Risk Score for Prediction of Cesarean Delivery due to Cephalopelvic Disproportion in Bhumibol Adulyadej Hospital

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Date
2010-05-27
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Royal Thai Airforce Medical Gazette
Abstract
Objective : To identify the risk scoring system based on risk factors for the prediction of cesarean delivery due to cephalopelvic disproportion (CPD).Study Design : Case-controlled study.Setting : Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital.Subjects : 802 cases of pregnant women who delivered at Bhumibol Adulyadej Hospital between July 1, 2005 and May 31, 2007.Main outcomes : Risk scores for prediction of prediction of cesarean delivery due to CPD.Material and Methods : Risk factors were identified and analyzed by a stepwise logistic regression. Regression coefficients were transformed into item scores and added up to a total scroe. Risk of cesarean delivery due to CPD was analyzed as the predictor for low and high risk group.Results : A risk scoring system was developed includes maternal height, nulliparity, fundal height, pre-pregnancy BMI, BMI before delivery and birth weight. The total score from 0-11. The scoring system could be predicted 76.8 % of cesarean delivery due to CPD, by the area under the receiver operating characteristic (ROC) curve, the cutoff score is 3.25, could be predicted CPD with a sensitivity of 80 % and a specificity of 57 %. The likelihood of cesarean delivery due to CPD in pregnant women with low risk (scores \< 3.25) was 0.35 and high risk (scores \> 3.25) was 1.86.Conclusion : The risk of cesarean delivery due to CPD may be predicted by a scoring system that identified women with low and high risk. The cutoff score is 3.25 (sensitivity 80 %, specificity 57 %) and accuracy 76.8 %.
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Royal Thai Airforce Medical Gazette; Vol. 56 No.1 January-April 2010; 20-29