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Filipos Mesay,1 Ergoye Melese,2 Gebiyaw Wudie,2 Sefineh Fenta Feleke,3 Anteneh Mengist Dessie4 1Department of Public Health, Gafat Health Center, Debre Tabor, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia; 4Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Sefineh Fenta Feleke; Filipos Mesay, Tel +251928573882 ; Tel +251984929331, Email fentasefineh21@gmail.com; mesayfilipos16@gmail.comBackground: An attempt at vaginal delivery by a woman who has previously had a cesarean section is known as a trial of labor after cesarean section. The most important issues are how to accurately anticipate successful vaginal birth after cesarean surgery and how to calculate the likelihood of success of vaginal birth after caesarean section that is suitable for women. Consequently, a tailored prediction of vaginal birth after caesarean section may result in a more effective counseling.Objective: To create a clinical risk score and prediction model for the success of vaginal birth following a previous caesarean section in women.Methods: A prognostic analysis was carried out at Felege Hiwot Comprehensive and Specialized Referral Hospital from 30 February 2017 to 30 March 2021. R statistical programming language version 4.0 was used for analysis once the data had been coded and entered into Epidata, version 3.02. Significant factors (P< 0.05) were kept in the backward multivariable logistic regression model, and variables with (P< 0.25) from the bi-variable logistic regression analysis were also added.Results: After a cesarean section, 67% of women were successful in giving birth vaginally. Previous successful vaginal birth after cesarean surgery, rupture of the membranes, and initiation time of ANC, the beginning of labor, parity and time since the previous delivery were remained in the final multivariable prediction model. The AUC of the model was 0.748 (95% CI: 0.714– 0.781).Conclusion: Overall, this study demonstrated the likelihood of predicting vaginal birth utilizing the ideal confluence of parity, membrane rupture, and onset of labor, prior history of VBAC, inter-delivery gap, and ANC beginning time. Sixty-seven percent of VBACs were successful. As a result, this model may aid in identifying pregnant women who are candidates for VBAC and who have a better likelihood of success.Keywords: prediction model, vaginal birth after cesarean section, risk score, Ethiopia

Firehiywot Teferi Mekonnin,1 Gizachew Abdissa Bulto2 1Department of Obstetrics and Gynecology, Ambo General Hospital, Ambo, Ethiopia; 2Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Gizachew Abdissa Bulto Email gizachab@yahoo.comBackground: The World Health Organization recommends a caesarean section (CS) rate at health facilities from 10 to 15%, but the rate is higher at most of the institutions in different countries, including Ethiopia resulting in negative health-related and economic consequences. Vaginal birth after caesarean section (VBAC) is a safe and appropriate choice to decrease the rate of CS. Though the success rate is 60– 80%, the number of mothers who experience the trial of labor is decreasing and the overall CS rate is rising. There is also limited information on determinants of successful VBAC in Ethiopia. Therefore, the study aimed to identify determinants of successful VBAC at public hospitals in Ambo town.Methods: A Facility-based retrospective unmatched case-control study was employed at public hospitals in Ambo town, Ethiopia, from June 1 to July 1, 2020. A systematic random sampling technique was used to select cases (n=74) and controls (n=221). The data were collected using a structured questionnaire and it was filled IN by reviewing the client’s medical record. The data were entered into Epi Info and exported to SPSS for analysis. Bivariate and multivariable logistic regression analysis was carried out for data analysis. Finally, statistical significance was determined based on the odds ratio with its 95% confidence interval and a p-value of < 0.05.Results: Mothers whose age was less than 25 years and 25– 29 years (AOR: 8.88; 95% CI 3.03, 26.03) and (AOR: 5.37; 95% CI 2.28, 12.66), respectively, mothers who had a history of previous successful VBAC (AOR: 3.01; 95% CI 1.47, 6.13), had a history of previous spontaneous vaginal delivery (AOR: 3.85; 95% CI 1.84, 8.05) and cervical dilation ≥ 4cm at admission (AOR: 2.05: 95% CI 1.14, 3.67) were independent determinants of successful VBAC.Conclusion: The study identified that past and present obstetric conditions played a significant role in the success of VBAC. Therefore, health workers have to consider those predictors while counselling and choosing mothers for trial of labor after caesarean section (TOLAC).Keywords: determinants, vaginal birth after caesarean section, Ambo town

George Linn,1,2 Yung-hsiang Ying,3 Koyin Chang21Show Chwan Memorial Hospital, Changhua, Taiwan; 2Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan; 3Department of Business Administration, College of Management, National Taiwan Normal University, Taipei, TaiwanBackground: Babies are sometimes delivered by cesarean section (CS) to women eligible for trial of labor after a cesarean (TOLAC) due to a fear of complications during the delivery process. This view is especially widespread in Taiwan, as evidenced by the extremely low rate (