A comparative study of three different forecasting methods for trial of labor after cesarean section

This study aims to establish a convenient and practical predelivery scoring system for trial of labor after cesarean section (TOLAC).

The data of 498 patients undergoing TOLAC were retrospectively studied. Indices with statistically significant differences, including cervical score, fetal weight, fetal pelvic index, body mass index and age, were selected. Combined with the presence of vaginal delivery history and indications of the previous cesarean section in these patients, three prenatal forecast scales for vaginal birth after cesarean (VBAC) were established. The receiver operating characteristic curve was drawn, and the best cut-off point was determined. Then, the areas under the curve of the three forecasting methods were compared. The scoring method with the largest area under the curve was considered the best method.

The six indications of cesarean section used for the forecasting scale were as follows: cervical score, fetal weight, body mass index, age, presence of vaginal delivery history and the presence of previous obstructive dystocia. The scale that had the largest area under the curve was considered the best forecasting scale.

The prenatal forecasting method for TOLAC was preliminarily investigated. It was determined that the scale with six indicators, such as the cervical score, could be used for the prenatal evaluation of TOLAC, providing a predictive basis for the possible success of the trial production for pregnant women. The method and process of VBAC section in our hospital was safe and effective.