MEASUREMENT OF INTRAPARTUM CAPUT SUCCEDANEUM AS A PREDICTOR OF DELIVERY MODE

Purpose: The aim of the study was to determine if the ultrasonographic measurement of Caput Succedaneum (CS) prior to entry into the true pelvis can predict of the delivery mode. Methods: We conducted a prospective cohort study. The CS was measured using Transvaginal ultrasound with the head station calculated using the Angle of Progression (AOP). Data were collated including the CS thickness, route of delivery, indication for operative delivery, demographic data and third stage complications. A Youden’s index was used to calculate a CS cut-off which was assessed for sensitivity and specificity by an ROC curve. Results: 46 patients recruited. 36 delivered spontaneously, 4 with vacuum extraction and 5 by Caesarean section. Three patients were excluded because of an AOP larger than the predetermined cut-off. Women were divided to two groups. Group 1: delivered vaginally (spontaneous or operative) and Group 2 delivered by Caesarean section. AOP and birth weight were comparable between the groups. The mean CS of Group 2 cases was significantly greater than Group 1 patients (15.84 mm vs. 9.56 mm, respectively (P=0.005). There was a significant difference between the groups in parturient age, gestational age and gravidity with a mean parity in Group 2 patients of 5 vs. 1.89 in Group 1 patients (P=0.013). A CS measurement>13.75mm was predictive of a Caesarean delivery with an 80% sensitivity and an 87% specificity. Conclusion: Measurement of the CS in early delivery can predict the delivery mode with a linear relationship between CS thickness and the risk of Caesarean section.