Performance of the Vaginal Touch in the Diagnosis of Vertex Presentation in Posterior Variety

Objective: To evaluate the performance of the vaginal touch in the diagnosis of vertex presentation in posterior variety. Materials Populations and Methods: Transversal analytical study conducted during 4 months (November 2017 - February 2018) at the University Hospital of Brazzaville. This study included parturients with a living foetus in term and in vertex presentation.？ The membranes were broken with less than 6 cm of vaginal dilatation. In each case the ultrasound was associated to verify the accuracy of the results of vaginal examination. The statistical tests used were: sensitivity, specificity, positive and negative predictive values, and Youden’s index. Results: One hundred and twenty-two vertex presentations were recorded, of which 31 (25.4%) had a posterior variety diagnosed successively with vaginal examination and ultrasound, while 23 (42.6%) were only on ultrasound. Parturients with foetuses in the posterior and anterior variety were similar in median age (30 [25.5 - 33.5] vs 27.5 [24 - 34], p > 0.05) and parity (2 [1.5 - 3.5] vs 2 [1 - 3], p > 0.05). Vaginal touch had: sensitivity of 57.4% [44.4 - 70.4], specificity of 94.1% [86.7 - 99.3], and Youden’s index of 0.52. The positive and negative predictive values were respectively 88.5% and 73.5%. The vaginal examination was influenced by: examiner (OR = 2.7 [1.21 - 6.07]; p < 0.05), sero-sanguine hump (OR = 7.5 [2.38 - 23.77]; p < 0.05), and BMI > 25 kg/m2 (OR = 3.4 [1.07 - 11.07], p < 0.05). Conclusion: The vaginal touch is not very effective in the diagnosis of the vertex presentation in posterior variety.