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A Prediction Score for Safe and Successful Vaginal Birth after Cesarean Delivery: A Prospective Controlled Study

Mustafa M Zaitoun, Sanaa Ali Nour Eldin and Eman Youssif Mohammad

The aim of this study was to; evaluate the demographic, obstetrical, and medical factors that influence the chances of vaginal birth after cesarean delivery to develop accurate prediction score for safe and successful Vaginal Birth after Cesarean Delivery (VBAC).

Patients and Methods: Two hundred fifty parturient women with previous one lower segment CS were included after Informed consent for the trail of VBAC if there were no contraindications for such trial.

Results: 77.6% of women delivered vaginally and 22.4% had emergency repeated CS. Trial of labor success rates were affected by maternal age, parity, gestational age, history of prior vaginal delivery inter-delivery duration, previous attempt of VBAC, indication of previous CS, BMI, Bishop score on admission, type of labor, and neonatal weight.

Conclusion: The variables of significant predictive value were; Bishop score (≥ 4), prior vaginal delivery, BMI<30 kg/m2, birth weight < 4.000 g, and the indication of previous CS. The proposed VBAC score may help to identify women with a greater chance for successful VBAC.

Recommendation: the trail of labor should be done under close maternal and fetal monitoring in a hospital with appropriate facilities and services for immediate CS in urgent cases.