A181 CAUSES FOR C-SECTION IN IBD PATIENTS: A RETROSPECTIVE REVIEW
Bibliographic record
Abstract
Abstract Background Inflammatory bowel disease (IBD) is a group of chronic inflammatory conditions including ulcerative colitis (UC), Crohn’s disease (CD) or IBD-unclassified. Current expert guidelines recommend only two IBD-related reasons to consider C-section: perianal CD and ileal pouch-anal anastomosis (IPAA) history. However, the incidence of C section among IBD patients is higher than the non-IBD patients. There is a sparsity of literature on what other factors influence the decision to perform caesarean delivery among IBD patients. Aims To investigate IBD-related and non-IBD related reasons leading to C-section in IBD patients. Methods A retrospective chart review was performed on women with IBD, >18 years of age and/or older, who delivered at Mount Sinai Hospital, Toronto 2016–2019. OB records and OR records were reviewed to obtain information specific to C-section. Results A total of 119 deliveries were reviewed. 47 out of the 119 had C-section delivery. 42.9% (N=21) of C-section was in UC patients and 57.1% (N=28) was in CD patients. Maternal request comprised 2.1% (N=1) and arrest of cervical dilation 6.4% (N=3). 20.4% (N=10) patients failed vaginal delivery. Only 8.7% of C-section deliveries were Primiparous. 42.9% (N=12) of patients from the CD category that underwent C-section had fistulizing CD. 46.4% (N=13) of patients with CD had stricturing CD and underwent C-Section. 63.8% (N=30) of the patients that had C-section had planned C-Section. 26.6% (N=8) of the planned C-section was due to a history of the perianal disease and only 13.3% (N=4) had an active perianal disease. Other causes for planned C-section included J-pouch (10%, N=3) and active UC (2.1%, N=1). As per expert recommendation, we would anticipate 14% of patients to have C-section due to IBD related reasons however we found that 30% of the patients had C-section due to IBD related reasons. Conclusions Based on the preliminary data from our retrospective study we find that 30% of the C-sections were due to IBD related reasons and 70% C-sections were from non-IBD related reasons. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".