Validation of the close-to-delivery prediction model for vaginal birth after cesarean delivery in a Middle Eastern cohort.
OBJECTIVE
To validate a prediction model for vaginal birth after cesarean (VBAC) that incorporates variables available at admission for delivery among Middle Eastern women.


METHODS
The present prospective cohort study enrolled women at 37weeks of pregnancy or more with cephalic presentation who were willing to attempt a trial of labor (TOL) after a single prior low transverse cesarean delivery at Al-Jahra Hospital, Kuwait, between June 2013 and June 2014. The predicted success rate of VBAC determined via the close-to-delivery prediction model of Grobman et al. was compared between participants whose TOL was and was not successful.


RESULTS
Among 203 enrolled women, 140 (69.0%) had successful VBAC. The predicted VBAC success rate was higher among women with successful TOL (82.4%±13.1%) than among those with failed TOL (67.7%±18.3%; P<0.001). There was a high positive correlation between actual and predicted success rates. For deciles of predicted success rate increasing from >30%-40% to >90%-100%, the actual success rate was 20%, 30.7%, 38.5%, 59.1%, 71.4%, 76%, and 84.5%, respectively (r=0.98, P=0.013).


CONCLUSIONS
The close-to-delivery prediction model was found to be applicable to Middle Eastern women and might predict VBAC success rates, thereby decreasing morbidities associated with failed TOL.
Department of Obstetrics and Gynecology, Al Jahra Hospital, Jahra, Kuwait.
Ahmed
A
Abdel Aziz
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Amal
A
Abd Rabbo
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. Electronic address: waleed.asa@gmail.com.
Waleed A
WA
Sayed Ahmed
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Rasha E
RE
Khamees
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Khaled A
KA
Atwa
D000328:Adult; D005260:Female; D006801:Humans; D007730:Kuwait; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*; D055815:Young Adult
Prediction model; Trial of labor; Vaginal birth after cesarean