasound Assessments and the Likelihood of Intrapartum Cesarean Delivery: A Prognostic Factor Study"],"prefix":"10.1055","clinical-trial-number":[{"clinical-trial-number":"nct02430038","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Sana","family":"Usman","sequence":"additional","affiliation":[{"name":"Imperial College London, London, United Kingdom of Great Britain and Northern Ireland","department":["Department of Metabolism, Digestion and Reproduction"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte Heiberg","family":"Kahrs","sequence":"additional","affiliation":[{"name":"National Center for Fetal Medicine, Norway","place":["Trondheim"],"department":["St Olavs Hospital, Trondheim University Hospital"]},{"name":"Norwegian University of Science and Technology, Norway","place":["Trondheim"],"department":["Department of Clinical and Molecular Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassim","family":"Hassan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, United Kingdom of Great Britain and Northern Ireland","place":["Colchester"],"department":["Colchester Hospital University NHS Foundation Trust"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Wilhelm-Benartzi","sequence":"additional","affiliation":[{"name":"Wales Cancer Trials Unit Centre for Trials Research, United Kingdom of Great Britain and Northern Ireland","place":["Cardiff"],"department":["College of Biomedical & Life Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell \u00c5smund","family":"Salvesen","sequence":"additional","affiliation":[{"name":"National Center for Fetal Medicine, Norway","place":["Trondheim"],"department":["St Olavs Hospital, Trondheim University Hospital"]},{"name":"Norwegian University of Science and Technology, Norway","place":["Trondheim"],"department":["Department of Clinical and Molecular Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbjorn","family":"Eggebo","sequence":"additional","affiliation":[{"name":"National Center for Fetal Medicine, Norway","place":["Trondheim"],"department":["St Olavs Hospital, Trondheim University Hospital"]},{"name":"Norwegian University of Science and Technology, Norway","place":["Trondheim"],"department":["Department of Clinical and Molecular Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Van Calster","sequence":"additional","affiliation":[{"name":"KU Leuven, Flanders, Belgium","place":["Leuven"],"department":["Department of Development and Regeneration"]},{"name":"Leiden University Medical Center, Zuid-Holland, Netherlands","place":["Leiden"],"department":["Department of Biomedical Data Sciences"]},{"name":"KU Leuven, Flanders, Belgium","place":["Leuven"],"department":["EPI-centre"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2104-5561","authenticated-orcid":false,"given":"Christoph","family":"Lees","sequence":"additional","affiliation":[{"name":"Imperial College London, London, United Kingdom of Great Britain and Northern Ireland","department":["Department of Metabolism, Digestion and Reproduction"]},{"name":"KU Leuven, Flanders, Belgium","place":["Leuven"],"department":["Department of Development and 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