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Building a Prediction Model for Vacuum-Assisted Operative Vaginal Delivery Risk
Arrigo Fruscalzo1, Ambrogio Pietro Londero, Angelo Calcagno
1Clinic of Obstetrics and Gynecology, St. Franziskus Hospital, Mx00FC;nster, Germany.
Aim:
The objective of this study was to evaluate the risk factors for operative vaginal delivery and to propose a new nomogram for predicting the risk.
Methods:
We retrospectively analyzed the data of 1,955 pregnancies that occurred in our clinic between the years 2007 and 2008. Included were singleton pregnancies with labor diagnosis after the 36th gestational week in which spontaneous or operative vaginal deliveries occurred. In this study, the operative delivery was carried out exclusively by vacuum extraction.
Results:
After univariate analysis and multivariate logistic regression stepwise model selection, maternal age, nulliparity, medically assisted procreation, gestational age at birth, male fetus, epidural analgesia and medical induction of labor were found to be the most predictive variables for operative vaginal delivery. Considering these factors we propose a new nomogram for an objectified determination of the risk of operative vaginal delivery.
Conclusions:
The new nomogram we propose could be an important tool for an objectified determination of the risk of operative vaginal delivery by vacuum extraction in individualized patient counseling.
