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A Scoring System for the Prediction of Successful Delivery in Low‐Risk Birthing Units

 

作者: DENISE KOONG,   SHARON EVANS,   CHERYL MAYES,   SUE McDONALD,   JOHN NEWNHAM,  

 

期刊: Obstetrics & Gynecology  (OVID Available online 1997)
卷期: Volume 89, issue 5, Part 1  

页码: 654-659

 

ISSN:0029-7844

 

年代: 1997

 

出版商: OVID

 

数据来源: OVID

 

摘要:

ObjectiveTo establish and test the effectiveness of a low-risk scoring system to predict obstetric outcome for the selection of women suitable for confinement in low-intervention units.MethodsRetrospective analyses were performed on data from 2900 women enrolled in the Western Australian Pregnancy Cohort Study and 1353 women managed at a midwifery-based birth center. A combination of the principal predictors of obstetric outcome, incorporating a previously published scoring system and various clinical features, was used to exclude high-risk cases at 18 weeks' and 36 weeks' gestation. Stepwise multivariate logistic regression analyses of the remaining pregnancies then produced a low-risk scoring system.ResultsThis system predicted a 55% chance of an uncomplicated delivery in a midwifery-based setting after allocating 54% of women to the low-risk category. It predicted an 82% chance of an uncomplicated delivery in a primary medical care setting with the allocation of 84% of women as low risk.ConclusionThe results of this study suggest that adding induction and augmentation of labor, together with low pelvic instrumental delivery, to the treatment options in a low-intervention unit would raise the rate of successful confinement within the unit from 55% to 82%. Our scoring system now requires prospective evaluation to further assess its clinical value.

 

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