J-B Haumonte1, M Raylet2, M Christophe3, F Mauviel4, A Bertrand5, R Desbriere6, C d'Ercole7. 1. Obstetrics and Gynaecology unit, Hospital Saint-Joseph, 13285 Marseille, France; Hôpital Nord, Assistance publique-hôpitaux de Marseille, 13015 Marseille, France. Electronic address: jb.haumonte@gmail.com. 2. Obstetrics and Gynaecology unit, centre hospitalier du Pays d'Aix, 13616 Aix-en-Provence, France. 3. Obstetrics and Gynaecology unit, CHG de Martigues, 13500 Martigues, France. 4. Obstetrics and Gynaecology unit, CHIC de Toulon-La-Seyne, 83100 Toulon-La-Seyne, France. 5. Obstetrics and Gynaecology unit, CHG de Salon-de-Provence, 13300 Salon-de-Provence, France. 6. Obstetrics and Gynaecology unit, Hospital Saint-Joseph, 13285 Marseille, France. 7. Obstetrics and Gynaecology unit, hôpital Conception, Assistance publique-hôpitaux de Marseille, 13005 Marseille, France.
Abstract
OBJECTIVE: To validate Grobman nomogram for predicting vaginal birth after cesarean delivery (VBAC) in a French population and adapt it. STUDY DESIGN: Multicenter retrospective study of maternal and obstetric factors associated with VBAC between May 2012 and May 2013 in 6 maternity units. External validation and adaptation of the prenatal and intrapartum Grobman nomograms for vaginal birth prediction after cesarean delivery in a French cohort. RESULTS: The study included 523 women with previous cesarean deliveries; 70% underwent a trial of labor for a subsequent delivery (n=367) with a success rate of 65% (n=240). In the univariate analysis, 5 factors were associated with successful VBAC: previous vaginal delivery before the cesarean (P<0.001), the number of previous vaginal deliveries (P<0.001), and a favorable cervix at delivery room admission, cervical effacement (P=0.035), or cervical dilatation at least 3cm (P<0.001), or a Bishop score >6 (P=0.03). A potentially recurrent indication (defined as arrest of dilation or descent as the indication for the previous cesarean) (P=0.039), a hypertensive disorder during pregnancy (P=0.05), and labor induction (P=0.017) were each associated with failed VBAC. External validation of the prenatal and intrapartum Grobman nomograms showed an area under the ROC curve of 69% (95% CI: 0.638, 0.736) and 65% (95% CI: 0.599, 0.700) respectively. Adaptation of the nomogram to the French cohort resulted in the inclusion of the following factors: maternal age, body mass index at last prenatal visit, hypertensive disorder, gestational age at delivery, recurring indication, cervical dilatation, and induction of labor. Its area under the curve to predict successful VBAC was 78% (95% CI: 0.738, 0.825). CONCLUSION: The nomogram to predict VBAC developed by Grobman et al. is validated in the French population. Adaptation to the French population, by excluding ethnicity, appeared to improve its performance. Impact of the nomogram use on the caesarean section rate has to be validated in a randomized control trial.
OBJECTIVE: To validate Grobman nomogram for predicting vaginal birth after cesarean delivery (VBAC) in a French population and adapt it. STUDY DESIGN: Multicenter retrospective study of maternal and obstetric factors associated with VBAC between May 2012 and May 2013 in 6 maternity units. External validation and adaptation of the prenatal and intrapartum Grobman nomograms for vaginal birth prediction after cesarean delivery in a French cohort. RESULTS: The study included 523 women with previous cesarean deliveries; 70% underwent a trial of labor for a subsequent delivery (n=367) with a success rate of 65% (n=240). In the univariate analysis, 5 factors were associated with successful VBAC: previous vaginal delivery before the cesarean (P<0.001), the number of previous vaginal deliveries (P<0.001), and a favorable cervix at delivery room admission, cervical effacement (P=0.035), or cervical dilatation at least 3cm (P<0.001), or a Bishop score >6 (P=0.03). A potentially recurrent indication (defined as arrest of dilation or descent as the indication for the previous cesarean) (P=0.039), a hypertensive disorder during pregnancy (P=0.05), and labor induction (P=0.017) were each associated with failed VBAC. External validation of the prenatal and intrapartum Grobman nomograms showed an area under the ROC curve of 69% (95% CI: 0.638, 0.736) and 65% (95% CI: 0.599, 0.700) respectively. Adaptation of the nomogram to the French cohort resulted in the inclusion of the following factors: maternal age, body mass index at last prenatal visit, hypertensive disorder, gestational age at delivery, recurring indication, cervical dilatation, and induction of labor. Its area under the curve to predict successful VBAC was 78% (95% CI: 0.738, 0.825). CONCLUSION: The nomogram to predict VBAC developed by Grobman et al. is validated in the French population. Adaptation to the French population, by excluding ethnicity, appeared to improve its performance. Impact of the nomogram use on the caesarean section rate has to be validated in a randomized control trial.
Authors: William A Grobman; Grecio Sandoval; Madeline Murguia Rice; Jennifer L Bailit; Suneet P Chauhan; Maged M Costantine; Cynthia Gyamfi-Bannerman; Torri D Metz; Samuel Parry; Dwight J Rouse; George R Saade; Hyagriv N Simhan; John M Thorp; Alan T N Tita; Monica Longo; Mark B Landon Journal: Am J Obstet Gynecol Date: 2021-05-24 Impact factor: 8.661
Authors: G Gitas; L Proppe; A K Ertan; S Baum; A Rody; M Kocaer; K Dinas; L Allahqoli; A S Laganà; A Sotiriadis; S Sommer; I Alkatout Journal: BMC Pregnancy Childbirth Date: 2021-05-04 Impact factor: 3.007
Authors: George Gitas; Ibrahim Alkatout; Kubilay A Ertan; Achim Rody; Louisa Proppe; Mustafa Kocaer; Antonio Simone Laganà; Leila Allahqoli; Themistoklis Mikos; Soteris Sommer; Sascha Baum Journal: J Turk Ger Gynecol Assoc Date: 2022-07-05