Among women undergoing trial of labour after one prior lower segment cesarean section, which factor is associated with the highest probability of successful vaginal birth?
- A Prior vaginal delivery at any time ✓
- B Prior cesarean performed for breech presentation
- C Maternal age under 30 years
- D Interdelivery interval longer than 18 months
Correct answer: A. Prior vaginal delivery at any time
Explanation
A history of previous vaginal delivery, whether before or after the index cesarean, is the single strongest predictor of successful trial of labour after cesarean, raising success rates to well above those of the general TOLAC candidate. An indication for the prior cesarean unlikely to recur, such as breech, also favours success, but less powerfully than an actual prior vaginal birth. Younger maternal age and a longer interdelivery interval are modest favourable factors, neither approaching the predictive weight of demonstrated ability to deliver vaginally.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.