An integrated model with classification criteria to predict vaginal delivery success after cesarean section

Abstract Background: Cesarean delivery (CD) is the most frequently performed surgical procedure worldwide. Trial of labor after cesarean (TOLAC) is associated with an increase in perinatal complications related to uterine rupture. However, in general, vaginal birth after cesarean (VBAC) is considered safe and women have less morbidity than those who undergo an elective repeat cesarean delivery. Objective: To develop an integrated model with the best performance criteria for predicting vaginal delivery success after cesarean delivery. Study design: Retrospective observational study including 2367 women that underwent a Trial of labor after cesarean. A predictive model using classification and regression tree modeling was constructed to predict vaginal delivery using maternal demographic, medical history, and labor predictors. Results: Vaginal delivery was best predicted by spontaneous onset of labor, estimated fetal weight < 3775 g, maternal body mass index < 25, previous cesarean delivery as an elective o...