MétaCan
Menu
Back to cohort

Vaginal Delivery After Caesarean Section

2008· article· en· W2010102189 on OpenAlex
Marc Miller, Leo R. Leader

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueAustralian and New Zealand Journal of Obstetrics and Gynaecology · 2008
Typearticle
Languageen
FieldMedicine
TopicMaternal and Perinatal Health Interventions
Canadian institutionsRoyal Ottawa Mental Health Centre
Fundersnot available
KeywordsCephalopelvic disproportionCaesarean sectionMedicineVaginal deliveryObstetricsVaginal birthUterine ruptureIncidence (geometry)PregnancyGynecologyUterus

Abstract

fetched live from OpenAlex

EDITORIAL COMMENT: This prospective study reports excellent results although the 64% vaginal delivery rate for those having a trial of scar is less than the other reported series quoted by the authors (table 5). The 1 case of uterine rupture occurring in the 125 women who had a trial of labour may have been called a ‘dehiscence’ by many since there was no bleeding or haematoma, and importantly no harm to fetus or mother. We respectfully disagree with the authors final comment that ‘most women with a previous Caesarean section can safely deliver vaginally’ since this study showed that only 64% (80 of 125) of those having a trial of labour, or 25% (80 of 318) of consecutive women with a previous Caesarean scar could safely deliver vaginally. It seemed to our reviewer that an unmentioned takeaway message was that good clinical judgement was required to select the 61% (193 of 318) of women for elective repeat Caesarean section, as well as providing superior care during labour to those who elected to do so. Summary: In a prospective study of 318 consecutive pregnancies complicated by previous Caesarean section, 193 (61%) had an elective repeat Caesarean section, 125 (39%) had a trial of labour and 80 (64%) of these women achieved a vaginal delivery. The incidence of uterine rupture was 0.8% (1 of 125). The vaginal delivery rate was not influenced by the indication for the first Caesarean section (including cephalopelvic disproportion), birth-weight, health insurance status, use of epidural analgesia or oxytocin in labour. Perinatal morbidity was unaffected by the mode of delivery and maternal morbidity was comparable following elective and emergency repeat Caesarean section. Patients having a vaginal delivery spent significantly less time in hospital. We conclude that vaginal delivery after lower segment Caesarean section is safe and should be considered in most patients after a critical review of the indication for the first Caesarean section.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.147
Threshold uncertainty score0.837

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.043
GPT teacher head0.296
Teacher spread0.253 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it