Women who have had a previous cesarean section should be encouraged to deliver vaginally if they are willing and if there is no obstetric contraindication. A predictive score can be used to estimate the chances of a successful vaginal birth after caesarean section (VBAC).
Parameters:
(1) Bishop score
(2) occurrence of vaginal delivery before cesarean section
(3) past indication for cesarean section
(3a) Grade A indications have a good chance for successful vaginal delivery
(3b) Grade D indications have a lower rate of successful vaginal delivery
|
Parameter |
Finding |
Yes |
No |
|
Bishop Score |
>= 4 |
4 |
0 |
|
vaginal delivery before cesarean section |
|
2 |
0 |
|
past indication |
Grade A • malpresentation • pregnancy induced hypertension • twins |
6 |
0 |
|
|
Grade B • placenta previa or abruptio placentae • prematurity • premature rupture of membranes |
5 |
0 |
|
|
Grade C • fetal distress • cephalopelvic disproportion or failure to progress • cord accident |
4 |
0 |
|
|
Grade D • macrosomia • IUGR |
3 |
0 |
score =
= (points for Bishop score) + (points for vaginal delivery) + (points for past indication)
where:
• only one past indication is used for scoring
Interpretation:
• minimum score 0
• maximum score 12
|
Score |
Chance for Vaginal Birth after Cesarean Section |
|
>= 4 |
>= 58% |
|
>= 6 |
>= 67% |
|
>= 8 |
>= 78% |
|
>= 10 |
>= 85% |
|
12 |
>= 88% |
Specialty: Obstetrics & Gynecology
ICD-10: ,
