Skripsi

AKURASI SKOR MATERNAL FETAL MEDICINE UNITS NETWORK VAGINAL BIRTH AFTER CESAREAN (MFMU VBAC) DALAM MEMPREDIKSI KEBERHASILAN PERSALINAN PERVAGINAM

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Background: The global and national rates of cesarean section (CS) continue to rise, including in Indonesia. Trial of Labor After Cesarean (TOLAC) serves as an alternative strategy to reduce the incidence of repeat CS; however, its success is influenced by various maternal and obstetric factors. In 2022, the World Health Organization recommended the Maternal Fetal Medicine Units (MFMU) VBAC Calculator as a predictive tool for TOLAC success. Evidence regarding its accuracy within the Indonesian population remains limited. This study aims to evaluate the accuracy of the MFMU VBAC score in predicting successful TOLAC at Dr. Mohammad Hoesin General Hospital Palembang and affiliated teaching hospitals. Methods: This observational study involved 32 women with a history of one prior CS who met the inclusion criteria. Maternal, obstetric, and neonatal characteristics, along with MFMU VBAC predictor variables, were analyzed using bivariate tests and multivariate logistic regression. Predictive accuracy was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results: A total of 29 out of 32 women (90.6%) achieved successful TOLAC. The ROC analysis yielded an Area Under the Curve (AUC) of 0.839 with a cut-off score of 64.8%. At this threshold, the sensitivity was 96.55%, specificity 33.3%, positive predictive value 50%, negative predictive value 93.3%, and overall accuracy 90.63%. Maternal height, comorbidities, and prior obstetric history were significantly associated with TOLAC success. Multivariate analysis identified two dominant predictors: maternal height (p = 0.017) and comorbidities (p = 0.015). Women with shorter stature and existing comorbid conditions had lower likelihood of TOLAC success. Conclusion: The MFMU VBAC score demonstrates high accuracy and excellent sensitivity in predicting TOLAC outcomes. Maternal height, comorbidities, and prior obstetric history were significant predictors influencing TOLAC success. This scoring system may serve as an effective clinical tool for selecting suitable candidates for vaginal birth after cesarean.

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Availability

Detail Information

Series Title

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Call Number

T1904432025

Publisher

Indralaya : Prodi Subspesialis Obsterti dan Ginekologi 1, Fakultas Kedokteran Universitas Sriwijaya., 2025

Collation

xv, 32 hlm.; ilus.; 29 cm

Language

Indonesia

ISBN/ISSN

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Classification

618.860 7

Content Type

Text

Media Type

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Carrier Type

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Edition

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Subject(s)

Prodi Subspesialis Obsterti dan Ginekologi 1
Obstetri — Komplikasi

Specific Detail Info

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Statement of Responsibility

TUTI

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