SONOGRAPHIC EVALUATION OF FETAL HEAD EXTENSION AND MATERNAL PELVIS INCASES OF BREECH PRESENTATION

Background. To investigate whether sonographic examination of the feta l head extension, pelvic adequacy and fetal position, could replace th e traditional x-ray method in the evaluation of the breech in labor. M ethods. Seventy-two parturients admitted in labor with a breech presen tation were prospectively evaluated by a newly proposed ultrasonograph ic approach. The head extension, obstetric conjugate and fetal attitud e obtained were further compared to the gold standard radiologic measu rements. Results. A highly significant correlation between ultrasonic and x-ray measurements for the fetal head extension (r=0.8696; p<0.000 1), obstetric conjugate (r=0.8931; p<0.0001), as well as high reliabil ity (95.5%) in diagnosing the breech variant by ultrasound have been f ound. Conclusions. Ultrasonic evaluation of breech presentation, as pe rformed by the proposed method, is simple, easy to perform and compare s well with the standard radiologic studies. It is suggested that mode rn ultrasonic technique, which carries no risk of ionizing radiation, may replace traditional xray examination of the breech in labor.