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A nomogram for Antenatal Estimation of Cephalopelvic Disproportion in Primiparous Women based on MRI Measurements
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  • Cheng Chen,
  • Mengmeng Yang,
  • Weizeng Zheng,
  • Yuan Chen,
  • tian dong,
  • Min Lv,
  • Xiaofu Yang,
  • Fangfang Xi,
  • Ying Jiang,
  • Xia Ying,
  • Wen Li,
  • Jian Xu,
  • baihui zhao,
  • Qiong Luo
Cheng Chen

Corresponding Author:[email protected]

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Mengmeng Yang
Women's Hospital School of Medicine Zhejiang University
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Weizeng Zheng
Women's Hospital, Zhejiang University School of Medicine
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Yuan Chen
Zhejiang University School of Medicine Women's Hospital
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tian dong
Zhejiang University
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Xiaofu Yang
Womens Hospital, Zhejiang University School of Medicine
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Fangfang Xi
Womens Hospital, Zhejiang University School of Medicine
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Ying Jiang
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Xia Ying
Womens Hospital, Zhejiang University School of Medicine
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Jian Xu
The Fourth Affiliated Hospital, Zhejiang University School of Medicine
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baihui zhao
Zhejiang University
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Qiong Luo
Womens Hospital, Zhejiang University School of Medicine
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Abstract

Objective: To develop and validate a predictive model assessing the risk of cesarean delivery in primiparous women based on the findings of magnetic resonance imaging (MRI) studies. Design: Observational study Setting: University teaching hospital. Population: 168 primiparous women with clinical findings suggestive of cephalopelvic disproportion. Methods: All women underwent MRI measurements prior to the onset of labor. A nomogram model to predict the risk of cesarean delivery was proposed based on the MRI data. The discrimination of the model was calculated by the area under the receiver operating characteristic curve (AUC) and calibration was assessed by calibration plots. The decision curve analysis was applied to evaluate the net clinical benefit. Main Outcome Measures: Cesarean delivery. Results: A total of 88 (58.7%) women achieved vaginal delivery, and 62 (41.3%) required cesarean section caused by obstructed labor. In multivariable modeling, the maternal body mass index before delivery, induction of labor, bilateral femoral head distance, obstetric conjugate, fetal head circumference and fetal abdominal circumference were significantly associated with the likelihood of cesarean delivery. The discrimination calculated as the AUC was 0.845 (95% CI: 0.783-0.908; P < 0.001). The sensitivity and specificity of the nomogram model were 0.918 and 0.629, respectively. The model demonstrated satisfactory calibration. Moreover, the decision curve analysis proved the superior net benefit of the model compared with each factor included. Conclusion: Our study provides a nomogram model that can accurately identify primiparous women at risk of cesarean delivery caused by cephalopelvic disproportion based on the MRI measurements.
25 Dec 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
28 Dec 2021Submission Checks Completed
28 Dec 2021Assigned to Editor
06 Jan 2022Reviewer(s) Assigned
28 Jan 2022Review(s) Completed, Editorial Evaluation Pending