Decision Tree Model of Sims et al for Predicting a Cesarean Section in a Nulliparous Woman in Labor

Description

Sims et al used decision tree analysis to predict the probability of a cesarean section being performed in a nulliparous woman in labor. This can help triage the woman for a trial of labor. The authors are from the University of Pittsburgh, Carnegie Mellon University, University of California Los Angeles and Siemens Corporate Research Inc.

Study group: 22,157 women with live-born singleton pregnancies from 1995 to 1997

Parameters:

(1) fetal presentation

(2) fetal distress

(3) placental abruption

(4) chorioamnionitis

(5) mother's age

(6) fetal growth

(7) maternal hypertension

Explanation:

(1) The first and second tables were initially one table that was split to simplify placement.

(2) Each terminal cell represents a terminal cell in the decision tree, proceeding from right to left.

Fetal Presentation	Fetal Distress	Placental Abruption	Chorio-Amnionitis	Terminal Cell
abnormal lie				1
breech				2
vertex	Y	Y		3
vertex	Y	N	Y	4
vertex	Y	N	N	5
vertex	N			6
vertex	N			7
vertex	N			8
vertex	N			9
vertex	N			10
vertex	N			11
vertex	N			12
vertex	N			13
vertex	N			14
vertex	N		Y	15
vertex	N		N	16
vertex	N			17
vertex	N			18
vertex	N			19

Mother's Age	Fetal Growth	Maternal Blood Pressure	Terminal Cell
			1
			2
			3
			4
			5
>34			6
30-34			7
25-29	IUGR		8
25-29	macro		9
25-29	normal	pre-eclampsia	10
25-29	normal	transient	11
25-29	normal	normal	12
20-24	IUGR		13
20-24	macro		14
20-24	normal		15
20-24	normal		16
12-19	IUGR		17
12-19	macro		18
12-19	normal		19

Terminal Cell	Percent Of Group With Cesarean Delivery
1	79%
2	91%
3	76%
4	46%
5	22%
6	4%
7	10%
8	2%
9	28%
10	24%
11	14%
12	6%
13	9%
14	43%
15	30%
16	10%
17	32%
18	66%
19	16%

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Description

Specialty

ICD-10

Terminal Cell	Percent Of Group With Cesarean Delivery
1	79%
2	91%
3	76%
4	46%
5	22%
6	4%
7	10%
8	2%
9	28%
10	24%
11	14%
12	6%
13	9%
14	43%
15	30%
16	10%
17	32%
18	66%
19	16%

Terminal Cell	Percent Of Group With Cesarean Delivery
1	79%
2	91%
3	76%
4	46%
5	22%
6	4%
7	10%
8	2%
9	28%
10	24%
11	14%
12	6%
13	9%
14	43%
15	30%
16	10%
17	32%
18	66%
19	16%

Terminal Cell	Percent Of Group With Cesarean Delivery
1	79%
2	91%
3	76%
4	46%
5	22%
6	4%
7	10%
8	2%
9	28%
10	24%
11	14%
12	6%
13	9%
14	43%
15	30%
16	10%
17	32%
18	66%
19	16%