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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2017

01-01-2017 | Maternal-Fetal Medicine

The SaTH risk-assessment tool for the prediction of emergency cesarean section in women having induction of labor for all indications: a large-cohort based study

Authors: Dimitrios Papoutsis, Angeliki Antonakou, Adam Gornall, Chara Tzavara, Michelle Mohajer

Published in: Archives of Gynecology and Obstetrics | Issue 1/2017

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Abstract

Purpose

To develop a risk-assessment model for the prediction of emergency cesarean section (CS) in women having induction of labor (IOL).

Methods

This was an observational cohort study of women with IOL for any indication between 2007 and 2013. Women induced for stillbirths and with multiple pregnancies were excluded. The primary objective was to identify risk factors associated with CS delivery and to construct a risk-prediction tool.

Results

6169 women were identified with mean age of 28.9 years. Primiparity involved 47.1 %, CS rate was 13.3 % and post-date pregnancies were 32.4 %. Risk factors for CS were: age >30 years, BMI >25 kg/m2, primiparity, black-ethnicity, non post-date pregnancy, meconium-stained liquor, epidural analgesia, and male fetal gender. Each factor was assigned a score and with increasing scores the CS rate increased. The CS rate was 5.4 % for a score <11, while for a score ≥11 it increased to 25.0 %. The model had a sensitivity, specificity, negative predictive value and positive predictive value of 75.8, 65.1, 93.8 and 25.0 %, respectively.

Conclusion

We have constructed a risk-prediction tool for CS delivery in women with IOL. The risk-assessment tool for the prediction of emergency CS in induced labor has a high negative-predictive value and can provide reassurance to presumed low-risk women.
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Metadata
Title
The SaTH risk-assessment tool for the prediction of emergency cesarean section in women having induction of labor for all indications: a large-cohort based study
Authors
Dimitrios Papoutsis
Angeliki Antonakou
Adam Gornall
Chara Tzavara
Michelle Mohajer
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4209-4

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