Factors affecting the success rate of vaginal birth after cesarean section

Abstract Background We aimed to develop and validate a nomogram for effective prediction of vaginal birth after cesarean (VBAC) and guide future clinical application. Methods We retrospectively analyzed data from hospitalized pregnant women who underwent trial of labor after cesarean (TOLAC), at the Fujian Provincial Maternity and Children’s Hospital, between October 2015 and October 2017. Briefly, we included singleton pregnant women, at a gestational age above 37 weeks who underwent a primary cesarean section, in the study. We then extracted their sociodemographic data and clinical characteristics, and randomly divided the samples into training and validation sets. We employed the least absolute shrinkage and selection operator (LASSO) regression to select variables and construct VBAC success rate in the training set. Thereafter, we validated the nomogram using the concordance index (C-index), decision curve analysis (DCA), and calibration curves. Finally, we adopted the Grobman’s model to perform comparisons with published VBAC prediction models. Results Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. Multivariate logistic regression models revealed that maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The constructed predictive model showed better discrimination than that from the Grobman’s model in the validation series (c-index 0.906 VS 0.694, respectively). On the other hand, decision curve analysis revealed that the new model had better clinical net benefits than the Grobman’s model. Conclusions VBAC will aid in reducing the rate of cesarean sections in China. In clinical practice, the TOLAC prediction model will help improve VBAC’s success rate, owing to its contribution to reducing secondary cesarean section.

Download Full-text

Frequency of Successful Vaginal Birth after Previous One Cesarean Section in Low Risk Pregnant Women

Annals of King Edward Medical University ◽

10.21649/akemu.v22i1.799 ◽

2016 ◽

Vol 22 (1) ◽

pp. 60

Author(s):

Saadia Rasheed ◽

Sehar Shahbaz ◽

Shazia Hammad

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Success Rate ◽

Placental Abruption ◽

Cost Effective ◽

Vaginal Birth ◽

Low Risk ◽

Vaginal Birth After Cesarean ◽

Live Fetus ◽

Prior Cesarean Section

AbstractAims and Objectives:determine the frequency of successful vaginal birth after cesarean section VBAC in low risk pregnant women.Study Design: It was a descriptive study.Duration:From 2010 to 2014.Material and Method:A total of 130 cases who were at term (37)+ weeks of gestation, between 20 40 years of age with a single prior cesarean section, presenting in their next pregnancy (G2) with a single, live fetus in cephalic presentation and those who given the consent of trial of VBAC were included in the study while high risk cases e.g. hypertensive disorders, gestational diabetes mellitus, placental abruption etc were excluded from this review. All these cases were collected from Maternity and Children's hospital Hail, Kingdom of Saudia Arabia.Results:In our study, 63.85% of the cases were between 20 30 years of age while 36.15% (n = 47) were between 31 40 years, mean sd was calculated as 27.24 3.52 years, mean gestational age was 38.43 2.43 weeks while successful vaginal birth after cesarean section was recorded in 78.46% (n = 102) while 21.54% (n = 28) had failed trial of VBAC.Conclusion:Higher success rate of vaginal birth after one cesarean section in low risk pregnant women is recorded while no significant adverse outcome in these cases is found. However, in our setup it is safe and cost-effective as well.Key Words:Cesarean delivery, low risk, VBAC, success rate, safe, cost effective.

Download Full-text

Comparative study for success rate of vaginal birth after cesarean section following labor induction by two forms of vaginal dinosprostone: A pilot study

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2014.41007 ◽

2014 ◽

Vol 04 (01) ◽

pp. 33-41 ◽

Cited By ~ 2

Author(s):

Mahmoud Fathy Hassan ◽

Osama El-Tohamy

Keyword(s):

Pilot Study ◽

Cesarean Section ◽

Comparative Study ◽

Success Rate ◽

Labor Induction ◽

Vaginal Birth ◽

Vaginal Birth After Cesarean

Download Full-text

Prediction of vaginal birth after cesarean delivery in southeast China: A retrospective cohort study

10.21203/rs.3.rs-30089/v2 ◽

2020 ◽

Author(s):

Hua-Le Zhang ◽

Liang-Hui Zheng ◽

Li-Chun Cheng ◽

Zhao-Dong Liu ◽

Lu Yu ◽

...

