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Predictors of Success during Induction Trial of Labor After Cesarean: A Calculator.
Antepartum Model
Does the patient have a diagnosis of chronic
hypertension?
Yes No
Does the patient have current, former or never tobacco
use?
Current
Former
Never
Was the indication for the patient' s primary cesarean labor dystocia?
Yes No
How many prior NSVDs has the patient had?
How many prior VBACS has the patient had?
How many years have passed since the patient's last
delivery?
Probabilityof successful VBAC =
Area under the receiver operating characteristic (ROC)
curve: 0.73 (95% CI 0.69-0.78).
Time of Delivery Model :
Does the patient have current, former or never tobacco
use?
Current
Former
Never
Was the indication for the patient's prior cesareans labor dystocia?
Yes No
Is the induction medically indicted?
Yes No
How many prior NSVDs has the patient had ?
How many prior VBACs has the patient had?
How many years have passed since the patient's last delivery?
What is the patient Simplified Bishop Score?
What is the patient's most recent BMI?
Probability of succesful VBAC =
Area under the receiver operating characteristic (ROC) curve: 0.75 (95% CI 0.71-0.79)
NSVD – normal
spontaneous vaginal delivery. VBAC – Vaginal birth after cesarean. BMI –
body mass index (kg/m²). *The simplified bishop score is calculated using
dilation, station and effacement sub-scores only, (score 0-9)1.
Antepartum
Model
Probability = 1 /
1+e^-((cHTN)(-0.61)+(tobacco use)(0.68)+(hx of tobacco use)(-0.69)+(prior
cesarean indication)(- 0.41)+(NSVD)(0.36)+(VBAC)(1.33)+(Delivery
interval)(-.0.08)+0.82)
Time of Delivery Model
Probability = 1 / 1+e^-((tobacco use)(0.77)+(hx of tobacco use)(-0.65)+(prior
cesarean indication)(-0.42)+(NSVD)(0.39)+(VBAC)(1.27)+(Delivery
interval)(-.0.07)+(Bishopscore)(0.17)+(BMI)(-0.04)+(Indicated
induction)(-0.41)+2.08)
cHTN -> chronic
hypertension, where 1 = yes
Tobacco use -> current tobacco use, where 1
= yes
Hx of tobacco use -> history of tobacco use, where 1 = yes
Prior cesarean indication -> indication for primary cesarean was labor
dystocia, where 1 = yes
NSVD -> number prior NSVD, enter number
VBAC -> number prior VBAC, enter number
Delivery interval -> interval in
years since last delivery
Bishop score -> Simplified bishop score,
enter number
BMI -> BMI, enter number
Indicated induction ->
induction is medically indicated, where 1 = yes
This calculator
was developed at The University of California San Diego to predict the
likelihood of successful VBAC during induction of labor trial of labor after
cesarean. The Antepartum Model is designed for counseling in the prenatal
period, while the Time of Delivery Model is designed for counseling at the
time of planned delivery. The calculator, including antepartum and time of
delivery models, is available for further clinical validation, please
contact drogerson@health.ucsd.edu.
1.
https://perinatology.com/calculators/Bishop%20Score%20Calculator.htm
REFFERENCE Daniella Rogerson1 , Carolina Díaz Luévano1 , Anika
Christofferson2 , Ravi Agarwal2 , Payton Ottum1 , Keri Cowles1 , Dana
Canfield3 , Marni Jacobs1 , Cynthia Gyamfi-Bannerman1,3. Predictors of
Success during Induction Trial of Labor After Cesarean : A Calculator.
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