Predictive value of traction force measurement in vacuum extraction : Development of a multivariate prognostic model
(2017) In PLoS ONE 12(3). p.1-10- Abstract
Objective: To enable early prediction of strong traction force vacuum extraction. Design: Observational cohort. Setting: Karolinska University Hospital delivery ward, tertiary unit. Population and sample size: Term mid and low metal cup vacuum extraction deliveries June 2012 - February 2015, n = 277. Methods: Traction forces during vacuum extraction were collected prospectively using an intelligent handle. Levels of traction force were analysed pairwise by subjective category strong versus non-strong extraction, in order to define an objective predictive value for strong extraction. Statistical analysis: A logistic regression model based on the shrinkage and selection method lasso was used to identify the predictive capacity of the... (More)
Objective: To enable early prediction of strong traction force vacuum extraction. Design: Observational cohort. Setting: Karolinska University Hospital delivery ward, tertiary unit. Population and sample size: Term mid and low metal cup vacuum extraction deliveries June 2012 - February 2015, n = 277. Methods: Traction forces during vacuum extraction were collected prospectively using an intelligent handle. Levels of traction force were analysed pairwise by subjective category strong versus non-strong extraction, in order to define an objective predictive value for strong extraction. Statistical analysis: A logistic regression model based on the shrinkage and selection method lasso was used to identify the predictive capacity of the different traction force variables. Predictors: Total (time force integral, Newton minutes) and peak traction (Newton) force in the first to third pull; difference in traction force between the second and first pull, as well as the third and first pull respectively. Accumulated traction force at the second and third pull. Outcome: Subjectively categorized extraction as strong versus non-strong. Results: The prevalence of strong extraction was 26%. Prediction including the first and second pull: AUC 0,85 (CI 0,80-0,90); specificity 0,76; sensitivity 0,87; PPV 0,56; NPV 0,94. Prediction including the first to third pull: AUC 0,86 (CI 0,80-0,91); specificity 0,87; sensitivity 0,70; PPV 0,65; NPV 0,89. Conclusion: Traction force measurement during vacuum extraction can help exclude strong category extraction from the second pull. From the third pull, two-thirds of strong extractions can be predicted.
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- author
- Pettersson, Kristina ; Yousaf, Khurram ; Ranstam, Jonas LU ; Westgren, Magnus and Ajne, Gunilla
- publishing date
- 2017-03-01
- type
- Contribution to journal
- publication status
- published
- in
- PLoS ONE
- volume
- 12
- issue
- 3
- article number
- e0171938
- pages
- 1 - 10
- publisher
- Public Library of Science (PLoS)
- external identifiers
-
- pmid:28257459
- scopus:85014429628
- ISSN
- 1932-6203
- DOI
- 10.1371/journal.pone.0171938
- language
- English
- LU publication?
- no
- id
- a674fa76-c68b-401f-bb88-ec57ec0b9a42
- date added to LUP
- 2019-06-24 15:42:45
- date last changed
- 2024-09-04 02:41:51
@article{a674fa76-c68b-401f-bb88-ec57ec0b9a42, abstract = {{<p>Objective: To enable early prediction of strong traction force vacuum extraction. Design: Observational cohort. Setting: Karolinska University Hospital delivery ward, tertiary unit. Population and sample size: Term mid and low metal cup vacuum extraction deliveries June 2012 - February 2015, n = 277. Methods: Traction forces during vacuum extraction were collected prospectively using an intelligent handle. Levels of traction force were analysed pairwise by subjective category strong versus non-strong extraction, in order to define an objective predictive value for strong extraction. Statistical analysis: A logistic regression model based on the shrinkage and selection method lasso was used to identify the predictive capacity of the different traction force variables. Predictors: Total (time force integral, Newton minutes) and peak traction (Newton) force in the first to third pull; difference in traction force between the second and first pull, as well as the third and first pull respectively. Accumulated traction force at the second and third pull. Outcome: Subjectively categorized extraction as strong versus non-strong. Results: The prevalence of strong extraction was 26%. Prediction including the first and second pull: AUC 0,85 (CI 0,80-0,90); specificity 0,76; sensitivity 0,87; PPV 0,56; NPV 0,94. Prediction including the first to third pull: AUC 0,86 (CI 0,80-0,91); specificity 0,87; sensitivity 0,70; PPV 0,65; NPV 0,89. Conclusion: Traction force measurement during vacuum extraction can help exclude strong category extraction from the second pull. From the third pull, two-thirds of strong extractions can be predicted.</p>}}, author = {{Pettersson, Kristina and Yousaf, Khurram and Ranstam, Jonas and Westgren, Magnus and Ajne, Gunilla}}, issn = {{1932-6203}}, language = {{eng}}, month = {{03}}, number = {{3}}, pages = {{1--10}}, publisher = {{Public Library of Science (PLoS)}}, series = {{PLoS ONE}}, title = {{Predictive value of traction force measurement in vacuum extraction : Development of a multivariate prognostic model}}, url = {{http://dx.doi.org/10.1371/journal.pone.0171938}}, doi = {{10.1371/journal.pone.0171938}}, volume = {{12}}, year = {{2017}}, }