Construction and application of nomogram prediction model for trial of labor after cesarean
10.3969/j.issn.1009-0754.2025.01.014
- VernacularTitle:剖宫产术后再次妊娠阴道试产的列线图预测模型构建及应用
- Author:
Yunfeng QIAN
1
;
Guoqing CHENG
;
Xuemei DENG
;
Dandan WEI
Author Information
1. 201800 上海,海军军医大学第三附属医院妇科
- Keywords:
Trial of labor after cesarean;
Nomogram;
Decision-making curve
- From:
Journal of Navy Medicine
2025;46(1):63-67
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors of the failure in trial of labor after cesarean(TOLAC),construct and verify a prediction model for the risk of TOLAC.Methods The clinical data of 273 pregnant women who underwent TOLAC in The First Affiliated Hospital of Naval Medical University from 2019 to 2022 were retrospectively analyzed.Logistic regression was used to analyze influencing factors of the failure in TOLAC,and a nomogram model was established for individualized risk assessment.The best threshold of failure risk of TOLAC was evaluated by the decision-making curve and clinical influence curve.Results There were statistically significant differences in the age,gestational week,body mass index(BMI)before delivery,time to the last cesarean,cervical Bishop score and delivery times between the successful trial delivery group and the failed trial delivery group.The best intervention threshold was 0.72,that is,vaginal trial delivery should to be stopped when the risk of TOLAC failure was more than 72%as evaluated by the prediction model.Conclusion Age,gestational week,BMI before delivery,time to the last cesarean,Bishop score of cervix and delivery times are influencing factors for TOLAC failure.The prediction model based on these factors can provide a quantifiable TOLAC risk for pregnant women.
