A population of 2029 pregnant women (929 primiparas; 1100 multiparas) has been used to examine aspects of the calculation of obstetric risk scores from the presence of individual risk factors. The findings have been related to fetal outcome in these pregnancies and the following conclusions were reached: (1) the use of Bayes theorem for the calculation of a risk score is superior to the simple addition of weighted risk factors; (2) the diagnostic efficiency of a risk score is somewhat reduced when the data base used for calculation of the score is derived from a population different from that of the current pregnancy; (3) there is almost total overlap of risk scores in women with satisfactory and unsatisfactory fetal outcome. It is concluded that risk scores can be used to identify a small group of women at particularly high risk; in the remainder of the population scores are unhelpful except perhaps to indicate the women who do not require an intensive program of antenatal care.

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Current obstetric risk-scoring systems depend upon simple addition of weighted or unweighted risk factors. In this study a population of 994 pregnant women (470 primiparae; 524 multiparae) has been examined in order to compare the use of weighted and unweighted risk scores, together with Bayes theorem, in estimating an overall risk score from the presence of individual risk factors. The findings have been related to fetal outcome in these pregnancies and expressed as receiver-operating characteristic (ROC) curves for different cutoff levels between normal and abnormal. In primiparae, the use of weighted risk factors, with or without Bayes theorem, was clearly superior to the use of unweighted factors. In multiparae there was only a marginal difference between the three approaches. The increasing use of computerised information system in antenatal care should make calculation of risk scores for every pregnant woman a practical option.

Objective To ascertain the number and type of obstetric computer systems (OCS) in Great Britain, and to ascertain user satisfaction with these systems. Design A postal questionnaire was circulated to every consultant obstetrician in Great Britain at the beginning of 1992. Main outcome measures Information was sought on the hardware, software and uses of obstetric computer systems. Satisfaction with, benefits and problems of the system were also assessed. Results There was an 87.5% response rate. Of the 264 units questioned, 100 units reported that they had a computer system. Sixty‐five units used terminals connected to a mainframe or minicomputer and 17 used stand‐alone personal computers (PCs). Local area networks (LANs) were used in 19 units and wide area network (WANs) in 22 units. Software varied from commercial turnkey systems to in‐house systems. The quoted annual running cost ranged from £50 to £48 000. Most units were satisfied with their system. Problems included slow operating times, unreliability, user unfriendliness, deficiencies in training and inadequate customer support services. Conclusions Obstetric computer systems are now coming into widespread use. Despite problems, the use of such systems is likely to increase. This survey establishes a database for those units who are considering acquiring or changing their computer system for the purpose of audit or research.

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