CClinicalTrials.gg
Status unknownNCT02739503Updated Jan 10, 2017

Fetal Head Circumference as a Predictor of Operative Delivery

An observational study in Pregnancy, sponsored by Hillel Yaffe Medical Center. Status unknown at 1 site in Israel. Open to female participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-01-10.

Sponsored by Hillel Yaffe Medical Center · Observational

The sponsor has not verified this record recently (last verified Jan 2017), so the status shown — last known as Recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
500
Ages
18 Years to 45 Years
Sex
Female
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Study summary

This study set out to investigate whether antenatal ultrasound evaluation of the Fetal Head Circumference (FHC) could potentially possess a predictive role in determining women at increased risk for operative delivery or cesarean section.

Read the detailed description

When vaginal delivery poses a danger to the mother or newborn infant, operative delivery (instrumental or cesarean section) is indicated. Some specific indications for operative delivery include prolonged second-stage of labor, suspected compromise of the fetus, health-related disorders of the fetus or the mother that justify shortening of the second-stage of active labor and more. In cases where cephalo-pelvic disproportion (CPD) is suspected or when instrumental delivery is not possible or fails, cesarean section plays a critical role . Studies trying to identify women at greatest risk of CPD have concluded that neither x ray, nor computed tomography or magnetic resonance imaging have a proven value in labor management or in predicting clinical outcomes . Previous studies assessing fetal factors that are associated with operative delivery have focused mainly on estimated fetal weight to predict macrosomia. Nonetheless, ultrasound estimation of the fetal weight was shown to differ by as much as 20% from actual birth weight, and identifying cases with suspected fetal macrosomia, other than for diabetic pregnancies, was not found to improve labor outcome . As weeks may possibly elapse between the time of last antenatal assessment and onset of labor, a further challenge is related to the timing of ultrasound assessment. Several studies have shown an association between increased Fetal Head Circumference (FHC) and prolonged second-stage of labor, instrumental delivery and cesarean section . However, FHC can only be acquired following delivery and has no predictive value for interventions in labor.

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Conditions studied

  • Pregnancy
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In context

Lead sponsor

Hillel Yaffe Medical Center is the lead sponsor of 301 studies on the registry; 10 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

Women at term (37+0 - 42+0 weeks' gestation)

Inclusion criteria

  1. Women at term (37+0 - 42+0 weeks' gestation)
  2. Singleton pregnancies
  3. Cephalic presentation
  4. Anticipated vaginal delivery

Exclusion criteria

Exclusion Criteria:

  1. Younger than 18 years old and older than 45 years old
  2. Women who incapable of providing informed consent
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No

Interventions

  • DeviceUltrasound

    Patients will receive ultrasound in the ultrasound unit at Hillel Yaffe Medical Center within 10 days before onset of induced or spontaneous labors. The ultrasound team has been trained in FHC , Estimated Fetal Weight (EFW) and Biparietal Diameter (BPD) measurement .Optimal ultrasound measurements of FHC and BPD will be obtained. The average of 3 fetal head circumference measurements will be recorded. Investigators consider the FHC and BPD to be optimal when a clear outline of the entire fetal skull is measured, and the landmarks (the thalamus, cavum septum pellucidum and choroid plexus in the atrium of the lateral ventricles) are visualized. Subsequent information of labor outcome as well as normal head circumference ,post-delivery will be obtained from maternal and neonatal medical records.

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What researchers measure

Primary outcomes

  1. The rate of "operative delivery" including instrumental deliveries or cesarean sections.

    Time frame: 1 year

Secondary outcomes

  1. Length (in hours) of the first and second stages of labor.

    Time frame: 1 year

  2. Rate of obstetric anal sphincter injury.

    Time frame: 1 year

  3. Rate of early postpartum hemorrhage (PPH).

    Time frame: 1 year

  4. Rate of neonatal trauma.

    Time frame: 1 year

  5. Rate of admission to the neonatal intensive care unit.

    Time frame: 1 year

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Study locations

1 of 1 sites recruiting
  • Department of Obstetrics and Gynecology, Hillel-Yaffe Medical Center
    Hadera, 38100, Israel
    • Ofer Limonad, M.D · Contact · oferlimonad@gmail.com · 00-972-52-5322972
    • Ofer Limonad, M.D · Principal investigator
    • Alon Scrim, M.D · Principal investigator
    Recruiting
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References and documents

Publications

  • ACOG Practice Bulletin No. 154: Operative Vaginal Delivery. Obstet Gynecol. 2015 Nov;126(5):e56-e65. doi: 10.1097/AOG.0000000000001147. No abstract available. PubMed 26488523 ↗
  • Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet. 2001 Oct 13;358(9289):1203-7. doi: 10.1016/S0140-6736(01)06341-3. PubMed 11675055 ↗
  • Maharaj D. Assessing cephalopelvic disproportion: back to the basics. Obstet Gynecol Surv. 2010 Jun;65(6):387-95. doi: 10.1097/OGX.0b013e3181ecdf0c. PubMed 20633305 ↗
  • Lenhard MS, Johnson TR, Weckbach S, Nikolaou K, Friese K, Hasbargen U. Pelvimetry revisited: analyzing cephalopelvic disproportion. Eur J Radiol. 2010 Jun;74(3):e107-11. doi: 10.1016/j.ejrad.2009.04.042. Epub 2009 May 13. PubMed 19443160 ↗
  • Peregrine E, O'Brien P, Jauniaux E. Clinical and ultrasound estimation of birth weight prior to induction of labor at term. Ultrasound Obstet Gynecol. 2007 Mar;29(3):304-9. doi: 10.1002/uog.3949. PubMed 17290365 ↗
  • Irion O, Boulvain M. Induction of labour for suspected fetal macrosomia. Cochrane Database Syst Rev. 2000;(2):CD000938. doi: 10.1002/14651858.CD000938. PubMed 10796221 ↗
  • Elvander C, Hogberg U, Ekeus C. The influence of fetal head circumference on labor outcome: a population-based register study. Acta Obstet Gynecol Scand. 2012 Apr;91(4):470-5. doi: 10.1111/j.1600-0412.2012.01358.x. Epub 2012 Feb 28. PubMed 22229662 ↗
  • Mujugira A, Osoti A, Deya R, Hawes SE, Phipps AI. Fetal head circumference, operative delivery, and fetal outcomes: a multi-ethnic population-based cohort study. BMC Pregnancy Childbirth. 2013 May 7;13:106. doi: 10.1186/1471-2393-13-106. PubMed 23651454 ↗
  • Verburg BO, Steegers EA, De Ridder M, Snijders RJ, Smith E, Hofman A, Moll HA, Jaddoe VW, Witteman JC. New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol. 2008 Apr;31(4):388-96. doi: 10.1002/uog.5225. PubMed 18348183 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 10, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02739503
Lead sponsor
Hillel Yaffe Medical Center
Responsible party
Sponsor
First posted
Apr 15, 2016
Start date
Apr 2016
Primary completion
Jun 2017 (estimated)
Completion
Jun 2017 (estimated)
Last update
Jan 10, 2017

Study contacts

Ofer Limonad, M.D
Contact
oferlimonad@gmail.com
Alon Shrim, M.D
Contact
alon.shrim@gmail.com
Ofer Limonad, M.D
principal investigator · Hillel Yaffe Medical Center

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Jan 2017. You cannot join it, but the record below documents what was studied.

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