title: Prediction of successful trial of labor after cesarean - the benefit of prior vaginal delivery.
abstract: OBJECTIVE
  To determine predictive factors for vaginal birth after cesarean section (VBAC).
  
  
  METHODS
  A retrospective cohort study of all women with singleton pregnancies and a prior single low transverse cesarean section (CS) who attempted vaginal delivery in a tertiary hospital (2010-2014). Pregnancy outcome of women with VBAC was compared to those who failed vaginal delivery. Sub-analysis for women with no prior vaginal deliveries was performed. Pregnancies with non-cephalic presentation, estimated fetal weight >4000 g and any contraindications for vaginal delivery were excluded.
  
  
  RESULTS
  Of the 40 714 deliveries, 1767 women met inclusion criteria. Among them 1563 (88.5%) had a VBAC and 204 (11.5%) failed. There was no significant difference between the groups regarding maternal age, comorbidities and pregnancy complications. Predictors for VBAC were (odds ratio, 95% confidence interval) interval from prior CS (1.13, 1.04-1.22, p=0.004), previous VBAC (2.77, 1.60-4.78, p < 0.001), prior vaginal delivery prior to the CS (3.05, 1.73-5.39, p < 0.001) and induction of labor (0.62, 0.40-0.97, p = 0.03). For women with no prior vaginal birth, only birthweight was associated with VBAC (0.99, 0.99-1.00, p = 0.02).
  
  
  CONCLUSIONS
  While different variables may influence the rate of VBAC, the predictive ability of VBAC for women with no previous vaginal deliveries remains poor.
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Avital
authors.initials: A
authors.lastname: Wertheimer
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000379:methods; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D012189:Retrospective Studies; D013997:Time Factors; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*
keywords: Cesarean section; pregnancy; vaginal birth after cesarean section