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% |
Specialty: Obstetrics & Gynecology
ICD-10: ,