Friday, January 27, 2017

Model developed to predict chances of vaginal delivery in nulliparous women undergoing induction of labor-- News from SMFM 2017, Las Vegas.

 

According to statistics by CDC, 23.3% of women in USA undergo induction of labor making it one of the most common obstetric procedure performed in US hospitals.

A study presented at the 37th  annual meeting of Society for Maternal-Fetal Medicine , January 23-28 , Las Vegas by Dr. Tetsuya Kawakita and his colleagues sought to  develop a model that could predict  the likelihood of successful induction of labor. [1]

The researchers used data from Consortium on Safe labor study, a retrospective multicenter study that extracted data on labor and delivery across 19 hospitals in United states. [2]

Of 12,413 nulliparous women at ≥37 weeks’ gestation who had labor undergone induction, 9,550 (76.9%) delivered vaginally.

The researchers studied the various demographic, obstetric and neonatal factors in these study group and by running stepwise logistic regression were able to identify factors associated with successful vaginal birth.

The maternal factors were maternal age, BMI, race, weeks at induction, gestational diabetes or prediabetes, cervical dilatation, effacement and consistency.  Fetal factors were station of fetal head, amount of liquor, IUGR and CTG at the beginning of the procedure. Taking all these factors into account a Nomogram was created, each maternal factor was allotted a fixed number of points. A maternal BMI of 70 received 8 points while a BMI of 20 received 95 points. Similarly, if maternal age at labor was 45 she received 4 points while 25 points were given if her age was 20.

The total points were calculated with a maximum of 317 points. The higher the number of points the patient received, the probability of vaginal delivery also increased.  


Adapted from SMFM 2017 abstracts 










[1] http://www.ajog.org/article/S0002-9378(16)31917-2/fulltext
[2] https://www.nichd.nih.gov/about/org/diphr/eb/research/Pages/safe-labor.aspx

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