A new study shows that a widely available cesarean prediction tool accurately predicts delivery outcomes and highlights maternal risks, helping patients and providers make better-informed choices about induction.
Study: External validation of calculator for cesarean delivery during induction of labor. Image credit: Tatiana Diuvbanova/Shutterstock.com
A team of US-based researchers externally validated a risk calculator that predicts the probability of cesarean delivery during labor induction. The findings,published in the International Journal of Gynecology and Obstetrics,reveal that the calculator works satisfactorily in predicting cesarean delivery risk and maternal adverse outcomes.
Background
The rate of labor induction,which is primarily carried out to achieve safe vaginal delivery,has increased significantly in recent times. The probability of cesarean delivery during induction varies between 9% and 59%.
Various predictive models have been developed to calculate the risk of cesarean delivery for women undergoing induction. Thes models are expected to facilitate clinical decision-making about induction and predict the risk of adverse pregnancy outcomes.However, only a few of these models have been validated in an external population or linked with adverse outcomes.
In the current study, researchers validated the predictive capacity of a published risk calculator developed by Rossi and colleagues in the U.S.
Study design
The study population included a total of 548 women with singleton pregnancy (pregnancy involving a single baby) who were undergoing labor induction at 32 weeks or more of pregnancy.
The risk calculator under examination was used to calculate cesarean delivery risk scores for each participant, which were categorized as less than 10%, 10% to less than 30%, and 30% or greater.These scores were used to predict the probability of cesarean delivery during induction and its association with maternal and neonatal adverse outcomes.
Key findings
Among 548 pregnant women who underwent labor induction, 29% had a cesarean delivery and 71% had a vaginal delivery.
The external validation of the risk calculator in the study population revealed that the calculator’s risk prediction is equivalent to the observed events of cesarean delivery, indicating a good discriminative efficacy. Specifically, the area under the receiver operating characteristic curve (AUC) was 0.77, demonstrating good predictive performance, and calibration results showed