THE EFFECT OF SONOGRAPHİC HEAD CİRCUMFERENCE ON DELİVERY MODE AND PERİNEAL LACERATİON

Aim: The present study aimed to determine the role of headcircumference for delivery mode and perineal laceration bothin primiparous and multiparous patients and compare this rolewith estimated fetal weight.Material and Method: A total of 866 patients, who deliveredin our clinic were divided into two groups: vaginal delivery(n=604) and cesarean section (n=262). Demographiccharacteristics, sonographic head circumference, estimatedfetal weight, birth week and weight, presence of severeperineal laceration, gender, neoatal head circumference, Apgarscores were compared between groups.Results: The median head circumference was 339 (302-384)milimeter in vaginal delivery and 347 (314-384) milimeter incesarean section (p<0.001). Sonographic head circumferencewas positively correlated with estimated fetal weight(r=0.561,p<0.001), birth weight (r=0.446,p<0.001) and neonatalhead circumference (r=0.396,p<0.001). Head circumference>35.4 predicted cesarean section with 36.3% sensitivity and84.8% specificity (AUC=0.637,p<0.001) and >35.2 predictedperineal laceration with 78.6% sensitivity and 85.4% specificity(AUC=0.853,p<0.001). Head circumference was superiorfor cesarean section as compared to estimated fetal weight(p=0.003) whereas no difference was found for perineallaceration (p=0.64).Head circumference >34.9 predictedcesarean section with 60% sensitivity and 73.8% specificity(AUC=0.692,p<0.001) in primiparous while >35.4 predictedcesarean section with 34.3% sensitivity and 84.5% specificity inmultiparous women (AUC=0.624,p<0.001).Conclusion: Considering large head circumference wasmore strongly associated with cesarean delivery and perineallacerations than estimated fetal weight, we suggest thatmeasuring head circumference would be an appropriateapproach for determining delivery mode and complications.