Troyer and Parisi developed a scoring system for identifying women likely to have a vaginal delivery following a previous cesarean section. The authors are from the University of Texas Health Science Center at Houston.
Inclusion criteria:
(1) singleton pregnancy with gestational age >= 36 weeks
(2) vertex presentation
(3) transverse lower uterine segment scar
Exclusion criteria:
(1) undocumented, low vertical or classic uterine incision
(2) multiple gestation
(3) malpresentation
(4) < 36 weeks gestation
Parameters:
(1) history of a previous dysfunctional labor (previous cesarean section performed for failure to progress, cephalopelvic disproportion, or dystocia)
(2) history of previous vaginal delivery
(3) fetal heart tracing on admission
(4) induction of labor
|
Parameter |
Finding |
Points |
|
history of previous dysfunctional labor |
no |
0 |
|
|
yes |
1 |
|
history of previous vaginal delivery |
no |
1 |
|
|
yes |
0 |
|
fetal heart tracing on admission |
reassuring |
0 |
|
|
nonreassuring |
1 |
|
labor induction |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the more likely a repeat cesarean section will be required.
|
Total Score |
Percent Vaginal Delivery |
|
0 |
92% |
|
1 |
74% |
|
2 |
67% |
|
3 or 4 |
46% |
Purpose: To predict the probability that a woman in labor will deliver vaginally following a previous cesarean section (VBAC) using the score of Troyer and Parisi.
Specialty: Obstetrics & Gynecology
Objective: risk factors
ICD-10: O32,
