Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study
Background: Outcomes of trial of scar (TOS) correlate well with predictions provided by vaginal birth after cesarean scoring systems. In Cameroon, there is limited data on the implementation and effectiveness of these scoring systems, as well as the materno-fetal outcomes of TOS. Objectives: The obj...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2024-01-01
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| Series: | Journal of Integrated Health Sciences |
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| Online Access: | https://journals.lww.com/10.4103/jihs.jihs_5_24 |
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| author | Alembong Eleanor Ngeh-Nkeng Forchap Nkemanjong Milton Nkengfua Samuel Elong Felix Adolphe Egbe Obinchemti Thomas |
| author_facet | Alembong Eleanor Ngeh-Nkeng Forchap Nkemanjong Milton Nkengfua Samuel Elong Felix Adolphe Egbe Obinchemti Thomas |
| author_sort | Alembong Eleanor Ngeh-Nkeng |
| collection | DOAJ |
| description | Background:
Outcomes of trial of scar (TOS) correlate well with predictions provided by vaginal birth after cesarean scoring systems. In Cameroon, there is limited data on the implementation and effectiveness of these scoring systems, as well as the materno-fetal outcomes of TOS.
Objectives:
The objective was to utilize the Flamm score in predicting the success of TOS, and to evaluate the maternal and fetal outcomes observed following TOS in Yaounde and Douala Gyneco-Obstetric and Pediatric Hospitals from 2017 to 2021.
Material and Methods:
We included files of 310 parturient women with single transverse lower uterine segment cesarean section, who had TOS. Data on sociodemographic, reproductive health, Flamm scoring, and labor outcomes were documented using a structured data extraction form and analyzed using the Statistical Package for the Social Sciences version 25.
Results:
Of the 310 patients, 73.9% had successful vaginal deliveries (VDs) and 26.1% had repeated emergency cesarean. Flamm score predictions were associated with TOS outcomes (P = 0.0001), with mean score of 5.87 ± 0.01 for successful VD compared to 3.72 ± 0.126 for repeat cesarean. Probability of successful VD increased with Flamm score, ranging from 0% for scores of two to 100% for scores > 7, with a cutoff score of 4.5 (Se = 75.0%, Sp = 75.3%). The main maternal complication was one uterine rupture (0.32%) and neonatal complications were three stillbirths (0.98%) and one early neonatal death (0.32%) after repeat cesarean.
Conclusions:
TOS is associated with high success rates in tertiary hospitals in Cameroon. Applying Flamm score will improve the chances of a successful VD following TOS, and should be encouraged. |
| format | Article |
| id | doaj-art-dda9747b52b34027b951a102dcdbf01a |
| institution | Kabale University |
| issn | 2347-6486 2347-6494 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Journal of Integrated Health Sciences |
| spelling | doaj-art-dda9747b52b34027b951a102dcdbf01a2025-08-20T03:42:35ZengWolters Kluwer – Medknow PublicationsJournal of Integrated Health Sciences2347-64862347-64942024-01-01121212710.4103/jihs.jihs_5_24Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective StudyAlembong Eleanor Ngeh-NkengForchap Nkemanjong MiltonNkengfua SamuelElong Felix AdolpheEgbe Obinchemti ThomasBackground: Outcomes of trial of scar (TOS) correlate well with predictions provided by vaginal birth after cesarean scoring systems. In Cameroon, there is limited data on the implementation and effectiveness of these scoring systems, as well as the materno-fetal outcomes of TOS. Objectives: The objective was to utilize the Flamm score in predicting the success of TOS, and to evaluate the maternal and fetal outcomes observed following TOS in Yaounde and Douala Gyneco-Obstetric and Pediatric Hospitals from 2017 to 2021. Material and Methods: We included files of 310 parturient women with single transverse lower uterine segment cesarean section, who had TOS. Data on sociodemographic, reproductive health, Flamm scoring, and labor outcomes were documented using a structured data extraction form and analyzed using the Statistical Package for the Social Sciences version 25. Results: Of the 310 patients, 73.9% had successful vaginal deliveries (VDs) and 26.1% had repeated emergency cesarean. Flamm score predictions were associated with TOS outcomes (P = 0.0001), with mean score of 5.87 ± 0.01 for successful VD compared to 3.72 ± 0.126 for repeat cesarean. Probability of successful VD increased with Flamm score, ranging from 0% for scores of two to 100% for scores > 7, with a cutoff score of 4.5 (Se = 75.0%, Sp = 75.3%). The main maternal complication was one uterine rupture (0.32%) and neonatal complications were three stillbirths (0.98%) and one early neonatal death (0.32%) after repeat cesarean. Conclusions: TOS is associated with high success rates in tertiary hospitals in Cameroon. Applying Flamm score will improve the chances of a successful VD following TOS, and should be encouraged.https://journals.lww.com/10.4103/jihs.jihs_5_24cesarean sectionflamm scoretrial of labor after cesareantrial of scarvaginal birth after cesarean |
| spellingShingle | Alembong Eleanor Ngeh-Nkeng Forchap Nkemanjong Milton Nkengfua Samuel Elong Felix Adolphe Egbe Obinchemti Thomas Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study Journal of Integrated Health Sciences cesarean section flamm score trial of labor after cesarean trial of scar vaginal birth after cesarean |
| title | Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study |
| title_full | Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study |
| title_fullStr | Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study |
| title_full_unstemmed | Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study |
| title_short | Outcome of Trial of Labor after Cesarean Delivery: Evaluating the Flamm Scoring System in Two Hospitals in Cameroon: A 5-year Retrospective Study |
| title_sort | outcome of trial of labor after cesarean delivery evaluating the flamm scoring system in two hospitals in cameroon a 5 year retrospective study |
| topic | cesarean section flamm score trial of labor after cesarean trial of scar vaginal birth after cesarean |
| url | https://journals.lww.com/10.4103/jihs.jihs_5_24 |
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