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Predicting the success of a trial of labor with a simple scoring system
C A Vinueza1, S P Chauhan, L Barker
1Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, USA.
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.
Study Design:
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.
Conclusion:
In our population, we confirmed the inverse relationship between the Troyer-Parisi scoring system and a successful trial of labor.