EP21.10: Evaluation of Caesarean section pregnancy classification according to Delphi consensus: a training study for inexperienced doctors

The classification of CSP plays a crucial role in obstetric management, aiding in decision-making and predicting potential complications. The Delphi consensus offers a simplified classification based on gestational sac invasion along specific lines within the uterus. However, its ease of training and application, particularly among inexperienced doctors, remains uncertain. This study aims to evaluate the training process and utilization of Delphi consensus in classifying CSP compared to the Cali's cross over sign (COS) method. A group of 16 young doctors participated in a 2-week training program focusing on CSP classification using either Delphi consensus or Cali's cross over sign. The training included theory lectures and examination of documented cases. Subsequently, participants underwent an evaluation comprising 20 documented CSP cases, including images and videos. These cases consisted of 25% Type 1 CSP, 50% Type 2 CSP, and 25% Type 3 CSP, initially assessed by an experienced expert. Agreement between participant assessments and expert evaluations was analysed. Evaluation of CSP using COS demonstrated a mean agreement of 55 ± 13% (range: 20-80%) with the initial expert assessments. In contrast, assessments based on Delphi consensus showed a higher mean agreement of 75% ± 14% (range: 50-100%). The Delphi consensus method exhibited superior agreement levels, indicating its effectiveness and ease of understanding among inexperienced doctors. The Delphi consensus classification of CSP offers good agreement levels and is easily comprehensible for inexperienced doctors. Its simplicity and effectiveness make it a valuable tool in obstetric training and practice, facilitating accurate classification and management of Caesarean section pregnancies.