[Cesarean section risk assessment for pregnant women at term].

BACKGROUND

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.

OBJECTIVE

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.

MATERIAL AND METHODS

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.

RESULTS

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%.

CONCLUSION

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.