OBJECTIVE: To investigate whether increased fetal adiposity diagnosed ultrasonographically is associated with labor dystocia, increased risk of operative delivery, and shoulder dystocia. DESIGN: Prospective case-control study. SETTING: Education and research hospital. POPULATION: 400 pregnant women between 37 and 41 weeks of gestation. METHODS: Correlation analyses, logistic regression analyses, and ROC analyses to evaluate soft tissue thickness in relation to labor dystocia, shoulder dystocia, and operative delivery. MAIN OUTCOME MEASURES: In addition to standard ultrasonographic measurements, we evaluated fetal soft tissue thickness in pregnant women who started labor. RESULTS: While the vaginal delivery rate was 77.3%, a cesarean was performed in 22.7% of pregnant women. We found positively correlated with the duration of the active phase and second stage of labor, birth weight of baby, and biometrical parameters. In addition, we examined and determined that the cesarean section, shoulder dystocia, and labor dystocia increased as the baby adipose tissue thickness increased. We investigated the effect of parameters on the results of the study with logistic regression analysis and possible threshold values with ROC analysis. CONCLUSION: In our study, evaluation of the fetal adipose tissue complex during delivery was significant in terms of labor dystocia and operative delivery. We think it may be a guide for future studies in the literature. Funding: This study was funded by AUTHORS Keywords: Labor, Labor dystocia, Fetal adipose tissue, Antepartum ultrasonography Tweetable Abstract: Fetal adipose tissue ultrasonographic measurement to be checked just before delivery may give clues about the progress of labor.