VBAC Risk Score (Grobman)
Estimates likelihood of successful vaginal birth after caesarean (VBAC) using Grobman nomogram factors.
Score interpretation
Score 0–3: Low likelihood of successful VBAC (~40–50%).
→ Counsel regarding risks of failed VBAC vs elective repeat CS. Consider repeat elective CS if ≥2 prior caesareans, uterine scar complications, or patient preference. Obstetric consultant review.
Score 4–6: Moderate likelihood of successful VBAC (~60–75%).
→ VBAC is a reasonable option. Discuss individualised risks and benefits. Continuous CTG in labour mandatory. IV access. Uterine scar rupture risk ~0.5–0.7%.
Score 7–10: High likelihood of successful VBAC (>80%).
→ VBAC strongly favoured if no contraindications. Continuous intrapartum CTG. Immediate access to theatre. Uterine rupture risk ~0.3–0.5%. Avoid high-dose oxytocin.
Interpretation bands for the VBAC Risk. Apply clinical judgement and local guidance.
References
- Grobman WA et al. Prediction of uterine rupture associated with attempted vaginal birth after cesarean delivery. Am J Obstet Gynecol. 2008.
- RCOG Green-top Guideline No. 45. Birth After Previous Caesarean Birth. 2015.
Related
Curated clinical cross-links plus same-class fallbacks.
- Hydroxyprogesterone Caproate / Progesterone (Preterm Birth Prevention) · Progestogen (Preterm Birth Prevention)
- Clotrimazole · Topical / vaginal imidazole antifungal
- Estradiol (HRT — Hormone Replacement Therapy) · Oestrogen Replacement Therapy
- Progesterone (Vaginal) · Progestogen
- Metronidazole (Bacterial Vaginosis) · Antibiotic (Nitroimidazole) — BV Treatment
- Clotrimazole (Vulvovaginal Candidiasis) · Antifungal (Azole) — Topical/Vaginal
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Pre-Eclampsia / Eclampsia in ED · NICE NG133; RCOG Green-top 10A
- Suspected Ectopic Pregnancy · NICE NG126; RCOG Green-top 21
- Polycystic Ovary Syndrome (PCOS) · International PCOS Guideline 2023; NICE CKS
- Pre-eclampsia Management · NICE NG133 2019
- Ectopic Pregnancy · NICE CG154 / RCOG GTG 21
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.