title: Vaginal birth after caesarean section prediction models: a UK comparative observational study.
abstract: OBJECTIVE
  Primarily, to assess the performance of three statistical models in predicting successful vaginal birth in patients attempting a trial of labour after one previous lower segment caesarean section (TOLAC). The statistically most reliable models were subsequently subjected to validation testing in a local antenatal population.
  
  
  METHODS
  A retrospective observational study was performed with study data collected from the Northern Ireland Maternity Service Database (NIMATs). The study population included all women that underwent a TOLAC (n=385) from 2010 to 2012 in a regional UK obstetric unit. Data was collected from the Northern Ireland Maternity Service Database (NIMATs). Area under the curve (AUC) and correlation analysis was performed.
  
  
  RESULTS
  Of the three prediction models evaluated, AUC calculations for the Smith et al., Grobman et al. and Troyer and Parisi Models were 0.74, 0.72 and 0.65, respectively. Using the Smith et al. model, 52% of women had a low risk of caesarean section (CS) (predicted VBAC >72%) and 20% had a high risk of CS (predicted VBAC <60%), of whom 20% and 63% had delivery by CS. The fit between observed and predicted outcome in this study cohort using the Smith et al. and Grobman et al. models were greatest (Chi-square test, p=0.228 and 0.904), validating both within the population.
  
  
  CONCLUSIONS
  The Smith et al. and Grobman et al. models could potentially be utilized within the UK to provide women with an informed choice when deciding on mode of delivery after a previous CS.
authors: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Holles St, Dublin 2, Ireland; Department of Obstetrics and Gynaecology, National Maternity Hospital, Holles St, Dublin 2, Ireland. Electronic address: fmone@nmh.ie.
authors: Fionnuala
authors: F
authors: Mone
authors: Sims IVF, Clonskeagh Rd, Dublin 14, Ireland.
authors: Conor
authors: C
authors: Harrity
authors: Department of Obstetrics and Gynaecology, National Maternity Hospital, Holles St, Dublin 2, Ireland.
authors: Adam
authors: A
authors: Mackie
authors: CSTAR, School of Public Health, Physiotherapy and Population Science, University College Dublin, Ireland.
authors: Ricardo
authors: R
authors: Segurado
authors: Department of Obstetrics, Royal Maternity Hospital, Belfast BT12 6BA, UK.
authors: Brenda
authors: B
authors: Toner
authors: Department of Obstetrics and Gynaecology, Craigavon Area Hospital, 68 Lurgan Rd, Portadown BT63 5QQ, UK.
authors: Timothy R
authors: TR
authors: McCormick
authors: Department of Obstetrics and Gynaecology, Craigavon Area Hospital, 68 Lurgan Rd, Portadown BT63 5QQ, UK.
authors: Aoife
authors: A
authors: Currie
authors: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Holles St, Dublin 2, Ireland; Department of Obstetrics and Gynaecology, National Maternity Hospital, Holles St, Dublin 2, Ireland.
authors: Fionnuala M
authors: FM
authors: McAuliffe
mesh_terms: D000328:Adult; D019540:Area Under Curve; D005260:Female; D005544:Forecasting / Q000379:methods; D006801:Humans; D015233:Models, Statistical; D009660:Northern Ireland; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean
keywords: Prediction; Statistical model; Trial of labor after cesarean section; Vaginal birth after cesarean section