Simulator to predict chance of caesarean?


Traditionally, doctors and midwives have used a technique called pelvimetry to measure the pelvis and try to determine its adequacy for giving birth. But pelvic size is just one factor in how smoothly labor will go, rendering the method largely insufficient.

Scientists in France have been working to take some of the guesswork out of labor predictions ... their newly developed software, called Predibirth, predicts birth outcomes quite accurately.

The researchers used their software to process magnetic resonance images of 24 pregnant women, capturing the pelvis and fetus, and then simulating 72 possible trajectories the baby's head might take through the birth canal. The program then uses this data to score the mother's chances of having a normal (vaginal) birth.

... Of the 24 women in the study, the 13 who delivered normally all had highly favorable birth outcome scores. Three women who had high-risk scores underwent elective C-sections. Of the five women who underwent emergency C-section, the three with obstructed labor had high-risk scores, and the two who experienced heart rhythm abnormalities had mildly favorable or favorable scores.

More accurate measurements of labor risks might not only keep C-section rates lower and help identify necessary C-sections before they become emergencies, but these measurements could also better inform those who want to deliver at home whether it is safe to do so.

I wonder if all of those women had undergone extensive preparation for birth and had sought continuity of midwifery care? Of 24 women, only 13 delivered vaginally. That is only 54%! Private midwifery care generally had rates of normal birth up around 90%.

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