A 33-year-old woman, gravida 4 para 2, with one previous caesarean for breech presentation is counselled about trial of labour after caesarean. Which single factor is the strongest predictor of a successful vaginal birth?

• A Interdelivery interval longer than 18 months
• B Estimated fetal weight below 3500 g
• C Maternal age under 35 years
• D Prior vaginal delivery ✓

Explanation

A history of prior vaginal delivery, particularly vaginal birth after a caesarean, is the strongest predictor of VBAC success, with success rates approaching 90 percent in some series compared with about 70 percent overall. Indication for the index caesarean also matters, but a previous vaginal birth dominates all demographic factors. Short interdelivery intervals reduce success modestly and raise uterine rupture risk slightly.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.