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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
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  • Virginia A Aparicio,
  • José Castro-Piñero,
  • Irene Coll-Risco,
  • Nuria Marín Jiménez,
  • Laura Baena Garcia
Virginia A Aparicio
University of Granada

Corresponding Author:[email protected]

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José Castro-Piñero
University of Cadiz
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Irene Coll-Risco
Universidad de Granada
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Nuria Marín Jiménez
University of Granada
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Laura Baena Garcia
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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.