Risk score for failed trial of vaginal birth after a previous cesarean section including data of labor course.

摘要: AIM There is much discussion about the advantages and disadvantages of a trial labor after cesarean (TOLAC). Some data suggest greater likelihood success, lower risks TOLAC. Our goal was to identify clinical demographic variables associated with failed TOLAC, available at admission for spontaneous until 3 h later, aim building two scores risk METHODS This nested case-control study live births women one previous cesarean, in public Brazilian teaching hospital. Preterm, induction, noncephalic presentations, twins, fetal malformations were excluded. Cases controls, successful It accessed association cases 20 (P < 0.05). Associated tested multivariate analysis build scores, which internally validated. RESULTS We included 260 42 218 controls. found 11 In score be applied admission, we hypertension, fundal height, vaginal birth dilatation admission. second height membrane status difference Both presented good performance receiver-operator curve (areas under curve: 0.73 0.84, respectively). translated into nomograms use. CONCLUSION Two built later. believe that choosing more favorable makes TOLAC lower.