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ORIGINAL RESEARCH article

Front. Med.
Sec. Obstetrics and Gynecology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1430815
This article is part of the Research Topic Maternal-Fetal Interface Formation and Pregnancy Outcome View all 9 articles

The value of ultrasonographic factors in predicting cesarean following induction

Provisionally accepted
Guangpu Liu Guangpu Liu 1Fan C. Zhou Fan C. Zhou 2*Zhifen Yang Zhifen Yang 3*Jingya Zhang Jingya Zhang 3*
  • 1 Department of Obstetrics, Hebei Cancer Clinical Medical Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
  • 2 Department of neurology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China
  • 3 Department of Obstetrics, Fourth Hospital of Hebei Medical University, Shijiazhuang, China

The final, formatted version of the article will be published soon.

    This study aimed to develop and validate a prediction model of cesarean following induction of labor (IOL). A nomogram for the prediction of cesarean following IOL for singleton, cephalic term deliveries was created by comparing combinations of ultrasonographic and nonultrasonographic factors in a retrospective manner using patient data collected from a Chinese hospital between July, 2017 and December, 2023. Model discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and a calibration curve.Subsequently, decision curve analysis (DCA) was conducted to pinpoint the optimal probability threshold for the predictive model to exhibit practical significance for clinical decision-making. A total of 738 women were included. The inclusion of ultrasound factors yielded a higher AUC when combined with nonultrasonographic factors. Of the three ultrasonographic factors analyzed, the most predictive factor for cesarean following IOL was fetal head circumference. After generating a nomogram with eight validated factors, including maternal age, gestational age, height, prior caesarean delivery, previous vaginal delivery, modified Bishop score, body mass index at delivery, and fetal head circumference by ultrasound, the trained and validated AUC values were 0.826 (95% confidence interval 0.786-0.867) and 0.883 (95% confidence interval 0.839-0.926), respectively. Decision curve analysis indicated that the model provided net benefits of between 0% and 80% of the probability threshold, indicating the benefits of using the model to make decisions concerning patients who fall within the identified range of the probability threshold.Our nomogram based on obstetric factors and fetal head circumference as obtained by ultrasound could be used to help counsel women who are considering IOL.The model demonstrates favorable net benefits within a probability threshold range of 0 to 80%.

    Keywords: Trial of Labor, Weight Gain, Caesarean Section, Body Mass Index, pregnancy Fetal head circumference, cesarean following induction, ultrasound, Induction of labor

    Received: 10 May 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Liu, Zhou, Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Fan C. Zhou, Department of neurology, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China
    Zhifen Yang, Department of Obstetrics, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
    Jingya Zhang, Department of Obstetrics, Fourth Hospital of Hebei Medical University, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.