A Better Model for Predicting Successful Trial of Labor After Cesarean Delivery

Vaginal birth after cesarean delivery (VBAC) is associated with better maternal and neonatal outcomes than repeat cesarean delivery — but what factors at admission indicate that a trial of labor after cesarean delivery (TOLAC) will succeed? Using data from a retrospective cohort of women with singleton pregnancies and previous cesarean deliveries, investigators developed a model to predict TOLAC success. Only the first delivery after the primary cesarean birth was analyzed. Of 5445 women at 14 Intermountain Healthcare hospitals in Utah who gave birth after a primary cesarean delivery, 1170 underwent TOLAC; of these, 80% achieved VBAC. The patient population was predominantly white, married, and privately insured, with normal body-mass index…