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Comparing intrapartum ultrasound and clinical examination in the assessment of fetal head position in African women

Yaw A. Wiafe
Yaw A. Wiafe
, 
Bill Whitehead
Bill Whitehead
, 
Heather Venables
Heather Venables
 and 
Edward T. Dassah
Edward T. Dassah
   | Dec 31, 2019
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Article Category: research-article
Published Online: Dec 31, 2019
Page range: 249 - 254
Received: Mar 25, 2019
Accepted: Jun 24, 2019
DOI: https://doi.org/10.15557/jou.2019.0037
Keywords
© 2019 Yaw A. Wiafe et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Left occiput posterior (LOP) position
Left occiput posterior (LOP) position

Fig. 2.

Right occiput posterior (ROP) position
Right occiput posterior (ROP) position

Fig. 3.

Direct occiput posterior (DOP) position
Direct occiput posterior (DOP) position

Reproductive characteristics of the women

Variables Number a Percentage (%)
Age group (years)
<20 9 4.5
20–29 134 68.0
30–39 55 27.5
Mean ± SD (years) 26.8 ± 4.9
Body mass index (kg/m2) 27.8 ± 3.5
Parity
Nulliparous 92 47.0
Primiparous 43 22.0
Multiparous 61 31.0
Mean gestational age ± SD (weeks) 39.6 ± 1.07
Ruptured membranes
Yes 69 36.0
No 127 64.5
Fetal head positions (ultrasound)
Left occiput anterior 21 10.7
Left occiput transverse 60 30.6
Left occiput posterior 35 17.9
Direct occiput posterior 5 2.6
Right occiput posterior 30 15.3
Right occiput transverse 33 16.9
Right occiput anterior 12 6.1

Kappa table of agreement between Ultrasound and Digital VE on fetal head position

Overall agreement in the range of 45o
Ultrasound (+)/ (–)
Digital VE (+)/ (–) + – Total:
+ (n: 68) (n: 128) (n: 196)
– (n: 0) (n: 66) (n: 66)
Total: 68 194 262
Observed agreements % 134 (51.15%) Kappa = 0.211; 95% CI: From 0.151 to 0.271
Agreements expected by chance %: 99.7 (38.07)
Agreement on occiput posterior positions
Ultrasound (+)/ (–)
Digital VE (+)/ (–) + – Total:
+ (n: 14) (n: 56) (n: 70)
– (n: 14) (n: 112) (n: 126)
Total: (n: 28) (n: 168) (n: 196)
Observed agreements % 126 (64.29%) Kappa = 0.103; 95% CI: From –0.022 to 0.227
Agreements expected by chance %: 118.0 (60.209%)
Agreement on transverse positions
Ultrasound (+)/ (–)
Digital VE (+)/ (–) + – Total:
+ (n: 23) (n: 70) (n: 93)
– (n: 23) (n: 80) (n: 103)
Total: (n: 46) (n: 150) (n: 196)
Observed agreements % 103 (52.55%) Kappa = 0.025 95% CI: From –0.182 to 0.057
Agreements expected by chance %: 100.7 (51.35%)

Kappa table of agreement on OP positions in the sub-group with ruptured and intact membranes

Occiput posterior position with ruptured membranes
Ultrasound (+)/ (–)
Digital VE (+)/ (–) + – Total:
+ (n: 7) (n: 23) (n: 30)
– (n: 7) (n: 34) (n: 41)
Total: (n: 14) (n: 57) (n: 71)
Observed agreements % 41 (57.75%) Kappa = 0.067; 95% CI: From –0.137 to 0.272
Agreements expected by chance %: 38.8 (54.69%)
Occiput posterior position with intact membranes
Ultrasound (+)/(–)
Digital VE (+)/ (–) + – Total:
+ (n: 7) (n: 33) (n: 40)
– (n: 9) (n: 76) (n: 85)
Total: (n: 16) (n: 109) (n: 125)
Observed agreements % 83 (66.40%) Kappa = 0.082; 95% CI: From –0.077 to 0.241
Agreements expected by chance %: 79.2 (63.39%)
eISSN:
2451-070X
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Basic Medical Science, other
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