Obstet Gynecol Sci > Volume 67(1); 2024 > Article |
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Ethical approval
Due to the nature of the study as a literature review approval by an institutional review board was not required for this study.
Study | Characteristics of study | No. of participants | Parity | Fetal head position | Cutoff AOP | Outcome |
---|---|---|---|---|---|---|
Torkildsen et al. (2011) [24] | Prolonged 1st | 110 | Nulliparous | N.A. |
≥110° <100° |
VD: 87% (95% CI, 75-93%) VD: 38% (95% CI, 21-57%) |
Eggebo et al. (2014) [25] | Prolonged 1st | 150 | Nulliparous |
N.A. Non-OP |
≥110° <110° |
VD: 88% (95% CI, 79-93%); OR, 3.11; 95% CI, 1.01-9.56 VD: 57% (95% CI, 45-69%); OR, 3.36; 95% CI, 1.24-9.12 |
Solaiman et al. (2020) [26] | Prolonged 1st | 28 | Nulliparous (25%), multiparous (75%) | LOP (64.3%), ROP (10.7%), LOT (10.7%), LOA (7.1%), ROA (7.1%) | 115° | VD: AUC, 0.913; sensitivity, 93%; specificity, 84%; PPV, 87%; NPV, 91% |
Marsoosi et al. (2015) [40] | 1st stage & nulliparous and multiparous | 70 | Nulliparous (64.3%), multiparous (35.7%) | N.A. | Mean±SD: 103.02°±10.727°, 88.60°±5.857° | VD (n=65), CS (n=5) |
Nishimura et al. (2016) [41] | 1st stage & nulliparous and multiparous | 63 | Nulliparous (54%), multiparous (46%) | N.A. | <105° | CS d/t arrest of labor: 95% CI, 79°-105°; P=0.035; sensitivity, 401.4%; specificity, 90.9% |
Bulut et al. (2020) [42] | 1st stage & nulliparous and multiparous | 122 | Nulliparous (34.3%), multiparous (63.7%) | N.A. | >132.5° | VD: 91% (95% CI, 0.62-0.93; P=0.002), sensitivity, 70%; specificity, 75% |
Frick et al. (2020) [17] | 1st stage & nulliparous and multiparous | 512 | Nulliparous (41.3%), multiparous (58.7%) | N.A. | >113° | Decreased CS for failure to progress: OR, 0.96 (95% CI, 0.94-0.99) |
Priya et al. (2021) [43] | 1st stage & nulliparous and multiparous | 200 | Nulliparous (67.5%), multiparous (32.5%) | N.A. | >99.6° | VD: AUC, 0.920 (95% CI, 0.88-0.95) |
Vinod et al. (2022) [44] | 1st stage & nulliparous and multiparous | 185 | Nulliparous (74.1%), multiparous (25.9%) | N.A. | ≥89° | VD: AUC, 0.789; sensitivity, 79.3%; specificity, 65.6%; PPV, 81.3%; NPV, 62.7% |
Nouri-Khasheh-Heiran et al. (2023) [45] | 1st stage & nulliparous and multiparous | 392 | Nulliparous (42.34%), multiparous (57.66%) | N.A. | 135° | VD: sensitivity, 91.2%; P<0.001 |
Ingeherg et al. (2017) [46] | 1st stage & nulliparous only | 36 | Nulliparous | N.A. | ≥105° | VD success rate: 58.33% vs. 19.2% |
Chor et al. (2019) [47] | 1st stage & nulliparous only | 183 | Nulliparous | N.A. | Median (IQR): 108.3° (100.9°-114.2°) | CS for non-progressive labor |
Pérez et al. (2017) [48] | 1st stage & nulliparous only | 101 | Nulliparous | N.A. | >125° | VD: AUC, 0.85 (95% CI, 0.77-0.92); sensitivity, 67.1% |
Hjartardóttir et al. (2021) [27] | 1st stage & nulliparous only | 99 | Nulliparous | N.A. | ≥93° | VD: AUC, 0.67 (95% CI, 0.55-0.80); sensitivity, 79% |
