Determination of fetal head station: Do professors and residents of obstetrics and gynecology reach an agreement?

Document Type : Original Article

Authors

1 Gynecology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Clinical Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Determination of fetal head station is an important factor during labor progress. This study evaluated the agreement and correlation between professors and residents of obstetrics and gynecology in the determination of fetal head station based on a vaginal examination during labor. 
Methods: In this cross-sectional study, term pregnant women with cephalic presentation in an active phase of labor underwent vaginal examinations simultaneously by residents and professors of obstetrics and gynecology. Their examination findings regarding a fetal head station, cervical dilation and effacement were recorded both by professors and the residents. Data were analyzed by SPSS version 16 using Spearman’s correlation and Intraclass Correlation Coefficient tests between results obtained by two groups of assessors (residents and professors).
Results: Our data analysis showed that the agreement between obstetricians and residents for cervical dilatation, cervical effacement, and a fetal head station was 0.88, 0.9 and 0.67 respectively (p <0.001). The correlation between obstetricians and residents for determination of cervical dilatation, cervical effacement and, a fetal head station was 0.77, 0.79 and 0.52, respectively (p <0.001).
Conclusions: The agreement and correlation between professors and residents in obstetrics and gynecology about the determination of fetal head station are lower than those for cervical dilatation and effacement. Because of the importance of accurate determination of fetal head station in the first stage of labor, a new approach (new invented device for determine fetal head station) should be developed to for determining of fetal station.

Keywords


1-      Awan N, Rhoades A, Weeks AD. The validity and reliability of the StationMaster: A device to improve the accuracy of station assessment in labour. Eur J Obstet Gynecol Reprod Biol. 2009; 145(1):65-70.
2-        Buchmann E, Libhaber E. Interobserver agreement in intrapartum estimation of fetal head station. Int. J. Gynecol. Obstet. 2008;101(3):285-9.
3-        Arias T, Tran A, Breaud J, Fournier JP, Bongain A, Delotte J. A prospective study into the benefits of simulation training in teaching obstetric vaginal examination. Int. J. Gynecol. Obstet. 2016;133(3):380-84.
4-       Zara L.Z. Lok, Michael C.M. Chor Reliability of digital vaginal examination for fetal head position determination: A prospective observational study. Edorium J Gynecol Obstet. 2015;1:5–9.
5-       Ludvigsen E, Skjeldestad F.E. Station of the fetal head at complete cervical dilation impacts duration of second stage of labor, Eur J Obstet Gynecol. 2019. http://dx.doi.org/10.1016/j.eurox 2019.100100.
6-        Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P, Cucherat M, et al. Birth simulator: reliability of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologists classification. Am J Obstet Gynecol. 2005;192(3):868-74.
7-        Sebitloane H, Moodley J, Esterhuizen T. Prophylactic antibiotics for the prevention of postpartum infectious morbidity in women infected with human immunodeficiency virus: a randomized controlled trial. Am J Obstet Gynecol. 2008;198(2):189. e1- e6.
8-        Maaita M, AL-Amro SQ, Fayez MD I, Quran FA. Jordanian women’s Feelings, Opinions and Knowledge of Vaginal Examination during Child Birth. JRMS. 2017;24(2):58-69. 
9-       Nizarrd J, Haerman S, Paltieli Y et al. Determination of fetal head station and position during labor: a new technique that combines ultrasound and a position- tracking system. Am J Obstet Gynecol 2009; 200(4):404. e1-5.
10-   Ghi T, Farina A, Pedrazzi A. Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound. Ultrasound Obstet Gynecol 2009; 33: 331–36.
11-    Akhlaghi F, Najaf Najafi M, Bazmi F. Diagnostic agreement about fetal head station between station meter device and vaginal examination. Iranian Journal of Obstetrics, Gynecology and Infertility 2020;23(1): 1-6. Persian.