Table 2.
Parameter values for base-case and sensitivity analyses.
| Description | Base Case | Parameter Range | Source | |
|---|---|---|---|---|
| Low | High | |||
| Average age of first pregnancy* | 26 | – | – | 6 |
| Birth rate, age 25–29* | 0.11 | – | – | 6 |
| Birth rate, age 30–34* | 0.10 | – | – | 6 |
| Birth rate, age 35–39* | 0.05 | – | – | 6 |
| Birth date, age 40–44* | 0.01 | – | – | 6 |
| Cost IOCS use (setup + utilization costs) | $ 22,154.00 | $ 16,615.50 | $ 27,692.50 | 19 |
| Cost IOCS setup | $ 64.45 | $ 48.34 | $ 80.56 | 11 |
| Cost cesarean, routine | $ 9,777.00 | $ 7,332.75 | $ 12,221.25 | 19 |
| Cost of cesarean due to uterine rupture | $ 11,602.00 | $ 8,701.50 | $ 14,502.50 | 19 |
| Cost of hemorrhage | $ 9,394.00 | $ 7,045.50 | $ 11,742.50 | 19 |
| Cost, emergent hysterectomy | $ 16,410.00 | $ 12,307.50 | $ 20,512.50 | 19 |
| Cost, hysterectomy, non-emergent | $ 16,410.00 | $ 12,307.50 | $ 20,512.50 | 19 |
| Cost of mild transfusion reaction | $ 10,976.00 | $ 8,232.00 | $ 13,720.00 | 19 |
| Cost of pregnancy loss due to Rh | $ 8,972.00 | $ 6,729.00 | $ 11,215.00 | 19 |
| Cost of repeat cesarean delivery, non-emergent/scheduled | $ 9,777.00 | $ 7,332.75 | $ 12,221.25 | 19 |
| Cost of treatment for severe transfusion related illness | $ 15,887.18 | $ 11,915.38 | $ 19,858.97 | 19 |
| Cost of TOLAC | $ 17,514.00 | $ 13,135.50 | $ 21,892.50 | 24 |
| Cost, transfusion alone | $ 25,190.43 | $ 18,892.82 | $ 31,488.04 | 19 |
| Cost of allogenic transfusion + IOCS | $ 29,730.38 | $ 22,297.78 | $ 37,162.97 | 19 |
| Cost of treatment for uterine rupture | $ 18,314.00 | $ 13,735.50 | $ 22,892.50 | 24 |
| Cost of VBAC | $ 12,514.00 | $ 9,385.50 | $ 15,642.50 | 24 |
| Probability of setting up IOCS | 0.87 | 0.65 | 1.00 | 11 |
| Probability of use of IOCS alone | 0.82 | 0.62 | 1.00 | 13 |
| Probability of IOCS used at all | 0.21 | 0.16 | 0.26 | 11 |
| Probability of death from hemorrhage | 0.000018 | 0.00 | 0.00 | 17 |
| Probability of dying | 0.00001 | 0.00001 | 0.00002 | 23 |
| Probability of actually hemorrhaging in cases of high risk for hemorrhage | 0.22 | 0.17 | 0.28 | 21 |
| Probability of actually hemorrhaging in cases of low risk for hemorrhage | 0.01 | 0.01 | 0.01 | 21 |
| Probability of emergent hemorrhage | 0.01 | 0.01 | 0.01 | 21 |
| Probability of hemorrhage (primary cesarean delivery) | 0.048 | 0.04 | 0.06 | 31 |
| Probability of having high risk for hemorrhage | 0.004 | 0.00 | 0.00 | 21 |
| Probability of hysterectomy | 0.0047 | 0.00 | 0.01 | 33 |
| Probability of emergent hysterectomy | 0.003 | 0.00 | 0.00 | 33 |
| Probability of needing either transfusion or IOCS | 0.13 | 0.10 | 0.16 | 11 |
| Probability of pregnancy loss due to Rh sensitization | 0.0001 | 0.00 | 0.00 | 19 |
| Probability of severe transfusion related illness | 0.032 | 0.02 | 0.04 | 32 |
| Probability of TOLAC | 0.196 | 0.15 | 0.25 | 6 |
| Probability of transfusion alone | 0.02 | 0.02 | 0.03 | 25 |
| Probability of allogenic transfusion + IOCS | 0.016 | 0.01 | 0.02 | 7 |
| Probability of contracting transfusion-related illness (pooled risk) | 0.006 | 0.00 | 0.01 | 23,26–30 |
| Probability of uterine rupture associated with TOLAC | 0.007 | 0.01 | 0.008 | 24 |
| Probability of VBAC | 0.78 | 0.20 | 1.0 | 6,24 |
| Utility of cesarean due to uterine rupture | 0.51 | 0.32 | 0.74 | 36,37 |
| Utility of hemorrhage | 0.87 | 0.65 | 0.91 | 47 |
| Utility of hemorrhage, received IOCS only | 0.96 | 0.72 | 0.91 | 39 |
| Utility of hemorrhage, received allogeneic transfusion | 0.59 | 0.44 | 0.74 | 36,39 |
| Utility of hysterectomy (chronic utility) | 0.88 | 0.75 | 0.95 | 46 |
| Utility of hysterectomy (acute utility) | 0.57 | 0.30 | 0.93 | 36–39,43,46 |
| Utility of pregnancy loss due to Rh sensitization | 0.90 | 0.50 | 1.00 | 40,42 |
| Utility of repeat cesarean (acute) | 0.42 | 0.32 | 0.53 | 36 |
| Utility of TOLAC | 0.84 | 0.63 | 0.91 | 36 |
| Utility of transfusion related illness | 0.75 | 0.56 | 0.91 | |
| Utility of mild transfusion reaction | 0.90 | 0.68 | 0.91 | 41 |
| Utility of severe transfusion related illness | 0.60 | 0.45 | 0.75 | 41 |
| Utility of uterine rupture | 0.51 | 0.38 | 0.64 | 38 |
| Utility of VBAC | 0.62 | 0.47 | 0.78 | 36,38 |
| Utility of well state, no further pregnancies | 0.91 | 0.50 | 0.99 | 37 |
| Utility of well state after cesarean | 0.59 | 0.31 | 0.96 | 48 |
| Utility of well state, after hemorrhage | 1.00 | 0.97 | 0.99 | 37 |
| Utility of well state, after allogeneic transfusion and IOCS | 0.86 | 0.82 | 0.90 | 34 |
| Utility of well state, after allogeneic transfusion alone | 0.80 | 0.60 | 0.91 | 35 |
| Utility of well state, after cesarean (chronic) | 0.91 | 0.50 | 0.10 | 37,44,45,48 |
*
Data used in birth tables to model probability of pregnancy post-base case throughout the reproductive lifespan. No ranges applied since these values were not varied in sensitivity analyses.
TOLAC, trial of labor after cesarean
VBAC, vaginal birth after cesarean
IOCS, intraoperative cell salvage