Predicting the success of a trial of labor with a simple scoring system.
OBJECTIVE
To determine the applicability of a simple scoring system, by Troyer and Parisi, in predicting the success of a trial of labor among parturients with prior cesarean delivery.


METHODS
Retrospectively, all patients who underwent a trial of labor over six consecutive years were reviewed. chi 2, Fisher's exact test and analysis of variance followed by the Turkey or Dunn test were used when appropriate. P < .05 was considered significant.


RESULTS
There were 263 trials of labor, of which 63% (167) ended in vaginal delivery. While 21% had a score of 0, 40%, 28% and 11% had a score of 1, 2 and at least 3, respectively. The frequency of vaginal birth was significantly different between the four groups (P < .001): 98% for a score of 0, 69% for 1, 40% for 2 and 33% for 3-4. Occurrence of cesarean delivery for cephalopelvic disproportion (2%, 24%, 39%, 56%; P < .001) or for a nonreassuring fetal heart rate tracing (0%, 7%, 21%, 11%; P < .001) was significantly different between the four groups.


CONCLUSIONS
In our population, we confirmed the inverse relationship between the Troyer-Parisi scoring system and a successful trial of labor.
Vinueza
C A
CA
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, USA.
Chauhan
S P
SP
Barker
L
L
Hendrix
N W
NW
Scardo
J A
JA
D000328:Adult; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D007744:Obstetric Labor Complications / Q000145:classification*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean