International Journal of Women's Health (Aug 2023)

Prediction of Emergency Cesarean Section Using Detectable Maternal and Fetal Characteristics Among Saudi Women

  • Wahabi H,
  • Fayed A,
  • Elmorshedy H,
  • Esmaeil SA,
  • Amer YS,
  • Saeed E,
  • Jamal A,
  • Aleban SA,
  • Aldawish RA,
  • Alyahiwi LS,
  • Abdullah Alnafisah H,
  • AlSubki RE,
  • Albahli NK,
  • Almutairi AA

Journal volume & issue
Vol. Volume 15
pp. 1283 – 1293

Abstract

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Hayfaa Wahabi,1,2 Amel Fayed,3 Hala Elmorshedy,3 Samia Ahmad Esmaeil,1,2 Yasser S Amer,1,4 Elshazaly Saeed,5 Amr Jamal,1,2 Sarah A Aleban,3 Reema Abdullah Aldawish,3 Lara Sabri Alyahiwi,3 Haya Abdullah Alnafisah,3 Raghad E AlSubki,3 Norah khalid Albahli,3 Aljohara Ayed Almutairi3 1Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University Medical City and College of Medicine, Riyadh, Saudi Arabia; 3Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 4Clinical Practice Guidelines Unit, Quality Management Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia; 5Prince Abdulla bin Khaled Coeliac Disease Research Chair, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Amel Fayed, Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box: 84428, Riyadh, 11671, Saudi Arabia, Tel + (966) 5943 95059, Email [email protected]: The worldwide rate of cesarean section (CS) is increasing. Development of prediction models for a specific population may improve the unmet need for CS as well as reduce the overuse of CS.Objective: To explore risk factors associated with emergency CS, and to determine the accuracy of predicting it.Methods: A retrospective analysis of the medical records of women who delivered between January 1, 2021-December 2022 was conducted, relevant maternal and neonatal data were retrieved.Results: Out of 1793 deliveries, 447 (25.0%) had emergency CS. Compared to control, the risk of emergency CS was higher in primiparous women (OR 2.13, 95% CI 1.48 to 3.06), in women with higher Body mass index (BMI) (OR 1.77, 95% CI 1.27 to 2.47), in association with history of previous CS (OR 4.81, 95% CI 3.24 to 7.15) and in women with abnormal amniotic fluid (OR 2.30, 95% CI 1.55 to 3.41). Additionally, women with hypertensive disorders had a 176% increased risk of emergency CS (OR 2.76, 95% CI 1.35– 5.63). Of note, the risk of emergency CS was more than three times higher in women who delivered a small for gestational age infant (OR 3.29, 95% CI 1.93– 5.59). Based on the number of risk factors, a prediction model was developed, about 80% of pregnant women in the emergency CS group scored higher grades compared to control group. The area under the curve was 0.72, indicating a good discriminant ability of the model.Conclusion: This study identified several risk factors associated with emergency CS in pregnant Saudi women. A prediction model showed 72% accuracy in predicting the likelihood of emergency CS. This information can be useful to individualize the risk of emergency CS, and to implement appropriate measures to prevent unnecessary CS.Keywords: emergency cesarean section, indications, prediction, Saudi Arabia

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