AI Article Synopsis
- The study aimed to validate the MFMU's VBAC calculator in an Israeli cohort and identify variables that could improve VBAC prediction.
- An analysis of 490 women revealed that 80.8% successfully delivered vaginally, but the original calculator's performance was subpar (AUC of 0.709).
- An improved model that considered factors like previous VBAC and maternal diabetes achieved better predictive accuracy (AUC of 0.771), highlighting the need for further validation before the calculator's broader use.
Article Abstract
Objective: To validate the Maternal Fetal Medicine Unit's (MFMU) vaginal birth after cesarean delivery (VBAC) calculator in an Israeli cohort, and to detect other variables associated with VBAC and construct an improved VBAC calculator.
Methods: A retrospective cohort study was performed at a single university-affiliated medical center. Women carrying a singleton, term, cephalic-presenting fetus, with previous one low transverse cesarean delivery who opted for trial of VBAC were included. Demographic and obstetric characteristics were incorporated into the MFMU's calculator, to predict probabilities of VBAC and compare prediction performance with the original publication utilizing receiver operating characteristic (ROC) statistics. Logistic regression analysis was used to investigate other variables and construct an improved model for success of VBAC.
Results: Of 490 parturients, 396 (80.8%) had a successful vaginal delivery. Compared to the original publication, the MFMU's calculator underperformed: area under the ROC curve (AUC) was 0.709 (95% confidence interval [CI] 0.652-0.766, P < 0.001). Sensitivity, specificity, positive and negative predictive values, and overall accuracy were 67.42%, 65.96%, 89.30%, 32.46%, and 32.46%, respectively. An improved model that included previous VBAC, prior vaginal delivery, spontaneous onset of delivery, and maternal diabetes resulted in improved prediction performance with an AUC of 0.771 (95% CI 0.723-0.82, P < 0.001).
Conclusion: MFMU's VBAC calculator needs to be validated in different populations before implementation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ijgo.14439 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Antepartum multidisciplinary approach improves postpartum pain scores in patients with opioid use disorder.
J Perinat Med
January 2025
Department of Obstetrics, Gynecology, and Reproductive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Objectives: Pregnancies affected by opioid use disorder (OUD) face difficulties with postpartum pain control. This study aims to determine if prenatal anesthesia consultation for patients on medication for opioid use disorder (MOUD) affects maternal postpartum pain control.
Methods: This is a retrospective cohort study of pregnant patients diagnosed on MOUD who received prenatal care and delivered at a single academic institution between January 2017 and July 2023.
The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation.
J Clin Med
January 2025
Department of Cardiovascular & Thoracic Anaesthesia and Critical Care, University Hospital of Martinique, F-97200 Fort-de-France, Martinique, France.
Acute cardiovascular disorders are incriminated in up to 33% of maternal deaths, and the presence of sickle cell anemia (SCA) aggravates the risk of peripartum complications. Herein, we present a 24-year-old Caribbean woman with known SCA who developed a vaso-occlusive crisis at 36 weeks of gestation that required emergency Cesarean section. In the early postpartum period, she experienced fever with rapid onset of acute respiratory distress in the context of COVID-19 infection that required tracheal intubation and mechanical ventilatory support with broad-spectrum antibiotics and blood exchange transfusion.
View Article and Find Full Text PDFAbnormal Venous Flow in Pregnant Women with Mild Right Ventricular Dysfunction in Repaired Tetralogy of Fallot: A Clinical Model for Organ Dysfunction in Preeclampsia.
J Clin Med
December 2024
Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
Pregnant women with congenital heart disease carry a high risk of complications, especially when cardiac function is suboptimal. Increasing evidence suggests that impaired right ventricular (RV) function has a negative effect on placental function, possibly through venous congestion. We report a case series of hepatic and renal venous flow patterns in pregnant women with right ventricular dysfunction after repaired Tetralogy of Fallot (ToF), relative to those observed in normal pregnancy and preeclampsia.
View Article and Find Full Text PDFAdverse Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome with Pre-Conceptional Hyperandrogenism: A Multi-Institutional Registry-Based Retrospective Cohort Study.
J Clin Med
December 2024
Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
: Women with polycystic ovarian syndrome (PCOS) are at higher risk for pregnancy complications. The PCOS population is heterogeneous, with different phenotypes linked to varying risks of adverse outcomes. However, literature on pre-conceptional hyperandrogenism is limited and based on small sample sizes.
View Article and Find Full Text PDFEn Caul Cesarean Delivery-A Safer Way to Deliver a Premature Newborn? Narrative Review.
J Clin Med
December 2024
Department of Gynecology, Obstetrics and Neonatology, Division of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Premature deliveries and preterm newborns are of a special significance to obstetricians. Despite great improvement in neonatal intensive care in the last two decades, prematurity is still the leading cause of neonatal mortality and morbidity. Complications associated with premature deliveries are malpresentation, prolapse of the umbilical cord, entrapment of some parts of the fetal body, as well as severe bruising or bone fractures.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!