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Novillo-Del Álamo B, Martínez-Varea A, Satorres-Pérez E, Nieto-Tous M, Modrego-Pardo F, Padilla-Prieto C, García-Florenciano MV, Bello-Martínez de Velasco S, Morales-Roselló J. Prediction of Failure to Progress after Labor Induction: A Multivariable Model Using Pelvic Ultrasound and Clinical Data. J Pers Med 2024; 14:502. [PMID: 38793084 PMCID: PMC11122556 DOI: 10.3390/jpm14050502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/27/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Objective: Labor induction is one of the leading causes of obstetric admission. This study aimed to create a simple model for predicting failure to progress after labor induction using pelvic ultrasound and clinical data. Material and Methods: A group of 387 singleton pregnant women at term with unruptured amniotic membranes admitted for labor induction were included in an observational prospective study. Clinical and ultrasonographic variables were collected at admission prior to the onset of contractions, and labor data were collected after delivery. Multivariable logistic regression analysis was applied to create several models to predict cesarean section due to failure to progress. Afterward, the most accurate and reproducible model was selected according to the lowest Akaike Information Criteria (AIC) with a high area under the curve (AUC). Results: Plausible parameters for explaining failure to progress were initially obtained from univariable analysis. With them, several multivariable analyses were evaluated. Those parameters with the highest reproducibility included maternal age (p < 0.05), parity (p < 0.0001), fetal gender (p < 0.05), EFW centile (p < 0.01), cervical length (p < 0.01), and posterior occiput position (p < 0.001), but the angle of descent was disregarded. This model obtained an AIC of 318.3 and an AUC of 0.81 (95% CI 0.76-0.86, p < 0.0001) with detection rates of 24% and 37% for FPRs of 5% and 10%. Conclusions: A simplified clinical and sonographic model may guide the management of pregnancies undergoing labor induction, favoring individualized patient management.
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Affiliation(s)
- Blanca Novillo-Del Álamo
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - Alicia Martínez-Varea
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
- Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Department of Medicine, CEU Cardenal Herrera University, 12006 Castellón de la Plana, Spain
- Faculty of Health Sciences, Universidad Internacional de Valencia, 46002 Valencia, Spain
| | - Elena Satorres-Pérez
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - Mar Nieto-Tous
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - Fernando Modrego-Pardo
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - Carmen Padilla-Prieto
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - María Victoria García-Florenciano
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - Silvia Bello-Martínez de Velasco
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
| | - José Morales-Roselló
- Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (B.N.-D.Á.); (E.S.-P.); (M.N.-T.); (F.M.-P.); (C.P.-P.); (M.V.G.-F.); (S.B.-M.d.V.); (J.M.-R.)
- Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
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D'Souza R, Ashraf R, Foroutan F. Prediction models for determining the success of labour induction: A systematic review and critical analysis. Best Pract Res Clin Obstet Gynaecol 2021; 79:42-54. [DOI: 10.1016/j.bpobgyn.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 01/03/2023]
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