Antenatal screening for fetopelvic dystocias; a cost-effectiveness approach to the choice of simple indicators for use by auxiliary personnel

Screening for fetopelvic dystocias is one of the important objectives of an antenatal clinic. In developing countries such screening often has to be carried out by auxiliary personnel, which makes it mandatory to use simple indicators. In a prospective study of 4772 women in Kasongo (Zaire), the value of such simple indicators was tested. The results show that such screening is potentially highly effective. The obstetrical history is the backbone of such screening. Which indicator(s) will actually constitute the best screening criterion is a matter of trade-off between effectiveness (the proportion of dystocias that are correctly predicted) and acceptable cost (the number of women referred by the criterion)