Phaloprakarn and Tangjutgamol reported a score for predicting the risk of primary cesarean delivery for a woman with gestational diabetes. The authors are from Vajira Hospital and Navamindradhiraj University in Bangkok, Thailand.
Patient selection: woman with gestational diabetes, no history of cesarean delivery
Exclusion criteria included "multiple pregnancies" such as twins, triplets, etc.
Outcome: primary cesarean delivery (CD)
Parameters:
(1) parity
(2) gestational weight gain versus Institute of Medicine (IOM) recommendations
(3) insulin use
Parameter
Finding
Points
parity
nulliparity
3
multiparity
0
weight gain
above recommendation
1
at or below
0
insulin use
no
0
yes
2
where:
• Nulliparity indicates no previous pregnancy. Multiparity is multiple previous pregnancies. Primiparity is not covered. Primiparity will be scored with multiparity.
• History of a previous cesarean delivery not included since primary.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of cesarean delivery.
Total Score
Risk Group
Rate Primary CD
0
low risk
15%
1 to 3
intermediate risk
38%
4 to 6
high risk
62%
Performance:
• The area under the ROC curve is 0.72.
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