Application of seven prediction models of vaginal birth after cesarean in a Chinese hospital
10.3969/j.issn.1671-167X.2016.05.008
- VernacularTitle:剖宫产术后经阴道分娩的7种预测模型在中国的临床应用
- Author:
Tian MU
;
Yan WANG
;
Guoli LIU
;
Jianliu WANG
- Publication Type:Journal Article
- Keywords:
Vaginal birth after cesarean;
Trial of labor;
Scarred uterus;
Models,statistical
- From:
Journal of Peking University(Health Sciences)
2016;48(5):795-800
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the seven existing vaginal birth after cesarean (VBAC)screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China.Methods:In the study,53 patients with 1 previous cesarean delivery who then delivered between January 1,2007 and Novenber 31,2014 were recruited.The average age of the patients was (32.1 ±3.5 )years,the average gestational age was (38.0 ±2.3)weeks.There was no significant difference of the successful group and the failed group in the maternal /neonatal mortality and morbidity,also in the incidence of the postpartum hemorrhage and the postpartum infection.The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein,Flamm,Grobman,Gonen,Troyer,Smith and Torri.The data were analyzed using t test,rank-sum test,and receiver operating curve analysis. Results:44 trial of labor patients had a vaginal birth after cesarean delivery,and the successful rate was 83%.The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only.After recalculating the successful rate of VBAC in different score levels according to the references,there was significant difference between the rates of dif-ferent score levels when evaluated by the Weinstein model.The successful rates of different score levels were higher compared to the references (<50%)when evaluated by the Troyer (70%),Gonen (60%),Torri (85.7%)models.The area under the receiver operating characteristic curve of Weinstein prediction model (0.746)and Flamm prediction model (0.723)were more than 0.7,and there was no significant difference between the seven models.Conclusion:Among the seven scoring models,the Weinstein model is more applicable to the population of our country,but a new model more applying to Chinese women still needs to be created.
