Clinical Scorecard: Creation and assessment of a predictive framework for identifying the risk of forceps delivery in term singleton first-time mothers to enhance early detection and labor management strategies.

At a Glance

Key Highlights

• Independent risk factors for forceps delivery include BMI ≥ 28 kg/m2, fetal abdominal circumference ≥ 340 mm, grade II or III meconium-stained fluid, non-occipital anterior fetal position, and active phase duration ≥ 120 min.
• The predictive model achieved an AUC of 0.775, indicating good discrimination.
• The model demonstrated acceptable calibration and provided a net benefit over the treat-all strategy for clinically plausible threshold probabilities up to 0.35.
• The study emphasizes the importance of early risk identification to optimize intrapartum management.
• Further prospective validation is warranted to assess real-world clinical impact.

Guideline-Based Recommendations

Diagnosis

• Utilize the predictive model to identify high-risk cases of forceps delivery at the onset of the second stage of labor.

Management

• Implement targeted intrapartum care strategies based on identified risk factors.

Monitoring & Follow-up

• Continuously assess maternal and fetal characteristics during labor to inform decision-making.

Risks

• Be aware of the maternal and neonatal risks associated with prolonged labor and forceps delivery.

Patient & Prescribing Data

Term singleton primiparas undergoing labor

Early identification of high-risk mothers can facilitate timely mobilization of qualified operators and neonatal support.

Clinical Best Practices

• Adopt standardized protocols for forceps-assisted delivery.
• Ensure experienced obstetricians confirm indications for assisted vaginal delivery.
• Utilize objective risk assessment tools to guide clinical decision-making.

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