ArticleJournal of obstetrics and gynaecology of India2018
Predicting Successful Trial of Labor After Cesarean Delivery: Evaluation of Two Scoring Systems.
Article in Journal of obstetrics and gynaecology of India, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2019Pooled it
- Predictive factors for vaginal delivery in pregnant women with previous cesarean section: a case-control study.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Observational
- Factors associated with successful vaginal birth after one lower uterine transverse cesarean section delivery.Scientific reports · 2023Article
- Analysis of Maternal and Infant Outcomes and Related Factors of Vaginal Delivery of Second Pregnancy after Cesarean Section.Computational and mathematical methods in medicine · 2022Article
- Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundAttempting vaginal birth after cesarean section (VBAC) places women at an increased risk of complications. Trial of labor after cesarean (TOLAC) calculators aim to predict the chance of successful vaginal birth after cesarean (VBAC) based on the patient's preexisting demographic and clinical factors.
objectiveTo assess the rate of successful TOLAC using two calculators: FLAMM and the Grobman calculator, and to compare the performance of the two calculators in the successful prediction of VBAC.
methodsProspective cohort study in subjects with previous one caesarean section using well-defined inclusion and exclusion criteria.
resultsA total of 280 subjects with previous one cesarean section were enrolled. One hundred thirty-nine subjects consented for TOLAC, 90 (67%) underwent successful trial of vaginal birth, and 49 (32.8) required cesarean section. Cervical dilatation (p < 0.0001) and effacement (p < 0.0001), and any prior vaginal delivery (p < 0.02) were significantly associated with a successful outcome. At a cutoff score of 5, the sensitivity of the FLAMM score was 72% and specificity was 76%. For the Grobman calculator, the best sensitivity (69%) and specificity (67%) were seen at a cutoff score of 85%.
conclusionBoth prediction models, the FLAMM and the "close to delivery" nomogram, recommended by Grobman et al. are easy to use and could successfully estimate the chances of vaginal birth in previous caesarean, in this small cohort. The decision for women opting for TOLAC can be individualized, and patient-specific chances of success can be predicted by the use of these prediction models.
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