OBJECTIVE: The purpose of this study was to develop a model that predicts individual-specific risk of uterine rupture during an attempted vaginal birth after cesarean delivery. STUDY DESIGN: Women with 1 previous low-transverse cesarean delivery who underwent a trial of labor with a term singleton were identified in a concurrently collected database of deliveries that occurred at 19 academic centers during a 4-year period. We analyzed different classification techniques in an effort to develop an accurate prediction model for uterine rupture. RESULTS: Of the 11,855 women who were available for analysis, 83 women (0.7%) had had a uterine rupture. The optimal final prediction model, which was based on a logistic regression, included 2 variables: any previous vaginal delivery (odds ratio, 0.44; 95% CI, 0.27-0.71) and induction of labor (odds ratio, 1.73; 95% CI, 1.11-2.69). This model, with a c-statistic of 0.627, had poor discriminating ability and did not allow the determination of a clinically useful estimate of the probability of uterine rupture for an individual patient. CONCLUSION: Factors that were available before or at admission for delivery cannot be used to predict accurately the relatively small proportion of women at term who will experience a uterine rupture during an attempted vaginal birth after cesarean delivery.
OBJECTIVE: The purpose of this study was to develop a model that predicts individual-specific risk of uterine rupture during an attempted vaginal birth after cesarean delivery. STUDY DESIGN:Women with 1 previous low-transverse cesarean delivery who underwent a trial of labor with a term singleton were identified in a concurrently collected database of deliveries that occurred at 19 academic centers during a 4-year period. We analyzed different classification techniques in an effort to develop an accurate prediction model for uterine rupture. RESULTS: Of the 11,855 women who were available for analysis, 83 women (0.7%) had had a uterine rupture. The optimal final prediction model, which was based on a logistic regression, included 2 variables: any previous vaginal delivery (odds ratio, 0.44; 95% CI, 0.27-0.71) and induction of labor (odds ratio, 1.73; 95% CI, 1.11-2.69). This model, with a c-statistic of 0.627, had poor discriminating ability and did not allow the determination of a clinically useful estimate of the probability of uterine rupture for an individual patient. CONCLUSION: Factors that were available before or at admission for delivery cannot be used to predict accurately the relatively small proportion of women at term who will experience a uterine rupture during an attempted vaginal birth after cesarean delivery.
Authors: Mark B Landon; Catherine Y Spong; Elizabeth Thom; John C Hauth; Steven L Bloom; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary J O'sullivan; Baha M Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer; Steven G Gabbe Journal: Obstet Gynecol Date: 2006-07 Impact factor: 7.661
Authors: Mark B Landon; John C Hauth; Kenneth J Leveno; Catherine Y Spong; Sharon Leindecker; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary Jo O'Sullivan; Baha Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer; Steven G Gabbe Journal: N Engl J Med Date: 2004-12-14 Impact factor: 91.245
Authors: William A Grobman; Yinglei Lai; Mark B Landon; Catherine Y Spong; Kenneth J Leveno; Dwight J Rouse; Michael W Varner; Atef H Moawad; Steve N Caritis; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Mary J O'Sullivan; Baha M Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer Journal: Obstet Gynecol Date: 2007-04 Impact factor: 7.661
Authors: George A Macones; Alison G Cahill; David M Stamilio; Anthony Odibo; Jeffrey Peipert; Erika J Stevens Journal: Am J Obstet Gynecol Date: 2006-10 Impact factor: 8.661
Authors: William A Grobman; Yinglei Lai; Mark B Landon; Catherine Y Spong; Kenneth J Leveno; Dwight J Rouse; Michael W Varner; Atef H Moawad; Hyagriv N Simhan; Margaret Harper; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Mary J O'Sullivan; Baha M Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer Journal: Am J Perinatol Date: 2009-10-07 Impact factor: 1.862
Authors: Charlotte Lindblad Wollmann; Kyle D Hart; Can Liu; Aaron B Caughey; Olof Stephansson; Jonathan M Snowden Journal: Acta Obstet Gynecol Scand Date: 2020-10-31 Impact factor: 3.636