Models of Meister et al for Vaginal Delivery-Associated Anal Sphincter Injury: Anal Sphincter Injury in Nulliparous Mother

Description

Meister et al developed several models for predicting risk of perineal complications for women having a vaginal delivery. These models can help to identify a patient at increased risk for a laceration or anal sphincter injury. The authors are from Washington University in St. Louis.

Patient selection: woman delivering vaginally, nulliparous

Outcomes: anal sphincter injury

Parameters:

(1) race

(2) operative assistance to vaginal delivery

(3) fetal body weight in grams

(4) duration of pushing in minutes

(5) tobacco use

(6) maternal age

Parameter	Finding	Points
race	African American	-0.59
	other	0
operative delivery	yes	1.14
	no	0
fetal weight	< 3,500 g	0
	>= 3,500 g	0.19
duration of pushing	<= 60 minutes	0
	> 60 minutes	0.53
tobacco use	no	0
	yes	-1.13
age of the mother		0.04 * (age))

value of X =

= SUM(points for all 6 parameters) - 0.23

probability of anal sphincter injury =

= 1 / (1 + EXP((-1) * X))

Performance:

• The area under the ROC curve for anal sphincter injury is 0.77.

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Models of Meister et al for Vaginal Delivery-Associated Anal Sphincter Injury: Anal Sphincter Injury in Nulliparous Mother

Description

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