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Predictive value of traction force measurement in vacuum extraction : Development of a multivariate prognostic model

Pettersson, Kristina; Yousaf, Khurram; Ranstam, Jonas LU ; Westgren, Magnus and Ajne, Gunilla (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
publishing date
type
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publication status
published
in
PLoS ONE
volume
12
issue
3
pages
1 - 10
publisher
Public Library of Science
external identifiers
  • scopus:85014429628
ISSN
1932-6203
DOI
10.1371/journal.pone.0171938
language
English
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no
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a674fa76-c68b-401f-bb88-ec57ec0b9a42
date added to LUP
2019-06-24 15:42:45
date last changed
2019-09-11 04:20:16
@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>},
  articleno    = {e0171938},
  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},
  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},
  volume       = {12},
  year         = {2017},
}