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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 3

Category: Intrapartum Fetal Assessment

Poster Session 3

(743) Clinical Implications and Risk Factors of Increased Caput Succedaneum During Second Stage of Labor

Thursday, February 12, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Bar Narkis, MD, MPH (she/her/hers)

    Resident
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

    • Coauthor(s)

  • YG

    Yossi Geron, MD

    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

  • GZ

    Gil Zeevi, MD

    Dr
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

  • Yinon Gilboa, MD

    Professor
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

  • Miriam Lopian, MD

    Senior Doctor
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

  • Or Lee Rak, MD (she/her/hers)

    Senior Resident in Obstetrics and Gynecology
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

  • AR

    Asaf Romano, MD (he/him/his)

    OBGYN attending
    Helen Schneider Hospital for Women, Rabin Medical Center
    Petah Tikva, HaMerkaz, Israel

Objective:
Caput succedaneum (CapS) is a common finding during labor, yet remains understudied as a diagnostic and prognostic marker of labor dystocia. We sought to determine risk factors for large CapS and assess its association with maternal and neonatal morbidity using a novel sonographic measurement technique.

Study Design:
This single-center prospective cohort study included 121 women in the second stage of labor who underwent transperineal ultrasound. CapS was measured in three dimensions (figure 1), with the Z-axis (depth) chosen for analysis. Large CapS was defined as >2.5 cm. Maternal, fetal, and labor characteristics were collected. Head perineal distance (HPD), angle of progression (AoP), and fetal head position (OA, OP, OT) were also measured. Outcomes included mode of delivery, a composite neonatal morbidity index (Apgar < 7 at 5 minutes, umbilical artery pH < 7.1, NICU admission, or neonatal injury), and composite maternal morbidity.

Results:
Large CapS (n=28) was associated with prolonged second stage ( >3 hours, OR 4.81, p< 0.01), shorter HPD (3.1±1.0 vs. 3.9±1.1 cm, OR 1.91, p< 0.01), and narrower AoP (138° vs. 145°, OR 0.94, p=0.04). Fetal malposition was more frequent (non-OA vs. OA: OR 3.25, 95% CI 1.28–8.25, p=0.01). Rates of operative vaginal delivery (vacuum extraction: 64.3% vs. 35.5%, OR 4.91, p< 0.01) and cesarean section (14.3% vs. 6.5%, OR 6.00, p=0.02) were both increased in the large CapS group. Composite neonatal morbidity was higher in the large CapS group (39.3% vs. 18.3%, OR 2.89, p=0.02). No significant difference was found in maternal morbidity.

Conclusion:
A Z-axis CapS >2.5 cm is associated with prolonged labor, fetal malposition, increased neonatal complications, and higher rates of both vacuum-assisted and cesarean deliveries. Ultrasound-based CapS assessment may offer a valuable, underutilized tool for identifying labor dystocia and guiding timely obstetric decision-making.