Predicting the success of a trial of labor with a simple scoring system

OBJECTIVE: To determine the applicability of a simple scoring system, by Tr oyer and Parisi, in predicting the success of a trial of labor among partur ients with prior cesarean delivery. STUDY DESIGN: Retrospectively, all patients who underwent a trial Of labor over six consecutive years were reviewed. chi 2, Fisher's exact test and an alysis of variance followed by the Tukey or Dunn test were used when approp riate P<.05 was considered significant. RESULTS: There were 263 trials of labor, of which 63% (167) ended in vagina l delivery. While 21% had a score of 0, 40%, 28% and 11% had a score of 1, 2 and at least 3, respectively. The frequency of vaginal birth was signific antly different between the four groups (P <.001): 98% for a score of 0, 69 % for 1, 40% for 2 and 33% for 3-4. Occurrence of cesarean delivery for cep halopelvic disproportion (2%, 24%, 39%, 56%; P <.001) or for a nonreassurin g fetal heart rate tracing (0%, 7%, 21%, 21%; P<.001) was significantly dif ferent between the four groups. CONCLUSION: In our population, we confirmed the inverse relationship betwee n the Troyer-Parisi scoring system and a successful trial of labor.