Age <40 years | Yes No |
Vaginal Birth History | Before & After 1st Cesarean After 1st Cesarean Before 1st Cesarean None |
Reason other than failure to progress for first Cesarean | Yes No |
Cervical effacement at admission | >75% 25-75% <25% |
Cervical dilation >=4 cm at admission | Yes No |
Cesarean delivery is the most commonly performed major operation in the United States. Many of these are repeat Cesarean deliveries.
Vaginal Birth After Cesarean (VBAC) is a safe option, in many cases; however, complications are present, especially in those women who have an unsuccessful VBAC attempt.
This prediction rule, based upon 5022 VBAC patients, can assist in the determination of which women are likely or unlikely to have a successful trial of labor.
The items found to affect successful VBAC were:
The points are added together for each of these 5 items.
Total Score VBAC | % Successful |
0-2 | 49.1% |
3 | 59.9% |
4 | 66.7% |
5 | 77.0% |
6 | 88.6% |
7 | 92.6% |
8-10 | 94.9% |
Reference:
Flamm BL, Geiger AM. Vaginal Birth After Cesarean Delivery: An Admission Scoring System. Obstet Gynecol. 1997;90:907-10.