Does midtrimester cervical length aid in predicting vaginal birth after cesarean?

American Journal of Obstetrics and Gynecology
Emily S MillerWilliam A Grobman

Abstract

A longer midtrimester cervical length (CL) is associated with an increased chance of cesarean delivery, but CL has not been used to predict the chance of successful trial of labor after cesarean delivery (TOLAC). The objective of this study was to identify whether midtrimester CL improves the prediction of vaginal birth after cesarean delivery (VBAC) among women undergoing a TOLAC. Women with 1 prior cesarean and a singleton gestation in the vertex position who had a routine CL assessment between 18 and 24 weeks and chose to undergo a TOLAC were identified. Midtrimester CL and characteristics identifiable in early prenatal care that have been used in a validated predictive model for VBAC (ie, age, body mass index, race/ethnicity, prior vaginal delivery, prior VBAC, and indication for prior cesarean delivery) were abstracted from the medical record. Multivariable regressions with VBAC as the dependent variable, with and without CL, were created and their predictive capacity compared using receiver-operating characteristic curves and reclassification tables. Of the 678 women who met inclusion criteria, 517 (76.3%) experienced a VBAC. Mean midtrimester CL was lower in women who achieved a VBAC compared with those who required a ce...Continue Reading

References

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Apr 3, 2007·Obstetrics and Gynecology·William A GrobmanUNKNOWN National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU)
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Oct 3, 2013·Obstetrics and Gynecology·Emily S MillerWilliam A Grobman

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Citations

Apr 11, 2017·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Rupsa C BoeligVincenzo Berghella

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