Molina-Pérez Carlos José, Berumen-Lechuga María Guadalupe, Leaños-Miranda Alfredo
Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad Hospital de Gineco Obstetricia No. 4 "Luís Castelazo Ayala", Unidad de Investigación en Medicina Reproductiva. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Regional México Poniente, Coordinación Auxiliar Médica de Investigación en Salud. Toluca, Estado de México, México.
Rev Med Inst Mex Seguro Soc. 2025 Mar 3;63(2):e6357. doi: 10.5281/zenodo.14616915.
Every year, approximately 140 million births occur, with the majority being spontaneous deliveries in women without risk factors, resulting in vaginal births of healthy newborns.
To develop a prognostic score to predict the probability of cesarean section in pregnant women at term with a single live fetus presenting with initial labor at hospital admission.
Through a case-control study, pregnant women at term with initial labor at hospital admission were included. Cases were women with labor that culminated in an emergency cesarean section and controls were women who had a normal vaginal delivery. Clinical history was questioned, and a complete physical examination was performed. The odds ratio (OR) and 95% confidence intervals were calculated.
Seventy women were included, 27 cases and 43 controls. There were differences between groups in maternal weight, obesity, primiparity, uterine activity, history of premature rupture of membranes (PROM), cervical dilatation and effacement (p < 0.05). Factors associated with the risk of cesarean delivery were maternal obesity, primiparity, PROM, dilatation < 6 cm, and effacement < 50% (OR ≥ 3.3). Score ≥ 3.5 on the proposed scale is associated with the risk of cesarean delivery with a sensitivity of 81.5% and a specificity of 79%.
Factors associated with the risk of cesarean delivery are maternal obesity, primiparity, and PROM. Score >4 points on the proposed scale is associated with the risk of cesarean delivery.
每年约有1.4亿例分娩，其中大多数是无危险因素女性的自然分娩，分娩出健康的新生儿。
制定一种预后评分，以预测单活胎足月孕妇入院初产时剖宫产的概率。
通过病例对照研究，纳入入院初产的足月孕妇。病例为最终行急诊剖宫产的产妇，对照为正常阴道分娩的产妇。询问临床病史并进行全面体格检查。计算比值比（OR）和95%置信区间。
纳入70名女性，27例病例和43例对照。两组在产妇体重、肥胖、初产、子宫活动、胎膜早破（PROM）病史、宫颈扩张和消退方面存在差异（p<0.05）。与剖宫产风险相关的因素为产妇肥胖、初产、PROM、扩张<6cm和消退<50%（OR≥3.3）。所提议量表评分≥3.5与剖宫产风险相关，敏感性为81.5%，特异性为79%。
与剖宫产风险相关的因素为产妇肥胖、初产和PROM。所提议量表评分>4分与剖宫产风险相关。
