A Prospective Observational Study for the Vaginal Birth After Cesarean Score to Predict Successful Vaginal Birth After Cesarean Sections

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Gauri Pawar, Manisha Laddad, Ashish Kalburgi


Introduction: The study's objectives were to identify the variables that affect "Vaginal Birth After Caesarean Delivery (VBAC)" success and to develop a nomogram for estimating the likelihood of a successful VBAC. Previous research has demonstrated that factors such as maternal age, obesity, the time between pregnancies, and the reason for the prior caesarean section can all have an impact on the success of VBAC.

Materials and Techniques: The study included 500 women contemplating a TOLAC at a tertiary care institution who had previously undergone a caesarean section. The computed VBAC Score. The success of VBAC served as the main outcome indicator. The area under the receiver operating characteristic (ROC) curve was used to assess the VBAC Score's accuracy in predicting successful VBACs. In order to determine the independent determinants of successful VBAC, logistic regression analysis was utilised.

Results: 305 (61%) of the 500 patients who underwent a VBAC did so successfully. The successful VBAC group's mean VBAC Score was 0.64 (SD=0.19), while the unsuccessful VBAC group's was 0.45 (SD=0.19). The VBAC Score's area under the ROC curve for predicting a successful VBAC was 0.76 (95% CI 0.72-0.80), which indicates a fair level of accuracy. For predicting successful VBAC, a VBAC Score cut-off value of 0.50 exhibited a sensitivity of 72% and a specificity of 63%. Using logistic regression analysis, it was determined that prior vaginal delivery (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.56-3.51), a delivery interval of less than 18 months (odds ratio [OR] 0.53, 95% CI 0.32-0.88), and cervical dilation of at least 3 cm at admission were all independent predictors of successful VBAC.

Conclusion: The VBAC score indicates whether a VBAC will be successful. Three factors were independent predictors of successful VBAC: prior vaginal birth, an 18-month interval between deliveries, and a 3 cm cervical dilation at admission. These findings might help medical professionals manage and guide post-cesarean women who attempt labour. In order to define the appropriate inter-delivery duration for VBAC success and to validate these findings across a range of demographics and circumstances, more study is required.

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