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

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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; Westgren, Magnus; Ajne, Gunilla.

In: PLoS ONE, Vol. 12, No. 3, e0171938, 01.03.2017, p. 1-10.

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Pettersson, Kristina ; Yousaf, Khurram ; Ranstam, Jonas ; Westgren, Magnus ; Ajne, Gunilla. / Predictive value of traction force measurement in vacuum extraction : Development of a multivariate prognostic model. In: PLoS ONE. 2017 ; Vol. 12, No. 3. pp. 1-10.

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TY - JOUR

T1 - Predictive value of traction force measurement in vacuum extraction

T2 - PLoS ONE

AU - Pettersson, Kristina

AU - Yousaf, Khurram

AU - Ranstam, Jonas

AU - Westgren, Magnus

AU - Ajne, Gunilla

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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.

AB - 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.

U2 - 10.1371/journal.pone.0171938

DO - 10.1371/journal.pone.0171938

M3 - Article

VL - 12

SP - 1

EP - 10

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 3

M1 - e0171938

ER -