Gabbai et al reported a model for predicting prolonged hospitalization after a cesarean section. The authors are from Tel Aviv University and Tel Aviv Sourasky Medical Center.
Patient selection: woman having a cesarean section
Outcome: prolonged hospital stay >= 10 days
NOTE: The first author reported an earlier VBAC model that used race and ethnicity.
Parameters:
(1) body mass index (BMI) in kg per square meter
(2) antenatal platelet count
(3) indication for cesarean section
(4) preterm delivery (less than 37 weeks of gestation)
(5) multiple pregnancy
|
Parameter
|
Finding
|
Points
|
|
BMI
|
<= 40 kg per sq m
|
0
|
|
|
> 40 kg per sq m
|
1
|
|
antenatal platelet count
|
>= 100,000 per µL
|
2
|
|
|
< 100,000 per µL
|
0
|
|
indication
|
elective
|
1
|
|
|
urgent
|
2
|
|
|
neither
|
0
|
|
preterm delivery
|
no
|
0
|
|
|
yes
|
8
|
|
multiple pregnancy
|
no
|
0
|
|
|
yes
|
1
|
where:
• An emergency indication is presumed to be included in urgent.
• In the score in Table 3 the indication could be both elective and urgent.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• A score >= 3 was 75% sensitive and 85% specific for prolonged hospitalization.
Performance:
• The area under the ROC curve is 0.83.
Additional factors found on multivariate analysis but not include in score:
(1) abnormal placentation
(2) preeclampsia
(3) 5-minute Apgar score < 7
