A comparison of antenatal prediction models for vaginal birth
after caesarean section

ABSTRACT Introduction: An antenatal scoring system for vaginal birth after caesarean section (VBAC) categorises patients into a low or high probability of successful vaginal delivery. It enables counselling and preparation before labour starts. The current study aims to evaluate the role of Grobman nomogram and the Kalok scoring system in predicting VBAC success in Singapore. Methods: This is a retrospective study on patients of gestational age 37 weeks 0 day to 41 weeks 0 day who underwent a trial of labour after 1 caesarean section between September 2016 and September 2017 was conducted. Two scoring systems were used to predict VBAC success, a nomogram by Grobman et al. in 2007 and an additive model by Kalok et al. in 2017. Results: A total of 190 patients underwent a trial of labour after caesarean section, of which 103 (54.2%) were successful. The Kalok scoring system (AUC [area under the curve] 0.740) was a better predictive model than Grobman nomogram (AUC 0.664). Patient’s age odds ratio [OR] 0.915, 95% CI [confidence interval] 0.844–0.992), body mass index at booking (OR 0.902, 95% CI 0.845–0.962), and history of successful VBAC (OR 4.755, 95% CI 1.248–18.120) were important factors in predicting VBAC. Conclusion: Neither scoring system was perfect in predicting VBAC among local women. Further customisation of the scoring system to replace ethnicity with the 4 races of Singapore can be made to improve its sensitivity. The factors identified in this study serve as a foundation for developing a population-specific antenatal scoring system for Singapore women who wish to have a trial of VBAC. Keywords: Antenatal scoring system, caesarean section, obstetrics and gynaecology, trial of labour after caesarean section, vaginal birth after caesarean section

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Vaginal Birth After Caesarean Section (VBAC): Possible Antenatal Predictors of Success and Role of Ultrasound

Intrapartum Ultrasonography for Labor Management ◽

10.1007/978-3-030-57595-3_41 ◽

2021 ◽

pp. 489-498

Author(s):

Giuseppe Trojano ◽

Claudiana Olivieri ◽

Nicola Antonio Carlucci ◽

Renata Beck ◽

Ettore Cicinelli

Keyword(s):

Caesarean Section ◽

Vaginal Birth ◽

Predictors Of Success ◽

Vaginal Birth After Caesarean

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Vaginal birth after caesarean section prediction models: a UK comparative observational study

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2015.07.024 ◽

2015 ◽

Vol 193 ◽

pp. 136-139 ◽

Cited By ~ 15

Author(s):

Fionnuala Mone ◽

Conor Harrity ◽

Adam Mackie ◽

Ricardo Segurado ◽

Brenda Toner ◽

...

Keyword(s):

Caesarean Section ◽

Observational Study ◽

Prediction Models ◽

Vaginal Birth ◽

Vaginal Birth After Caesarean

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Vaginal birth after caesarean section: why and how?

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175280 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5554

Author(s):

Vidyadhar B. Bangal ◽

Satyajit Gavhane ◽

Vishesha Yadav ◽

Kunal Aher ◽

Dhruval Bhavsar

Keyword(s):

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Caesarean Section Rate ◽

Mode Of Delivery ◽

Vaginal Birth ◽

Maternal Complications ◽

History Of ◽

Spontaneous Onset ◽

Vaginal Birth After Caesarean

Background: With the significant rise in the incidence of primary caesarean section(CS) for various indications, an increasing proportion of the pregnant women coming for antenatal care, report with a history of a previous CS. This necessitates definite need to bring down the caesarean section rate, either by judicious selection of cases for primary caesarean section or by attempting vaginal delivery, following previous caesarean section (VBAC).Methods: A prospective observational study was conducted to find out the success of VBAC and the common predictive factors leading to successful VBAC. A total of 136 pregnant women with full term pregnancy, having history of previous one lower segment caesarean section and without any other medical and obstetrical complication were enrolled in the study.Results: Majority of the women (95.59%) had spontaneous onset of labor. The success of VBAC was 75 percent. The commonest maternal complications were fever (7.35%), scar dehiscence (3.68%), PPH (1.47%) and wound infection (2.21%).There was significantly higher number of women who had history of previous successful VBAC, had vaginal delivery (91.67%; p=0.038).It was observed that the rate of vaginal delivery was significantly high in women with Bishop’s score between 10 to 13 (94.64%) compared to 6 to 9 (61.25%) (p<0.001).The baby weight determined by ultrasound scan was significantly associated with mode of delivery (p=0.049).Conclusions: Vaginal Birth After Caesarean section is relatively safe, provided it is conducted in carefully selected cases, under constant supervision. Spontaneous onset of labour, good Bishops score and average baby weight were good predictors of successful VBAC.

