Predicting vaginal birth after cesarean section: A cohort study

Jennifer A. Tessmer-Tuck, Sherif A. El-Nashar, Adrianne R. Racek, Christine M. Lohse, Abimbola O. Famuyide, Myra J. Wick

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective: To develop a model to predict vaginal birth after cesarean (VBAC) in our population and to compare the accuracy of this model to the accuracy of a previously published widely used model. Materials and Methods: Women attempting trial of labor after cesarean delivery (TOLAC) at our institution from January 1, 2000 through May 30, 2010 were evaluated for inclusion. Demographic and clinical data were collected. Associations of these characteristics with VBAC were evaluated with univariate and multivariate logistic regression. We critically compared the accuracy of the resulting model to a previously published widely utilized model for predicting VBAC. Results: A total of 2,635 deliveries with at least 1 prior cesarean delivery were identified. TOLAC was attempted in 599 (22.7%) and resulted in 456 VBACs (76.0%) and 143 repeat cesareans (24.0%). VBAC success was independently associated with age <30 years, a body mass index <30, prior vaginal delivery, prior VBAC, and absence of a recurrent indication for cesarean. This model provided a range of successful probability of VBAC (38-98%) with an area under the receiver operating characteristic curve of 0.723. Conclusions: This study provides an accurate and simple model that can be utilized to guide decisions related to TOLAC.

Original languageEnglish (US)
Pages (from-to)121-126
Number of pages6
JournalGynecologic and Obstetric Investigation
Issue number2
StatePublished - Feb 2014


  • Cesarean section
  • Labor
  • Nomogram
  • Obstetrics
  • Trial of labor after cesarean delivery
  • Vaginal birth after cesarean

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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