Abstract

PIP: Researchers used hospital records of 550 primigravidae who delivered single infants during 1979-1982 at the Nixon Memorial Hospital in Segbwema, Sierra Leone to measure the value of various heights for screening women for risk of cephalopelvic disproportion (CPD). 39 of the women had a Caesarean section due to CPD. A high percentage (50%) of the shortest women (54 inches) with CPD delivered a child by Caesarean section, whereas just 2% of the tallest women with CPD (= or + 64 inches) did so. To screen for CPD, the researchers calculated the specificity and sensitivity for each height so they could identify that height which may best indicate CPD. The percentage of women who had a Caesarean section for CPD and were correctly identified (sensitivity) varied from 20.5% for women up to 54 inches to 92.3% for those 61-62 inches. Further the percentage of women who had CPD and did not need a Caesarean section (specificity) ranged from 98.4% for women up to 54 inches to 16% for those 61-62 inches. When the researchers plotted the sensitivities and specificities on a graph, they learned that the best choices for a screening height were 59 or 60 inches. 60 inches identified 84.5% of the primigravidae who had CPD whereas 59 inches identified 77% (7.6% difference). Moreover the difference in specificity between 59 and 60 inches was more pronounced (12%). It stood at 45% for 60 inches and 57% for 59 inches. The researchers chose greater sensitivity and thereby selected 60 inches as the screening height. They had to not only identify and refer women at risk of CPD, but limit the potential workload at hospitals and the ordeal of convincing women to go to a hospital.