The back-scratch test as a quick and easy clinical tool for the early
detection of the risk of caesarean section and oxytocin administration
during labour. The GESTAFIT project
Abstract
Objective. To determine the ability of the back-scratch test during
early second trimester of pregnancy to predict the odd of caesarean
section and the need of oxytocin administration to induce or stimulate
labour. Design. Longitudinal study. Population or sample: Pregnant women
from the GESTAFIT Project (n=157). Main Outcome Measures. Maternal
upper-body flexibility was assessed at 16th gestational week through the
back-scratch test. Type of birth and oxytocin administration was
registered from the obstetric medical records. Results. The receiver
operating characteristic curve analysis showed that the back-scratch
test was able to discriminate between vaginal and caesarean section
deliveries (area under the curve [AUC]=0.672 (95% confidence
interval [CI]:0.60-0.77, p=0.002)). The AUC to establish the ability
of the back-scratch test to detect the need of oxytocin administration
was 0.682 (95% CI:0.59-0.78, p=0.001). In the adjusted model, a
back-scratch test score <4.1 centimetres was associated to
~4 times greater increased odd ratio of having a
caesarean section (95% CI:1.7-10.2, p=0.002). A back-scratch test score
<3.6 centimetres was associated to ~5 times
greater increased odd ratio of requiring exogenous oxytocin
administration (95% CI:2.0-11.6, p=0.001). Conclusion. The back-scratch
test discriminates pregnant women with greater risk of caesarean section
from those with a vaginal delivery, and among those that will require
oxytocin from those that will not. The early identification of pregnant
women who fail to meet the suggested standards can help to easily,
quickly and cheaply identify these relevant birth-related complications
in order to initiate preventive strategies. Keywords. Pregnant woman,
upper-body flexibility, labour, obstetric risk.