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Predicting the success of vaginal birth after caesarean delivery: a retrospective cohort study in China

BMJ Open ◽

10.1136/bmjopen-2018-027807 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027807 ◽

Cited By ~ 2

Author(s):

Yun-Xiu Li ◽

Zhi Bai ◽

Da-Jian Long ◽

Hai-Bo Wang ◽

Yang-Feng Wu ◽

...

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Gestational Age ◽

Medical Records ◽

Retrospective Cohort ◽

Caesarean Delivery ◽

Primary Outcome ◽

Vaginal Birth ◽

History Of ◽

Vaginal Birth After Caesarean

ObjectivesTo develop a nomogram to predict the likelihood of vaginal birth after caesarean section (VBAC) among women after a previous caesarean section (CS).DesignA retrospective cohort study.SettingTwo secondary hospitals in Guangdong Province, China.ParticipantsInclusion criteria were as follows: pregnant women with singleton fetus, age ≥18 years, had a history of previous CS and scheduled for trial of labour after caesarean delivery (TOLAC). Patients with any of the following were excluded from the study: preterm labour (gestational age <37 weeks), two or more CSs, contradictions for vaginal birth, history of other uterine incision such as myomectomy, and incomplete medical records.Primary outcome measureThe primary outcome was VBAC, which was retrospectively abstracted from computerised medical records by clinical staff.ResultsOf the women who planned for TOLAC, 84.0% (1686/2006) had VBAC. Gestational age, history of vaginal delivery, estimated birth weight, body mass index, spontaneous onset of labour, cervix Bishop score and rupture of membranes were independently associated with VBAC. An area under the receiver operating characteristic curve (AUC) in the prediction model was 0.77 (95% CI 0.73 to 0.81) in the training cohort. The validation set showed good discrimination with an AUC of 0.70 (95% CI 0.60 to 0.79).ConclusionsTOLAC may be a potential strategy for decreasing the CS rate in China. The validated nomogram to predict success of VBAC could be a potential tool for VBAC counselling.

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Prediction of successful vaginal birth after caesarean section based on Flamm and Geiger scoring system a prospective observational study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184118 ◽

2018 ◽

Vol 7 (10) ◽

pp. 3998

Author(s):

Rajshree Sahu ◽

Naimaa Chaudhary ◽

Asha Sharma

Keyword(s):

Caesarean Section ◽

Observational Study ◽

Vaginal Delivery ◽

Scoring System ◽

Prospective Observational Study ◽

Emergency Caesarean Section ◽

Vaginal Birth ◽

New Delhi ◽

Emergency Caesarean ◽

Vaginal Birth After Caesarean

Background: The aim of this study was to evaluate the adequacy of Flamm and Geiger scoring system in prediction of successful vaginal birth after caesarean section.Methods: A prospective observational study was carried out on 75 pregnant women with previous one caesarean section in department of obstetrics and Gynecology, St Stephen’s hospital, New Delhi over a period of one year.Results: In the present study, out of 75 patients, 40% patients had successful VBAC and 60% patients had emergency LSCS. Among successful VBAC 70% patients had spontaneous vaginal delivery, while 23.3% patients had vacuum assisted and 6.7% had forceps assisted vaginal delivery. Most of the patients with total Flamm and Geiger score < 3 at the time of admission had emergency caesarean section while most of the patients with score >4 had successful VBAC. There were 53.3%, 75%, 85.7% and 100% probabilities of Successful VBAC with total score 4,5,6 and >8 respectively. Mean score for successful VBAC was 5±1.66and for emergency caesarean was 2.97±0.83.Conclusions: As total Flamm and Geiger score increases, a chance of successful VBAC increases. Application of Flamm and Geiger scoring gives fare judgment of successful vaginal birth in TOLAC and reduces the rate of failed trial leading to emergency caesarean section, thus improving outcome in a trial of labor.

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Factors Predisposing to Perinatal Death Related to Uterine Rupture During Attempted Vaginal Birth After Caesarean Section: Retrospective Cohort Study

Yearbook of Pediatrics ◽

10.1016/s0084-3954(07)70228-2 ◽

2006 ◽

Vol 2006 ◽

pp. 383-384

Author(s):

J.A. Stockman

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Retrospective Cohort Study ◽

Uterine Rupture ◽

Retrospective Cohort ◽

Perinatal Death ◽

Vaginal Birth ◽

Vaginal Birth After Caesarean

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CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2020.5.11 ◽

2020 ◽

pp. 78-84

Author(s):

Giang Truong Thi Linh ◽

Quang Mai Van

Keyword(s):

Birth Weight ◽

Caesarean Section ◽

Cesarean Section ◽

Pregnant Women ◽

Vaginal Birth ◽

Fetal Macrosomia ◽

Major Influence ◽

Maternal Complications ◽

Perineal Tear ◽

History Of

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.

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