Kandil et al. (2021) [49] | 1st stage & nulliparous only | 80 | Nulliparous | N.A. | >104° | VD: AUC, 0.962; sensitivity, 90%; specificity, 86%; PPV, 95%; NPV, 76%; accuracy, 88% |
Elkadi et al. (2021) [50] | 1st stage & nulliparous only | 56 | Nulliparous | N.A. | ≥97.0° | VD: AUC, 0.902 (95% CI, 0.817-1.000; P=0.002); sensitivity, 92.2% (95% CI, 81.1-97.8); specificity, 80.0% (95% CI, 28.4-99.5); PPV, 97.9% (95% CI, 88.9-99.9); NPV, 50.0% (95% CI, 15.7-84.3) |
Ibrahim et al. (2021) [51] | 1st stage & nulliparous only | 600 | Nulliparous | N.A. | 107.5° | VD: sensitivity, 52%; specificity, 81%; PPV, 89.8%; P=0.001 |
AOP, angle of progression; N.A., not applicable; VD, vaginal delivery; CI, confidence interval; OP, occiput posterior; OR, odds ratio; LOP, left occiput posterior; ROP, right occiput posterior; LOT, left occiput transverse; LOA, left occiput anterior; ROA, right occiput anterior; AUC, area under the receiver operating characteristic curve; PPV, positive predictive value; NPV, negative predictive value; SD, standard deviation; CS, cesarean section; d/t, due to; IQR, interquartile range.
Study | No. of participants | Parity | Stage | Fetal head position | Cutoff AOP | Outcome |
---|---|---|---|---|---|---|
Eggebø et al. (2014) [25] | 150 | Nulliparous | Prolonged 1st | N.A. |
≥110° <110° |
Increased time from US to delivery |
Frick et al. (2020) [17] | 512 | Nulliparous (41.3%), multiparous (58.7%) | 1st | N.A. | 125° |
9.7 hours for nulliparous with epidural 5.3 hours for nulliparous without epidural 3.3 hours for parous with syntocinon use 1.5 hours for parous without syntocinon use |
Hjartardóttir et al. (2021) [27] | 99 | Nulliparous | 1st | N.A. |
110° 125° ≥93° <93° |
5.2 hours (95% CI, 4.7-5.7 hours) 3.0 hours (95% CI, 2.4-3.7 hours) Median time of VD: 506 minutes, 732 minutes; HR, 2.07 (95% CI, 1.15-3.72) |
Tang et al. (2022) [22] | 375 | Nulliparous | 1st | N.A. |
<119° ≥119° |
Mean duration of VD: 5.5 hours, 2.5 hours |
Barbera et al. (2009) [29] | 88 | Nulliparous (42.0%), multiparous (58.0%) | 2nd | OA |
≤135° 136°-167° 168°-200° >200° |
Mean±SD (minutes): 42.1±3.16, 20.3±2.48, 12.4±2.36, 5.8±1.65 |
Ghi et al. (2014) [52] | 71 | Nulliparous | 2nd | OA (90.1%), OP (9.8%) | 139°-142° | >60 minutes: AUC, 0.777 (95% CI, 0.666-0.888); sensitivity, 92.6%; specificity, 54.5% |
Malik et al. (2020) [53] | 64 | Nulliparous | 2nd | N.A. |
90°-120° 121°-150° 151°-180° >180° |
Mean±SD (minutes): 107.5±18.32, 54.44±24.7, 20.79±10.31, 3.67±2.31 |
Carvalho Neto et al. (2021) [38] | 221 | Nulliparous (58.4%), multiparous (41.6%) | 2nd | OA (14.9%), OT (36.1%), OP (26.2%) |
<129.9° >129.9° |
Mean±SD (minutes): 103±88, 55±44 |
TTD, time to delivery; AOP, angle of progression; N.A., not applicable; US, ultrasound; CI, confidence interval; VD, vaginal delivery; HR, hazard ratio; OA, occiput anterior; SD, standard deviation; OP, occiput posterior; AUC, area under the receiver operating characteristic curve; OT, occiput transverse.
