The likelihood that a pregnant woman will undergo an emergency caesarean section after starting labour can be predicted by four parameters. Researchers from the University College London Hospitals studied 267 women at 36 weeks gestation or later who were scheduled for induction of labour. Of all the measures assessed, four factors in particular were strongly tied to the need for a c-section. Eighty women (30 percent) ended up having an emergency cesarean. Having never had a previous pregnancy raised the chances 20-fold. A body mass index over 30 (obese) was tied to 6 fold greater risk, while being tall reduced the chances slightly. Finally, a longer cervix measured by ultrasound was associated with a higher chance of having a caesarean. When these factors were considered together they were reasonably accurate in predicting who would undergo a caesarean. Before the study's findings can be used to counsel women, they need to be validated. If the results prove accurate, women could be told their risk of having an emergency caesarean delivery - and those at high risk could be offered the chance to have a planned c-section.
Obstetrics and Gynecology,
March 2006