[Does a combination of foetal biometry and maternal MRI pelvimetry decrease the frequency of secondary caesarean section?].
OBJECTIVE
Cephalopelvic disproportion (CPD) is a frequent indication for secondary Caesarean section. The delivery simulation software Anapelvis was developed to predict a CPD on the basis of foetal ultrasound biometry and maternal pelvimetry data. The objective of this retrospective study was to analyse the predictive value of Anapelvis software in consideration of antenatal foetal biometry quality.


METHODS
162 pregnant women with suspected CPD who had undergone a magnetic resonance imaging pelvimetry were included in this study. The antenatal foetal biometry was carried out within a week before delivery.


RESULTS
The positive predictive value (PPV) for arrest of delivery was 85.7% in the group of 79 pregnancies with planned vaginal delivery. Sensitivity was 56.3%, specificity 60.0% and negative predictive value (NPV) 24.3% accordingly. The highest accuracy [percent error (PE) -0.1%] of fetal weight estimation was found in the group where an arrest of delivery was predicted. The lowest accuracy (PE -4.4%) was detected in the group with the prediction of vaginal delivery.


CONCLUSIONS
Labour simulation software can be helpful only in such cases where an arrest of delivery was predicted. The accuracy of delivery simulation with the Anapelvis software was considerably affected by the quality of antenatal foetal ultrasound biometry.
Fasler
T
T
Klinik für Geburtshilfe, Universitätsspital Zürich, Schweiz.
Burkhardt
T
T
Wisser
J
J
Keller
T
T
Kurmanavicius
J
J
D000328:Adult; D001699:Biometry / Q000379:methods*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003944:Diagnostic Techniques, Obstetrical and Gynecological / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data*; D010388:Pelvis / Q000033:anatomy & histology; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D055815:Young Adult