A prospective study of a new prediction model of vaginal birth after cesarean section at a tertiary care centre
Journal Title: Turkish Journal of Obstetrics and Gynecology - Year 2020, Vol 17, Issue 4
Abstract
Objective: To create a new and simple model for predicting the likelihood of vaginal birth after cesarean (VBAC) section using variables available at the time of admission. Materials and Methods: A prospective observational study was performed at a tertiary care centre in Haryana over a period of 12 months (January 2018 - December 2018) in pregnant women attending the labour room with one previous cesarean section fulfilling the criteria for undergoing trial of labour after cesarean (TOLAC). The sample size was 150. A VBAC score was calculated for each patient using a new prediction model that included variables available at the time of admission such as maternal age, gestational age, Bishop’s score, body mass index, indication for primary cesarean section, and clinically estimated fetal weight. The results of the VBAC scores were correlated with outcomes i.e. successful VBAC or failed VBAC. The chi-square test and Student’s t-test was used for comparison among the groups. Descriptive and regression analysis was performed for the study variables. Results: Out of 150 TOLAC cases, 78% had successful VBAC and the remainder (22%) had failed VBAC. The observed probability of having a successful VBAC for a VBAC score of 0-3 was 34%, 4-6 was 68%, 7-9 was 90%, and ≥10 was 97%. The prediction model performed well with an area under the curve of 0.77 (95% CI: 0.68 to 0.85) of the receiver operating characteristics receiver operating characteristic curve. Conclusion: The present study shows that the proposed VBAC prediction model is a good tool to predict the outcome of TOLAC and can be used to counsel women regarding the mode of delivery in the current and subsequent pregnancies. Further studies of this model and other such models with different permutations and combinations of variables are required.
Authors and Affiliations
Pinkey Lakra, Bhagyashri Patil, Sunita Siwach, Manisha Upadhyay, Shivani Shivani, Vijayata Sangwan, Rajiv Mahendru
Keywords
Related Articles
- EP ID EP691679
- DOI 10.4274/tjod.galenos.2020.82205
- Views 141
- Downloads 0
Effects of reviewing childbirth scenarios on choice of delivery type: a randomized controlled trial
Objective: The incidence of cesarean section (CS) was estimated as about 48% between 2000 and 2012 in Iran. This study was conducted to assess the effects of reviewing written childbirth scenarios on the selection of del...
Different pathogenic mechanisms of early-onset preeclampsia, late-onset preeclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome
No Abstract.
First trimester complete blood cell indices in early and late onset preeclampsia
Objective: This study aimed to compare the first trimester complete blood count (CBC) indices of pregnancies complicated by early-onset preeclampsia (EOPE) or late-onset preeclampsia (LOPE). Material and Methods: A retr...
Neural and cardiac injury markers in fetal growth restriction and their relation to perinatal outcomes
Objective: To compare the levels of umbilical cord blood Neuron-Specific Enolase (NSE) and troponin T and venous blood gas samples between healthy newborns and growth-retarded fetuses with impaired Doppler velocity or lo...
Palliative pelvic exenteration using iliofemoral bypass with synthetic grafts for advanced cervical carcinoma
Objective: Recurrent cervical cancer can cause severe morbidity. Despite the severe morbidity after surgery, pelvic exenteration is still used today for mainly curative intent. This intention is neither based on randomiz...