World Health Matters: Ireland: Study predicts risk of Caesarean delivery

by Gary Finnegan: Researchers have developed a new scoring system that rates women’s risk of Caesarean section. The study combines a range of indicators to help maternity hospitals better manage patients and resources, and to prepare pregnant women for the possibility of surgery.

The multi-centre study focused on women having their first child and incorporated demographic, clinical and ultrasound data to develop a predictive tool for Caesarean delivery (CD) in singleton pregnancies.

Predicting which women will experience the greatest of difficulties during labour is an ongoing challenge for maternity units, posing medical and management challenges.

During the study, a detailed clinical evaluation and ultrasound assessment were performed after 39 weeks’ gestation. Women and their managing clinicians were blinded to the ultrasound-derived foetal biometry.

Of 2,336 women recruited to the Genesis Study, 491 (21%) had an unplanned CD. The five parameters determined to be the best combined predictors of CD were advancing maternal age, short maternal height, higher body mass index, a larger foetal abdominal circumference and increasing foetal head circumference.

The study’s conclusion was that, by using these five factors, overall risk of CD in nulliparous women at term can be better determined.

“We developed a simple risk scoring system for Caesarean delivery in first time mothers,” said Dr Naomi Burke of the Royal College of Surgeons in Ireland, who led the Genesis Study stated. “We hope this will aid women and obstetricians with decisions about labour and delivery.”

Professor Fergal Malone, chairman of the Perinatal Ireland Research Consortium commented said the “risk assessment tool may be useful for planning service needs as well as for individual patient’s decisions on place and mode of delivery”.