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Success Rate ◽

Gestational Age ◽

Prediction Models ◽

Curve Analysis ◽

Vaginal Birth ◽

Lasso Regression ◽

Vaginal Birth After Cesarean ◽

Decision Curve Analysis

Abstract Background We aimed to develop and validate a nomogram for effective prediction of vaginal birth after cesarean (VBAC) and guide future clinical application. Methods We retrospectively analyzed data from hospitalized pregnant women who underwent trial of labor after cesarean (TOLAC), at the Fujian Provincial Maternity and Children's Hospital, between October 2015 and October 2017. Briefly, we included singleton pregnant women, at a gestational age above 37 weeks who underwent a primary cesarean section, in the study. We then extracted their sociodemographic data and clinical characteristics, and randomly divided the samples into training and validation sets. We employed the least absolute shrinkage and selection operator (LASSO) regression to select variables and construct VBAC success rate in the training set. Thereafter, we validated the nomogram using the concordance index (C-index), decision curve analysis (DCA), and calibration curves. Finally, we adopted the Grobman’s model to perform comparisons with published VBAC prediction models. Results Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. Multivariate logistic regression models revealed that maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The constructed predictive model showed better discrimination than that from the Grobman’s model in the validation series (c-index 0.906 VS 0.694, respectively). On the other hand, decision curve analysis revealed that the new model had better clinical net benefits than the Grobman’s model. Conclusions VBAC will aid in reducing the rate of cesarean sections in China. In clinical practice, the TOLAC prediction model will help improve VBAC’s success rate, owing to its contribution to reducing secondary cesarean section.

Download Full-text

The success rate and associate factors of vaginal birth after cesarean section at Tu Du Hospital in Vietnam

International Journal of Pregnancy & Child Birth ◽

10.15406/ipcb.2018.04.00096 ◽

2018 ◽

Vol 4 (3) ◽

Keyword(s):

Cesarean Section ◽

Success Rate ◽

Vaginal Birth ◽

Vaginal Birth After Cesarean

Download Full-text

Factors predicting Success of Vaginal Birth after Cesarean Section

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1417 ◽

2016 ◽

Vol 8 (3) ◽

pp. 198-201

Author(s):

Uma Singh ◽

Manju L Verma ◽

S Nisha ◽

Pushpa L Sankhwar ◽

Sabuhi Qureshi

Keyword(s):

Cesarean Section ◽

Success Rate ◽

Cesarean Delivery ◽

Fetal Distress ◽

Vaginal Birth ◽

Vaginal Birth After Cesarean ◽

Trial Of Labor ◽

Emergency Cesarean ◽

Predicting Success ◽

History Of

ABSTRACT Aim The aim of this article is to study the various factors that can predict the success of vaginal birth after cesarean (VBAC) section. Materials and methods A retrospective cohort study of deliveries was conducted from 1 January 2014 to 31 December 2014 by the Department of Obstetrics and Gynecology in our hospital. Patients with previous low transverse cesarean section who had undergone a trial of labor were identified. Maternal inpatient and prenatal records were reviewed in all eligible subjects. During labor, uterine activity and fetal heart rate were monitored. When indicated, oxytocin or prostaglandin E2 was used for induction of labor according to Bishop score. Emergency cesarean delivery was considered in cases with the appearance of scar tenderness, fetal distress, nonprogress of labor, and deep transverse arrest. Results A total of 200 women were eligible for VBAC, but after written informed consent, 131 (65.5%) subjects were given trial of labor at term after one prior cesarean delivery among 3,604 deliveries while 69 (34.5%) subjects opted for elective repeat cesarean section. The overall VBAC success rate was 63.3% (76 of 120) in our study. History of spontaneous labor (p = 0.042) and history of previous vaginal delivery (p = 0.038) were found to be significantly associated with increased chance of success of VBAC, and lesser interdelivery interval was not found to be associated with decreased success rate (p = 0.096). Neither indication of previous cesarean nor birth weight of newborn (>3 kg) was found to be related to the success of VBAC. Conclusion Vaginal birth after cesarean section is a safe practice as long as it is offered with a proper selection of candidates with factors having a high success rate. Physicians need to be aware of factors having a good outcome before counseling mothers so that failure rates decrease and successful VBAC is increased. How to cite this article Verma ML, Nisha S, Singh U, Sankhwar PL, Qureshi S. Factors predicting Success of Vaginal Birth after Cesarean Section. J South Asian Feder Obst Gynae 2016;8(3):198-201.

Download Full-text