(125) Caput Succedaneum Sonographic Evaluation Prior to Vacuum Extraction Delivery: A Pilot Study

The presence of caput succedaneum (CapS) is associated with failure of vacuum extraction (VE) vaginal delivery. Our Aim was to explore to correlation between CapS sonographic evaluation and VE labor outcome. Correlation between clinical and sonographic CapS evaluation was also evaluated.

Study Design:

Prospective observational study. Twenty-five primiparas, at term, were recruited between January 1, 2021, and December 20, 2021, in a single tertiary university affiliated medical center. The study protocol was approved by the Rabin Medical Center Institutional Review Board. Sonographic evaluation of CapS was performed during the second stage of labor, immediately prior vacuum extraction. Maternal and neonatal outcomes were recorded, as well as vacuum procedure parameters. CapS sonographic evaluation was done in a novel technique, using 3-dimension measurements: a perpendicular line from the tip of the CapS and the skull (Z), and the maximal distance between the CapS in the horizontal (X) and vertical planes (Y) and the base of CapS, as depicted in Figure 1.

Results:

There were no significant correlations between CapS measurements and maternal or neonatal adverse outcomes. Large CapS measurements were substantially correlated with VE duration (p value = 0.054). No failed VE were recorded. Clinical and sonographic CapS measurements are well correlated. Larger CapS dimensions were substantially correlated with a narrow pubic arch angle and a longer second stage of labor (p value = 0.08 and 0.09 respectively).   

Conclusion:

CapS sonographic size was not correlated with maternal or neonatal outcomes, despite its known association with VE failure. CapS sonographic measurements did substantially correlate with the duration of VE and the duration of the second stage. Further larger cohort may be powered to demonstrate a correlation with neonatal and maternal outcomes.