Obstetrics & Gynaecology, Royal College of Surgeons in Ireland, Dublin, Ireland.
Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
BMC Pregnancy Childbirth. 2020 Jul 29;20(1):431. doi: 10.1186/s12884-020-03112-6.
The RECIPE study aims to validate a risk prediction model for intrapartum caesarean delivery which has been developed by our group. The Genesis study was a prospective observational study carried out by the Perinatal Ireland Research Consortium across 7 clinical centres in Ireland between October 2012 and June 2015. Genesis investigated a range of maternal and fetal parameters in a prospective blinded study of 2336 singleton pregnancies between 39 + 0-41 + 0 weeks' gestational age. This resulted in the development of a risk prediction model for Caesarean Delivery in nulliparous women at term. The RECIPE study now proposes to provide external validation of this risk prediction tool.
In order to externally validate the model, we aim to include a centre which was not involved in the original study. We propose a trial of risk-assignment for intrapartum caesarean amongst nulliparous women with a singleton pregnancy between 38 + 0 and 40 + 6 weeks' gestational age who are planning a vaginal birth. Results of the risk prediction tool will be concealed from participants and from midwives and doctors providing labour care.. Participants will be invited for an ultrasound scan and delivery details will be collated postnatally. The principal aim of this study is to externally validate the risk prediction model. This prediction model holds the potential to accurately identify nulliparous women who are likely to achieve an uncomplicated vaginal birth and those at high prospect of requiring an unplanned caesarean delivery.
Validation of the Genesis prediction model would enable more accurate counselling for women in the antenatal setting regarding their own likelihood of requiring an intrapartum Caesarean section. It would also provide valuable personalised information to women about the anticipated course of their own labour. We believe that this is an issue of national relevance that will impact positively on obstetric practice, and will positively empower women to make considered, personalised choices surrounding labour and delivery.
RECPIE 研究旨在验证我们小组开发的用于预测分娩时剖宫产的风险预测模型。Genesis 研究是由爱尔兰围产期研究联盟在爱尔兰的 7 个临床中心进行的一项前瞻性观察研究，研究时间为 2012 年 10 月至 2015 年 6 月。Genesis 研究对 2336 例孕龄为 39+0-41+0 周的单胎妊娠进行了前瞻性盲法研究，调查了一系列产妇和胎儿参数，由此开发了一种用于初产妇足月时剖宫产的风险预测模型。RECPIE 研究现在旨在提供该风险预测工具的外部验证。
为了对外验证该模型，我们旨在纳入一个未参与原始研究的中心。我们建议对计划阴道分娩的 38+0 至 40+6 周孕龄的初产妇进行剖宫产风险分配试验。将对产妇和提供分娩护理的助产士和医生隐瞒风险预测工具的结果。将邀请参与者进行超声扫描，并在产后收集分娩细节。本研究的主要目的是对外验证风险预测模型。该预测模型有可能准确识别那些可能顺利进行阴道分娩的初产妇，以及那些极有可能需要计划外剖宫产的产妇。
如果验证了 Genesis 预测模型，将能够更准确地为孕妇提供有关其自身需要进行剖宫产的可能性的咨询。它还将为女性提供有关其自身分娩过程预期的有价值的个性化信息。我们认为这是一个具有全国相关性的问题，将对产科实践产生积极影响，并将积极赋予女性围绕分娩做出深思熟虑、个性化选择的能力。
