Am J Perinatol 2007; 24(1): 005-010
DOI: 10.1055/s-2006-954956
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Prediction of Shoulder Dystocia Using Multivariate Analysis

Michael A. Belfort1 , Gary A. Dildy1 , George R. Saade2 , Victor Suarez2 , Steven L. Clark1
  • 1HCA Perinatal Safety Group, Nashville, Tennessee
  • 2Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
Further Information

Publication History

Publication Date:
27 December 2006 (online)

ABSTRACT

We evaluated the use of multivariate analysis in the prediction of shoulder dystocia (SD). One hundred consecutive cases with SD were matched with 100 controls without dystocia. All patients had term, vaginal delivery. Multivariate analysis was used to identify independent variables significantly related to shoulder dystocia. The regression coefficients for the identified factors were used to calculate a composite score from which receiver operating characteristics (ROC) curves were derived. Birthweight (BW), 1-hour Glucola (GLU), operative vaginal delivery (OVD), and height of fundus (HOF) were related independently to SD. The sensitivity and specificity reached 84 and 80%, respectively, with BW + GLU + OVD. Significant associations persisted when HOF and carbohydrate intolerance were substituted for BW and GLU, respectively. SD is independently associated with BW, GLU, and OVD, and may be predicted with clinically acceptable accuracy using multiple variables. This model may be useful in the design of prospective studies for managing suspected macrosomia.

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Michael A BelfortM.D. Ph.D. 

HCA Perinatal Safety Group, St. Marks Hospital

3900S 1140 E, Salt Lake City, UT 84124

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