Performance of maternal abdominal subcutaneous fat thickness in predicting cesarean section

Introduction: Overweight and obesity during pregnancy is associated with increased risk for cesarean delivery. BMI is the most frequently used parameters to define and to assess risk of pregnancy related complications. Maternal abdominal subcutaneous fat thickness (SCFT) can be used as a measure of obesity. The present study was done to find association of maternal SCFT with risk of cesarean section.
Methods: 200 women with singleton live pregnancy at 16-18 weeks were included in the study after obtaining written informed consent. Ultrasonography was done to assess foetal wellbeing and rule out congenital malformation. Maternal abdominal subcutaneous thickness was measured. All women were followed during labour till discharge. ROC curve analysis was done to predict the risk of cesarean section. Odd ratio for SCFT mediated risk of cesarean section was calculated.
Results: 32.5% women had cesarean delivery. Mean SCFT was also significantly more in women delivered by cesarean than who delivered vaginally (p <0.001). ROC curve analysis for SCFT showed that SCFT above 11.5 mm (AUC=0.735) predicted LSCS with a sensitivity of 86.2% and specificity of 47.4% and Youden index of 0.34. Increased abdominal SCFT was significantly associated with increased risk of LSCS. . Using 11.5 mm cut -off value (by ROC curve) for SCFT, the odd ratio of LSCS was 7.5 (95% CI 3.4056 – 16.5837, p <0.0001). Stitch line infection was seen in 15.38% women.
Conclusion: This study observed that measurement of SCFT by ultrasonography at 16-18 weeks pregnancy is a significant predictor of cesarean section.