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Q&A

Epidemiology

Poster Session 2

(489) Do fetal biometry parameters> 90th percentile increase the risk of Primary Cesarean Delivery?

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

To determine whether sonographic fetal biometry parameters > 90% increase the risk of primary cesarean delivery (PCD) in Appropriate for Gestational Age (AGA) neonates across different parity groups. 

Study Design: A retrospective analysis was conducted to assess the rate of PCD for AGA neonates with Fetal Biometry above 90% in various parity groups. Singleton pregnancies at term underwent sonographic estimation using the Hadlock scale within one week of delivery between 2020 and 2023. Pregnancies with known anomalies were excluded.

Results:

The study included 10,515 women, divided into primiparous (n=2,183), multiparous (parity 1-4) (n=5,587), and grand multiparous (parity ≥5) (n=2,745) groups. The overall rate of PCD was higher among primiparous women, 13.4%, compared to 3.6% in multiparas and 4.8% in grand multiparas (p< 0.01). For AC >90%, the rate was 24.6% in primiparas, 6.7% in multiparas, and 8.1% in grand multiparas (p< 0.01). For HC >90%, the rates were 25.2% in primiparas, 6.4% in multiparas, and 4.8% in grand multiparas (p< 0.01). For FL >90%, the rates were 14.2% in primiparas, 2.9% in multiparas, and 5.2% in grand multiparas (p< 0.01).

When comparing the rate of CD between biometric parameters >90% and Large for Gestational Age (LGA) neonates, a higher rate of CD was observed in women with AC or HC >90% compared to LGA in primiparas (24.6% and 25.2% vs 17.2%, p< 0.01) and multiparas (6.7% and 6.4% vs 6.03, p< 0.01). However, this difference was not significant in grand multiparas (8.1% and 4.8% vs 8.6%, p=0.1).

Conclusion:

AC and HC >90th centile confer an increased risk of PCD in primiparous and Multiparous patients but not in Grandmultiparous patients. These findings underscore the importance of considering fetal biometry, especially AC and HC, as key factors in decision-making regarding the mode of delivery, which may lead to better management and improved outcomes for pregnant women and their neonates.