The Significance of Maximum Vertical Pocket in Predicting Fetal Distress among Overdue Pregnant Women

Akram, Wisam

	The Significance of Maximum Vertical Pocket in Predicting Fetal Distress among Overdue Pregnant Women
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 25, Issue 3, 2012, Pages 221-226
Author
Wisam Akram
Abstract
Background; post term delivery accounts for 5- 10 % of the overall deliveries in labor wards. The main adverse of overdue pregnancy and post term labor include oligohydramnios, placental insufficiency and increased fetal weight with increased incidence of fetal injury at birth. Among the above factors, oligohydramnios is considered as the main factors which determine the onset of adverse side effects. Once develops induction of labor is mandatory. Aim of the study; to evaluate the maximum vertical pocket as an independent risk factor which can predict fetal distress during labor. Maximum vertical pocket is defined as the maximum cord free space measurable by ultrasound around buttock fetal area. Methods; a total of 60 women who are overdue yet less that 294 days from the last menstrual period date has been collected from the labor ward at AL-Yermouk Teaching Hospital. All of them came with spontaneous onset of labor. 30 women had normal vaginal delivery with no evidence of fetal distress, while 30 women had fetal distress requiring delivery by cesarean section. For all women maximum vertical pocket, amniotic fluid index, maximum deceleration with fetal distress as well as Apgar scores were recorded and correlated Results; there was a statistically significant correlations between maximum vertical pocket with longest deceleration, apgar score at 1 and 5 minutes, P values less than 0.001 for each. The cut off values for maximum vertical pocket was 3 cm with 83.33 % sensitivity and specificity. However it was not superior to that for amniotic fluid assessment by amniotic fluid index. Conclusion; there is no evidence that assessment of amniotic fluid volume by maximum vertical pocket is superior to that by amniotic fluid index in predicting fetal distress during labor. However in case that new scoring system for fetal well being in overdue pregnancy, maximum vertical pocket may be easier and more accurate to measure.

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