Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study
Abstract Background When a pregnant woman experiences unusual circumstances during a vaginal delivery, an unplanned cesarean section may be necessary to save her life. It requires knowledge and quick assessment of the risky situation to decide to perform an unplanned cesarean section, which only occ...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-06308-2 |
| _version_ | 1797272817783275520 |
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| author | Bezawit Melak Fente Mengstu Melkamu Asaye Temesgen Worku Gudayu Muhabaw Shumye Mihret Getayeneh Antehunegn Tesema |
| author_facet | Bezawit Melak Fente Mengstu Melkamu Asaye Temesgen Worku Gudayu Muhabaw Shumye Mihret Getayeneh Antehunegn Tesema |
| author_sort | Bezawit Melak Fente |
| collection | DOAJ |
| description | Abstract Background When a pregnant woman experiences unusual circumstances during a vaginal delivery, an unplanned cesarean section may be necessary to save her life. It requires knowledge and quick assessment of the risky situation to decide to perform an unplanned cesarean section, which only occurs in specific obstetric situations. This study aimed to develop and validate a risk prediction model for unplanned cesarean sections among laboring women in Ethiopia. Method A retrospective follow-up study was conducted. The data were extracted using a structured checklist. Analysis was done using STATA version 14 and R version 4.2.2 software. Logistic regression was fitted to determine predictors of unplanned cesarean sections. Significant variables were then used to develop a risk prediction model. Performance was assessed using Area Under the Receiver Operating Curve (AUROC) and calibration plot. Internal validation was performed using the bootstrap technique. The clinical benefit of the model was assessed using decision curve analysis. Result A total of 1,000 laboring women participated in this study; 28.5% were delivered by unplanned cesarean section. Parity, amniotic fluid status, gestational age, prolonged labor, the onset of labor, amount of amniotic fluid, previous mode of delivery, and abruption remained in the reduced multivariable logistic regression and were used to develop a prediction risk score with a total score of 9. The AUROC was 0.82. The optimal cut-off point for risk categorization as low and high was 6, with a sensitivity (85.2%), specificity (90.1%), and accuracy (73.9%). After internal validation, the optimism coefficient was 0.0089. The model was found to have clinical benefits. Conclusion To objectively measure the risk of an unplanned Caesarean section, a risk score model based on measurable maternal and fetal attributes has been developed. The score is simple, easy to use, and repeatable in clinical practice. |
| first_indexed | 2024-03-07T14:35:49Z |
| format | Article |
| id | doaj.art-518f9ea3cf784df584bc6a77a5727041 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-07T14:35:49Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-518f9ea3cf784df584bc6a77a57270412024-03-05T20:39:59ZengBMCBMC Pregnancy and Childbirth1471-23932024-02-012411910.1186/s12884-024-06308-2Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort studyBezawit Melak Fente0Mengstu Melkamu Asaye1Temesgen Worku Gudayu2Muhabaw Shumye Mihret3Getayeneh Antehunegn Tesema4Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of GondarDepartment of Women’s and Family Health, School of Midwifery, College of Medicine & Health Sciences, University of GondarDepartment of Clinical Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of GondarDepartment of Clinical Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarAbstract Background When a pregnant woman experiences unusual circumstances during a vaginal delivery, an unplanned cesarean section may be necessary to save her life. It requires knowledge and quick assessment of the risky situation to decide to perform an unplanned cesarean section, which only occurs in specific obstetric situations. This study aimed to develop and validate a risk prediction model for unplanned cesarean sections among laboring women in Ethiopia. Method A retrospective follow-up study was conducted. The data were extracted using a structured checklist. Analysis was done using STATA version 14 and R version 4.2.2 software. Logistic regression was fitted to determine predictors of unplanned cesarean sections. Significant variables were then used to develop a risk prediction model. Performance was assessed using Area Under the Receiver Operating Curve (AUROC) and calibration plot. Internal validation was performed using the bootstrap technique. The clinical benefit of the model was assessed using decision curve analysis. Result A total of 1,000 laboring women participated in this study; 28.5% were delivered by unplanned cesarean section. Parity, amniotic fluid status, gestational age, prolonged labor, the onset of labor, amount of amniotic fluid, previous mode of delivery, and abruption remained in the reduced multivariable logistic regression and were used to develop a prediction risk score with a total score of 9. The AUROC was 0.82. The optimal cut-off point for risk categorization as low and high was 6, with a sensitivity (85.2%), specificity (90.1%), and accuracy (73.9%). After internal validation, the optimism coefficient was 0.0089. The model was found to have clinical benefits. Conclusion To objectively measure the risk of an unplanned Caesarean section, a risk score model based on measurable maternal and fetal attributes has been developed. The score is simple, easy to use, and repeatable in clinical practice.https://doi.org/10.1186/s12884-024-06308-2Unplanned cesarean sectionPrediction modelEthiopia |
| spellingShingle | Bezawit Melak Fente Mengstu Melkamu Asaye Temesgen Worku Gudayu Muhabaw Shumye Mihret Getayeneh Antehunegn Tesema Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study BMC Pregnancy and Childbirth Unplanned cesarean section Prediction model Ethiopia |
| title | Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study |
| title_full | Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study |
| title_fullStr | Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study |
| title_full_unstemmed | Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study |
| title_short | Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study |
| title_sort | prediction of unplanned cesarean section using measurable maternal and fetal characteristics ethiopia a retrospective cohort study |
| topic | Unplanned cesarean section Prediction model Ethiopia |
| url | https://doi.org/10.1186/s12884-024-06308-2 |
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