Validation of the Prediction Model for Success of Vaginal Birth after Cesarean Delivery in Japanese Women

Abstract

Aim: To validate a previously developed prediction model for vaginal birth after cesarean (VBAC) using a Japanese cohort.Methods: We performed a cohort study of all term pregnant women with a vertex position, singleton gestation, and one prior low transverse cesarean delivery attempting a trial of labor between April 1985 and March 2010. Variables necessary for the prediction of successful VBAC were maternal age, pre-pregnancy body mass index, ethnicity, prior vaginal delivery, prior VBAC, and indication for prior cesarean delivery. They were extracted from medical records and put into the formula that calculates an individual woman's predicted VBAC success rate. The predicted rates were then partitioned into deciles and compared with the actual VBAC rates. The predictive ability of the model was assessed with a receiver operating characteristic and the area under the curve (AUC) was determined.Results: Seven hundred and twenty-five women who met the inclusion criteria had complete data available, of which 664 (91.6%) had VBAC. The predicted probability of VBAC, as calculated by the regression equation, was significantly higher in those who had a successful trial of labor (median 80.1%, interquartile range 71.5-88.7) than those who did not (median 69.4%, interquartile range 59.9-78.9, P<0.001). The predictive model had AUC of 0.80, which was comparative to the originally described one. When the predicted rates were each deciles of over 70%, the actual success rates were more than 90%.Conclusion: The previously published prediction model for VBAC developed in the USA is also available to Japanese women.

Use of Intracervical Foley Catheter for Induction of Labour in Cases of Previous Caesarean Section: Experience of a single tertiary centre in Oman

“…23 Yokoi et al also concluded that the best predictor for a successful VBAC was a previous VBAC in their study of 664 women with one previous Caesarean delivery. 24 To the best of the authors' knowledge, this study is the first of its kind to be conducted in Oman. The Sultan Qaboos University Hospital was one of the first centres in Oman to induce labour using a Foley catheter in cases of previous Caesarean delivery; the majority of other centres in Oman use prostaglandins for the induction of labour.…”

Predicting the chance of vaginal delivery after one cesarean section: validation and elaboration of a published prediction model

“…We have found one study on predictive factors affecting the outcome of VBAC from India [11], three Israeli publications [12,14,17], and one Japanese study [21]. Four publications were applicable for European settings.…”

“…Some models have been externally validated or supplemented with new variables in subsequent publications [2,[18][19][20][21]. To our knowledge, the most utilized model originates from the Grobman et al's study [8], considering only factors available at the first prenatal visit.…”

Impacto do parto vaginal após uma cesárea prévia sobre os resultados perinatais

“…Ao analisarmos os aspectos relacionados à variável idade materna, dois estudos merecem citação: o de Yokoi et al 21 no Japão, e o de Tan et al 22 na Malásia, que, ao estudarem as taxas de PVPC, não identificaram associação entre a idade materna e os demais resultados. No nosso estudo, gestantes adolescentes apresentaram taxas de PVPC, resultado semelhante ao citado por Pires et al 23 .…”