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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

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals, NHS Trust, Apley Castle, Grainger Drive, Telford, TF16TF, UK

    Dimitrios Papoutsis, Adam Gornall & Michelle Mohajer

  2. Department of Midwifery, Midwifery School, ‘Alexander’ Technological Educational Institute of Thessaloniki, Thessaloniki, Greece

    Angeliki Antonakou

  3. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece

    Chara Tzavara

Authors
  1. Dimitrios Papoutsis
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  2. Angeliki Antonakou
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  3. Adam Gornall
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  4. Chara Tzavara
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  5. Michelle Mohajer
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Corresponding author

Correspondence to Dimitrios Papoutsis.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Our study was a retrospective study, and for this type of study formal consent is not required.

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Papoutsis, D., Antonakou, A., Gornall, A. et al. 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. Arch Gynecol Obstet 295, 59–66 (2017). https://doi.org/10.1007/s00404-016-4209-4

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  • DOI: https://doi.org/10.1007/s00404-016-4209-4

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