Data complete?
Evaluation appropriate?
Total score
Probability of vaginal delivery
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Keep patient data confidential and comply with all legal requirements.
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Flamm and Geiger developed a scoring system which can be used to predict the chances of vaginal delivery following a cesarean section in a pregnant woman admitted in labor. This can help identify patients who may be candidates for a trial of labor. The authors are from the Kaiser Permanente Medical Center in Riverside, California.
Parameters:
(1) age
(2) vaginal birth history
(3) reason for first cesarean section
(4) cervical effacement on admission
(5) cervical dilation on admission
|
Parameter |
Finding |
Points |
|---|---|---|
|
woman's age |
< 40 years of age |
2 |
|
|
>= 40 years of age |
0 |
|
vaginal birth history |
before and after first cesarean section |
4 |
|
|
after first cesarean section |
2 |
|
|
before first cesarean section |
1 |
|
|
none |
0 |
|
reason for first cesarean section |
failure to progress |
0 |
|
|
other reason |
1 |
|
cervical effacement on admission |
> 75% |
2 |
|
|
25 - 75% |
1 |
|
|
< 25% |
0 |
|
cervical dilation on admission |
< 4 cm |
0 |
|
|
>= 4 cm |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the more likely the woman can be delivered vaginally.
|
Total Score |
Probability VBAC |
|---|---|
|
<= 2 |
49% |
|
3 |
60% |
|
4 |
67% |
|
5 |
77% |
|
6 |
87% |
|
7 |
93% |
|
>= 8 |
95% |
Copyright © 2025 The Medical Algorithms Company Limited
Purpose: To evaluate a woman's chances of vaginal birth after a cesarean section (VBAC) on admission for labor using the score of Flamm and Geiger.
Specialty: Obstetrics & Gynecology
Objective: risk factors, severity, prognosis, stage
ICD-10: O32,
