APPLICATION of a New Scoring System for The Screening Of High - Risk Pregnancy and Outcome Prediction

Abstract

Most risk scoring systems have been fraught with poor positive predictive values and inadequate sensitivity. Knox scoring system is a statistically derived scoring system with a predictive accuracy higher than any previously reported system. It had a predictive accuracy of 0.91, predicting 87% of the poor outcomes, with 16% of the pregnancies allocated to the high-risk group

Objectives: To apply this recent scoring system to a representative sample of the attendants of the Cairo University Hospital natal unit and define the magnitude of high risk pregnancy among them. Identification of the most common risk factors for unfavorable pregnancy outcome among study group. Relating the outcome of pregnancy to the risk level as determined by the score. Evaluate the scoring system as regards sensitivity and positive predictive value.

Results: Around 17 % of the studied sample have been assigned to the high-risk group. The most frequently encountered risk factors included: extremes of age, education to the primary level only, previous perinatal death, history of cardiac diseases, anemia, hypertension during pregnancy and premature labour. Around 18% of babies born to the study group were low birth weight. Fifteen percent were transferred to the neonatal unit. Perinatal death occurred at a rate of 5.6%. Significant associations between the risk level as determined by the score and the various unfavorable pregnancy outcomes have been demonstrated.