Study | Characteristics of study | No. of participants | Parity | Fetal head position | Cutoff AOP | Outcome |
---|---|---|---|---|---|---|
Barbera et al. (2009) [29] | 2nd stage & nulliparous and multiparous | 88 | Nulliparous (42.0%), multiparous (58.0%) | OA | >120° | All cases were delivered vaginally |
Ciaciura-Jarno et al. (2016) [54] | 68 | Nulliparous (52.9%), multiparous (47.0%) | N.A. |
Mean: 142.5° Mean: 113.4° |
VD group CS group |
|
Yonetani et al. (2017) [55] | 557 | Nulliparous (69.3%), multiparous (30.7%) | N.A. |
≥160° ≥150° |
VD in nulliparous (AUC, 0.70; sensitivity, 42.6%; specificity, 88.1%) VD in multiparous (AUC, 0.68; sensitivity, 51.8%; specificity, 78.6%) |
|
Pérez et al. (2017) [48] | 66 | Nulliparous (44.5%), multiparous (55.5%) | N.A. | >125° | VD: AUC, 0.97 (95% CI, 0.90-0.99); sensitivity, 91.38% | |
Barros et al. (2021) [56] | 113 | Nulliparous (65.5%), multiparous (34.5%) | N.A. | Median (IQR): 148° (136°-160°), 137° (125°-150°) |
Single instrumental VD Two instrumental VD or CS |
|
Carvalho Neto et al. (2021) [38] | 221 | Nulliparous (58.4%), multiparous (41.6%) | N.A. | >129.9° | VD: AUC, 0.76 (95% CI, 0.64-0.88, P=0.003); sensitivity, 85%; specificity, 63% | |
Brunelli et al. (2021) [57] | 63 | Nulliparous (46.0%), multiparous (54.0%) | Non-OP (62%), persistent OP (38%) | <118.5° | CS: AUC, 0.866 (95% CI, 0.761-0.972); sensitivity, 82%; specificity, 87% | |
Zarean et al. (2022) [58] | 80 | Nulliparous (55.0%), multiparous (45.0%) | N.A. | Mean±SD: 149.47°±4.47°, 137.48°±1.51°, 124.20°±6.81° |
VD VD with vacuum CS |
|
Ghi et al. (2013) [59] | 2nd stage & nulliparous only | 71 | Nulliparous | N.A. | 125°-127° | VD: AUC, 0.785 (95% CI, 0.923-0.970); P<0.001; sensitivity, 60.0%; specificity, 88.1% |
Marsoosi et al. (2015) [40] | 70 | Nulliparous | N.A. | ≥113° | VD: sensitivity, 90.8%; false positive value, 40% | |
Antonio Sainz et al. (2016) [60] | 70 | Nulliparous | Non-OP | >128° | Easy vacuum-assisted delivery (≤2 pulls) >85%; sensitivity, 80%; false-positive rate, 9.3% | |
Sainz et al. (2016) [61] | 61 | Nulliparous | N.A. | ≥120° | Vacuum-assisted delivery: easy, 92.3% (<3 vacuum pulls); difficult, 36.9% (≥vacuum pulls); impossible, 0% (CS) | |
Bultez et al. (2016) [62] | 235 | Nulliparous | OA (80%), OP (15%), OT (3.8%) | >145.5° | Vacuum extraction failure rate <5%: AUC, 0.67 (95% CI, 0.57-0.77); sensitivity, 86.2%; specificity, 49.0% | |
Sainz et al. (2017) [63] | 143 | Nulliparous | N.A. | >153.5° | VD with pushing: sensitivity, 95.2%; false-positive rate, 5.9% | |
Sainz et al. (2017) [63] | 28 | Nulliparous | N.A. |
>127.3° >139.7° |
VD at rest: ICC, 0.96 (95% CI, 0.89-0.99); P<0.005 VD with pushing: ICC, 0.98 (95% CI, 0.96-0.99); P<0.005 |
|
Malik et al. (2020) [53] | 64 | Nulliparous | N.A. | >116° | VD: AUC, 0.989; sensitivity, 96.49%; specificity, 96.43% | |
Hadad et al. (2021) [64] | 197 | Nulliparous | N.A. | >138° | VD: AUC, 0.82 (95% CI, 0.76-0.87); P<0.0001, sensitivity, 71.6%; specificity, 83.7% | |
