A woman with a single previous low-transverse cesarean section (LTCS) desires VBAC. Which factor is associated with the HIGHEST predicted success for trial of labour after cesarean (TOLAC)?
- A Previous cesarean for non-recurring indication with a prior vaginal delivery ✓
- B Previous cesarean for active phase arrest at full dilatation
- C Induction of labour with oxytocin for TOLAC
- D Interpregnancy interval less than 18 months
Correct answer: A. Previous cesarean for non-recurring indication with a prior vaginal delivery
Explanation
The highest TOLAC success rate (70–80%) is seen in women with a prior vaginal delivery AND a previous cesarean for a non-recurring indication such as breech. Proven prior vaginal delivery is the single strongest predictor of successful VBAC. Prior cesarean for dystocia carries lower success rates (~50–60%). Oxytocin augmentation slightly increases uterine rupture risk. Short interpregnancy intervals (< 18 months) are associated with higher rupture risk.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.