Validation of Risk Scoring Scheme for Cesarean Delivery due to Cephalopelvic Disproportion in Lamphun Hospital
Suthit Khunpradit MD*, Jayanton Patumanond MD**, Chamaiporn Tawichasri MD**
Affiliation : * Department of Obstetrics & Gynecology, Lamphun Hospital, Lamphun ** Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To validate the risk scoring scheme for cesarean delivery due to cephalopelvic disproportion in
Lamphun Hospital.
Materials and Methods : A case-control study was conducted between January 1st, 2005 and April 30th, 2006,
including, prospectively collected, 132 women who had cesarean delivery due to cephalopelvic dispropor-
tion (CPD) as cases and 394 women who delivered by normal labor as controls. Cases and controls were
evaluated for risk scores, the scoring scheme of which had previously been developed. The prediction by the
risk score was tested with an area under the receiver operating characteristic (ROC) curve of a logistic
regression. Another independent set of obstetric cases referred form community hospitals in Lamphun were
also evaluated for the risk scores.
Results : The risk scores explained 84.5% of the probability of CPD as demonstrated by the area under the
ROC curve. The scores of pregnant women referred from rural hospital underwent cesarean delivery were
higher than those with vacuum extraction and with normal delivery (mean = 9.2 + 2.4, 7.5 + 3.2 and 6.4 + 2.3
respectively). The score of cesarean delivery was significantly higher than normal delivery (p < 0.001) while
the score of vacuum extraction was in between and only slightly higher. (p = 0.116)
Conclusion : Risk scores obtained form this scoring scheme predicted cesarean delivery with high precision.
The scores also discriminated cesarean deliveries from normal deliveries among cases referred from commu-
nity hospitals. Community hospitals may gain benefit by adopting this simple scoring scheme into their
practices.
Keywords : Cephalopelvic disproportion, Cesarean section, Risk factors, Risk assessment, Pregnancy