Kalache et al. (2009) [36] | Prolonged 2nd stage | 26 | Nulliparous | OA | >120° | Easy vacuum delivery or vaginal delivery: 90% (R2 measure of fit=55%; LR chi-square P<0.0001) |
Cuerva et al. (2014) [65] | 30 | Nulliparous | LOT (10%), ROT (3.3%), LOA (46.7%), ROA (30%), OA (10%) | <138° | Complicated forceps delivery: AUC, 98.9%; sensitivity, 85.7%; specificity, 100% | |
Chan et al. (2019) [31] | 143 | Nulliparous (94.0%), multiparous (6.0%) | N.A. |
>138.7° >160.9° |
Successful instrumental delivery at rest: AUC, 0.75; sensitivity, 86.2%; specificity, 51.9%; at contraction: AUC, 0.86; sensitivity, 87.1%; specificity, 74.1% | |
Dall’Asta et al. (2019) [32] | 109 | Nulliparous | OA (66.1%), OT (11.9%), OP (22.0%) | Mean±SD: 153.3±19.8, 141.8±25.7 |
Spontaneous VD Obstetric intervention (CS or vacuum extraction) |
|
Katzir et al. (2023) [33] | 181 | Nulliparous | N.A. | ≥127° | VD: 88.6%; OR, 1.070; 95% CI, 1.031-1.111; P<0.001 |
AOP, angle of progression; OA, occiput anterior; N.A., not applicable; VD, vaginal delivery; CS, cesarean section; AUC, area under the receiver operating characteristic curve; CI, confidence interval; IQR, interquartile range; OP, occiput posterior; SD, standard deviation; OT, occiput transverse; ICC, interclass correlation coefficients; LR, likelihood ratio; LOT, left occiput transverse; ROT, right occiput transverse; LOA, left occiput anterior; ROA, right occiput anterior; OR, odds ratio.
Study | No. of participants | Parity | Stage | Fetal head position | Cutoff AOP | Outcome |
---|---|---|---|---|---|---|
Kalache et al. (2009) [36] | 26 | Nulliparous | Prolonged 2nd | OA | >120° | Easy vacuum delivery or vaginal delivery: 90% (R2 measure of fit=55%; LR chi-square P<0.0001) |
Cuerva et al. (2014) [65] | 30 | Nulliparous | Prolonged 2nd | LOT (10%), ROT (3.3%), LOA (46.7%), ROA (30%), OA (10%) | <138° | Complicated forceps delivery: AUC, 98.9%; sensitivity, 85.7%; specificity, 100% |
Chan et al. (2019) [31] | 143 | Nulliparous (94.0%), multiparous (6.0%) | Prolonged 2nd | N.A. |
>138.7° >160.9° |
Successful instrumental delivery at rest: AUC, 0.75; sensitivity, 86.2%; specificity, 51.9%; at contraction: AUC, 0.86; sensitivity, 87.1%; specificity, 74.1% |
Dall’Asta et al. (2019) [32] | 109 | Nulliparous | Prolonged 2nd | OA (66.1%), OT (11.9%), OP (22.0%) | Mean±SD: 153.3±19.8, 141.8±25.7 |
Spontaneous VD Obstetric intervention (CS or vacuum extraction) |
Katzir et al. (2023) [33] | 181 | Nulliparous | Prolonged 2nd | N.A. | ≥127° | VD: 88.6%; OR, 1.070; 95% CI, 1.031-1.111; P<0.001 |
AOP, angle of progression; OA, occiput anterior; LR, likelihood ratio; LOT, left occiput transverse; ROT, right occiput transverse; LOA, left occiput anterior; ROA, right occiput anterior; AUC, area under the receiver operating characteristic curve; N.A., not applicable; OT, occiput transverse; OP, occiput posterior; SD, standard deviation; VD, vaginal deivery; CS, cesarean section; OR, odds ratio; CI, confidence interval.