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Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1811-5; discussion 1815-9.

Vaginal birth after cesarean delivery: are there useful and valid predictors of success or failure?

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  • 1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505.

Abstract

OBJECTIVE:

Before parturition are there useful and valid predictors of successful or unsuccessful vaginal birth after previous cesarean birth that could be used to enhance the obstetric care of a patient and her pregnancy?

STUDY DESIGN:

The clinical course and outcome of all patients who attempted vaginal birth after cesarean delivery at one level III center during 1989 were evaluated to identify factors prognostic of a successful or unsuccessful patient group; use of this information in stepwise logistic regression and cluster analysis was disappointing.

RESULTS:

No single criterion or optimal clusters of factors were found and no equation achieved greater than 75% predictability of outcome with acceptable sensitivity and specificity.

CONCLUSIONS:

Before parturition prediction of outcome of vaginal birth after cesarean delivery is tenuous regardless of past obstetric history or recent clinical parameters. Thus it seems appropriate to encourage a trial of labor in almost all patients with a prior low-segment uterine incision (transverse or vertical) unless there is a strong physician or patient-derived contraindication to such an undertaking.

PMID:
1615990
[PubMed - indexed for MEDLINE]
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