What’s the best way to predict the success of a trial of labor after a previous C-section?
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Q: What's the best way to predict the success of a trial of labor after a previous C-section? Evidence-based answer: while 8 scoring tools predict success rates for a trial of labor after previous cesarean section (TOLAC), it's unclear which is the best because no trials have compared prediction tools against each other, and each tool has a unique set of variables. A "close-to-delivery"� scoring nomogram predicting the success rate of TOLAC correlates well (90% accuracy) with actual outcomes (strength of recommendation [SOR]: B, prospective and retrospective cohort studies) and has been externally validated with multiple additional cohorts. All other point-prediction scoring tools are accurate within 10% when predicting the success rate of TOLAC (SOR: B, prospective and retrospective cohort studies).
Journal of Family Practice, 64(12) 2015: E3-E7.