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A comparison of antenatal prediction models for vaginal birth after caesarean section
Annals of the Academy of Medicine, Singapore ; : 606-612, 2021.
Article in English | WPRIM | ID: wpr-887542
ABSTRACT
INTRODUCTION@#An antenatal scoring system for vaginal birth after caesarean section (VBAC) categorises patients into a low or high probability of successful vaginal delivery. It enables counselling and preparation before labour starts. The current study aims to evaluate the role of Grobman nomogram and the Kalok scoring system in predicting VBAC success in Singapore.@*METHODS@#This is a retrospective study on patients of gestational age 37 weeks 0 day to 41 weeks 0 day who underwent a trial of labour after 1 caesarean section between September 2016 and September 2017 was conducted. Two scoring systems were used to predict VBAC success, a nomogram by Grobman et al. in 2007 and an additive model by Kalok et al. in 2017.@*RESULTS@#A total of 190 patients underwent a trial of labour after caesarean section, of which 103 (54.2%) were successful. The Kalok scoring system (area under curve [AUC] 0.740) was a better predictive model than Grobman nomogram (AUC 0.664). Patient's age (odds ratio [OR] 0.915, 95% CI [confidence interval] 0.844-0.992), body mass index at booking (OR 0.902, 95% CI 0.845-0.962), and history of successful VBAC (OR 4.755, 95% CI 1.248-18.120) were important factors in predicting VBAC.@*CONCLUSION@#Neither scoring system was perfect in predicting VBAC among local women. Further customisation of the scoring system to replace ethnicity with the 4 races of Singapore can be made to improve its sensitivity. The factors identified in this study serve as a foundation for developing a population-specific antenatal scoring system for Singapore women who wish to have a trial of VBAC.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Trial of Labor / Cesarean Section / Retrospective Studies / Vaginal Birth after Cesarean / Area Under Curve Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Annals of the Academy of Medicine, Singapore Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Trial of Labor / Cesarean Section / Retrospective Studies / Vaginal Birth after Cesarean / Area Under Curve Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Annals of the Academy of Medicine, Singapore Year: 2021 Type: Article