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Main Authors: Klein, Ashley, Raff, Edward, Seamon, Elisabeth, Foley, Lily, Bussert, Timothy
Format: Preprint
Published: 2024
Subjects:
Online Access:https://arxiv.org/abs/2408.10876
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author Klein, Ashley
Raff, Edward
Seamon, Elisabeth
Foley, Lily
Bussert, Timothy
author_facet Klein, Ashley
Raff, Edward
Seamon, Elisabeth
Foley, Lily
Bussert, Timothy
contents An obstetric goal for a laboring mother is to achieve a vaginal delivery as it reduces the risks inherent in major abdominal surgery (i.e., a Cesarean section). Various medical interventions may be used by a physician to increase the likelihood of this occurring while minimizing maternal and fetal morbidity. However, patients with prelabor rupture of membranes (PROM) have only two commonly used options for cervical ripening, Pitocin and misoprostol. Little research exists on the benefits/risks for these two key drugs for PROM patients. A major limitation with most induction-of-labor related research is the inability to account for differences in \textit{Bishop scores} that are commonly used in obstetrical practice to determine the next induction agent offered to the patient. This creates a confounding factor, which biases the results, but has not been realized in the literature. In this work, we use a Bayesian model of the relationships between the relevant factors, informed by expert physicians, to separate the confounding variable from its actual impact. In doing so, we provide strong evidence that pitocin and buccal misoprostol are equally effective and safe; thus, physicians have more choice in clinical care than previously realized. This is particularly important for developing countries where neither medication may be readily available, and prior guidelines may create an artificial barrier to needed medication.
format Preprint
id arxiv_https___arxiv_org_abs_2408_10876
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle More Options for Prelabor Rupture of Membranes, A Bayesian Analysis
Klein, Ashley
Raff, Edward
Seamon, Elisabeth
Foley, Lily
Bussert, Timothy
Applications
Machine Learning
An obstetric goal for a laboring mother is to achieve a vaginal delivery as it reduces the risks inherent in major abdominal surgery (i.e., a Cesarean section). Various medical interventions may be used by a physician to increase the likelihood of this occurring while minimizing maternal and fetal morbidity. However, patients with prelabor rupture of membranes (PROM) have only two commonly used options for cervical ripening, Pitocin and misoprostol. Little research exists on the benefits/risks for these two key drugs for PROM patients. A major limitation with most induction-of-labor related research is the inability to account for differences in \textit{Bishop scores} that are commonly used in obstetrical practice to determine the next induction agent offered to the patient. This creates a confounding factor, which biases the results, but has not been realized in the literature. In this work, we use a Bayesian model of the relationships between the relevant factors, informed by expert physicians, to separate the confounding variable from its actual impact. In doing so, we provide strong evidence that pitocin and buccal misoprostol are equally effective and safe; thus, physicians have more choice in clinical care than previously realized. This is particularly important for developing countries where neither medication may be readily available, and prior guidelines may create an artificial barrier to needed medication.
title More Options for Prelabor Rupture of Membranes, A Bayesian Analysis
topic Applications
Machine Learning
url https://arxiv.org/abs/2408.10876