Childbirth simulation to assess cephalopelvic dystocia and chances for failed labor

Abstract

Objectives: Reducing the rate of failed labor and emergency caesarean section is of vital significance. A childbirth simulation software tool based on 5 minutes’ magnetic resonance imaging (MRI) performed at 37 weeks’ gestation, used to enhance the consulting obstetrician’s ability to predict the optimal delivery mode. Here, we aimed to analyze the predictive ability of this childbirth simulation software tool for choosing the optimal delivery mode compared with not using it. Methods: A retrospective cohort study was performed on 401 patients referred by their obstetrician for MRI pelvimetry at approximately 37 weeks of gestation between December 15, 2015 and December 15, 2016. We employed a childbirth simulation software to predict the optimal delivery mode. Those results were compared with results from the actual delivery mode. Results: The rate of emergency caesarean sections, inappropriately scheduled caesarean sections, and instrumental vaginal deliveries would have been reduced by 30·1%, 20·7%, and 20%, respectively, had the predictions from the childbirth simulation software been considered. The use of the childbirth simulation software did not significantly affect the overall caesarean section rate, but it improved the allocation between scheduled and emergency caesarean sections. Conclusions: The routine use of the childbirth simulation software as a clinical support tool for choosing the optimal delivery mode of singleton pregnancies with a cephalic presentation could reduce the number of emergency caesarean sections, insufficiently justified Caesarean sections, and instrumental deliveries.