A G4P3 with one prior lower segment cesarean section requests trial of labor after cesarean. Which single feature in her history is the strongest predictor of a successful vaginal birth?
- A Interdelivery interval of more than 24 months
- B Birth weight of the previous cesarean baby over 3.5 kg
- C A prior vaginal delivery ✓
- D Maternal age under 30 years
Correct answer: C. A prior vaginal delivery
Explanation
A prior vaginal delivery, whether before or after the cesarean, is the single strongest predictor of successful vaginal birth after cesarean, with success rates approaching 85 to 90 percent. It reflects a proven ability to deliver vaginally and predicts efficient labor. Other favorable factors include spontaneous labor onset and a nonrecurrent indication for the prior cesarean. Interdelivery interval, birth weight, and maternal age influence success modestly but none approaches the predictive power of a previous vaginal birth.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.