American Journal of Obstetrics & Gynecology
Volume 192, Issue 4 , Pages 1205-1211, April 2005

Fetal cheek-to-cheek diameter in the prediction of mode of delivery

  • Jacques S. Abramowicz, MD

      Affiliations

    • Departments of Obstetrics and Gynecology
    • Radiology, University of Chicago, Chicago, Ill
    • Corresponding Author InformationReprint requests: Jacques S. Abramowicz, MD, Department of Obstetrics and Gynecology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612.
    • ,
  • Sarosh Rana, MD

      Affiliations

    • Departments of Obstetrics and Gynecology
    • ,
  • Shelly Abramowicz, DMD, MPH

      Affiliations

    • Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, Fla

Received 30 December 2004; received in revised form 6 January 2005; accepted 6 January 2005.

Objective

The purpose of this study was to assess sonographic fetal cheek-to-cheek diameter (CCD) in predicting mode of delivery.

Study design

Two hundred sixty-four patients were considered in 2 parts. First, a retrospective analysis of 214 patients entered into a birth weight (BW) study. Measurements of the CCD, biparietal diameter (BPD), and BW, as well as labor data, were collected. Then a prospective study of patients at ≥38 weeks gestational age was conducted. Fetal weight (EFW) was estimated by routine measurements. Information regarding CCD was withheld from the delivering caregiver. Labor records were reviewed for BW and complications, defined as: instrumental delivery, cesarean section (C/S) for nonprogress of labor or “CPD,” and “difficult” vaginal delivery. The CCD, BW (both parts), or EFW (prospective part) and mode of delivery were compared.

Results

Abnormal CCD (>2SD above previously published norms for each GA) was closely associated with cesarean delivery, regardless of EFW. At term, risk of C/S with a CCD >7.9 cm was 94%.

Conclusion

Within limits, EFW alone has weak correlation with cesarean delivery. CCD, as a reflector of fetal adipose tissue, performs as well as actual BW and demonstrates good prediction for delivery by C/S.

Key words: Cheek-to-cheek diameter, Dystocia, Fetal weight, Labor, Macrosomia, Ultrasound

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 Presented at the 23rd Annual Meeting of the American Gynecological and Obstetrical Society, September 9-11, 2004, Bolton Landing, NY.

PII: S0002-9378(05)00071-2

doi:10.1016/j.ajog.2005.01.008

American Journal of Obstetrics & Gynecology
Volume 192, Issue 4 , Pages 1205-1211, April 2005

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