Development and internal validation of a clinical prediction model for external cephalic version

Velzel, Joost; Schuit, Ewoud; Vlemmix, Floortje; Molkenboer, J.F.M.; Post, Joris A. M. van der; Mol, Ben Willem J.; Kok, Marjolein

doi:10.1016/j.ejogrb.2018.06.019

Cited by 13 publications

(15 citation statements)

References 31 publications

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“…It is proved that our prediction model has a good ability to predict the success of ECV with a high C-index (0.841). It is superior to previous studies, such as 0.67 in Burgos et al 47 , 0.70 in Kok et al 48 , and 0.78 in Velzel et al 49 . The outcome judgment of ECV is immediate, not at birth, which avoids the deviation of ECV outcome judgment.…”

Section: Discussioncontrasting

confidence: 73%

A prospective study using an individualized nomogram to predict the success rate of external cephalic version

Lin

Liu

et al. 2022

Sci Rep

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To establish a clinical-based nomogram for predicting the success rate of external cephalic version (ECV) through a prospective study. This was a single-center prospective study that collected eligible breech pregnant women. 152 participants were enrolled in the training cohort, who received ECV procedures performed by a single operator. We used the training cohort to establish regression equations and prediction models. These variables include maternal factors (age, operation gestational age, pre-pregnancy BMI (Body Mass Index), operation BMI, BMI increase, multipara), ultrasound factors (fetal weight estimation, amniotic fluid index, placental location, type of breech presentation, spinal position), and anesthesia. Univariate and multivariable analyses were used to screen the factors affecting the success of ECV. A nomogram scoring model was established based on these factors. And C-index, DCA (Decision Curve Analysis) and calibration curve, Hosmer–Lemeshow test was used to verify the prediction effect of the model. Finally, 33 participants were enrolled in the testing cohort who received ECV with an unrestricted operator. We used C-index, DCA (decision curve analysis), and Hosmer–Lemeshow to verify the application value of the prediction model. The calibration curves and ROC curves of both the training cohort and testing cohort are plotted for internal and external validation of the model. The ECV success rate of the training cohort was 62.5%. Univariate analysis showed that the predictors related to the success rate of ECV were age, BMI increase value, AFI (amniotic fluid index), breech type, placental location, spinal position, anesthesia, and multipara. The prediction thresholds of the corresponding indexes were calculated according to the Youden index. Multivariate logistic regression analysis showed that BMI increase ≥ 3.85 kg/m2, AFI ≥ 10.6 cm, anesthesia, multipara, and non-anterior placenta were independent predictors of ECV success. Through the internal and external validation, it is confirmed that the model has a good calibration and prediction ability. Our nomogram has a good ability to predict the success rate of ECV.

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Section: Discussioncontrasting

confidence: 73%

A prospective study using an individualized nomogram to predict the success rate of external cephalic version

Lin

Liu

et al. 2022

Sci Rep

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“…Different models have been published. Some include a scoring system 19–21 that generates a score indicative of the probability of success, similar to the Bishop test, and others include a mathematical formula that includes the presence or absence of certain variables 18,22–26 . Furthermore, different models consider very different variables, both clinical and ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

López-Pérez

Lorente-Fernández

Velasco-Martínez

et al. 2020

J of Obstet and Gynaecol

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Aim: External cephalic version (ECV) is an effective and safe technique for avoiding breech presentation at birth. However, it continues rejected by many women. The aim of this study is to develop a predictive model of success of external cephalic version, determine the safety of the technique and perinatal outcomes after successful version. Methods: Data from 317 versions performed over a 6-year period were collected. Different clinical and ultrasound variables, complications, vaginal delivery after successful version and perinatal outcomes were analyzed. Results: The overall success rate was 72% (229 of 317 versions). The variables most related to success were parity, placental location, amniotic fluid volume, fetal sex, fetal head palpation and descent of the presenting part. A model for calculating the probability of success was developed in which to input parity, placentation and amniotic fluid data. The model correctly classified 98.8% of successful technique and 74% of all women. Complications were very few and mostly mild. Of women who had success, 77% (163 of 212) had a vaginal birth. No differences between neonatal outcomes were found. Conclusion: External cephalic version is a successful, safe technique with a high rate of subsequent vaginal delivery. A success prediction model based on some very easily obtained variables can personalize the probability of success.

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“…Si está ubicada la misma en anterior se considera un factor que impediría y entorpecería el éxito de la versión externa (Hutton et al, 2017;Levin et al, 2019;Melo et al, 2019). Sin embargo, si se localiza en posterior favorece el éxito de la versión (Burgos et al, 2011;Velzel et al, 2018).…”

Section: Manejo De La Presentación Pelviana Durante El Embarazounclassified

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Paneque¹,

Álvarez²,

Jiménez³

et al. 2023

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El texto se elaboró con el objetivo de incentivar, conducir, ejercitar y orientar al médico, en su actuar durante el trabajo de parto, para así lograr el éxito de este fisiológico, pero complejo proceso donde se armonizan y se relacionan múltiples factores en consonancia, para traer consigo una nueva vida; sin embargo, este no deja de tener desvíos en las que su reconocimiento y terapéutica oportuna permita evitar el surgimiento de complicaciones maternas y perinatales, inclusive la muerte.

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Development and internal validation of a clinical prediction model for external cephalic version

Cited by 13 publications

References 31 publications

A prospective study using an individualized nomogram to predict the success rate of external cephalic version

A prospective study using an individualized nomogram to predict the success rate of external cephalic version

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

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