cliot (version 1.0.0)

flamm_vbac_score: Flamm VBAC Risk Score

Description

Calculates the Flamm Score to predict the probability of a successful Vaginal Birth After Cesarean (VBAC). The model incorporates maternal age, vaginal birth history, indication for the primary cesarean, and cervical status at admission.

Usage

flamm_vbac_score(age, vaginal_history, reason_for_prior_c_section,
                 cervical_effacement_percent, cervical_dilation_cm)

Value

A list containing:

Flamm_Score

The calculated total score (Range 0-10).

Probability_Successful_VBAC

Estimated percentage probability of successful vaginal delivery.

Arguments

age

Numeric. Maternal age in years. (<40 adds 2 points).

vaginal_history

String. History of vaginal deliveries. "none": No vaginal deliveries (0 pts). "before": Vaginal delivery before C-section (1 pt). "after": Vaginal delivery after C-section (2 pts). "both": Vaginal deliveries before and after C-section (4 pts).

reason_for_prior_c_section

String. Indication for the first C-section. "failure_to_progress": Cephalopelvic disproportion/Failure to progress (0 pts). "other": Breach, fetal distress, etc. (1 pt).

cervical_effacement_percent

Numeric. Cervical effacement at admission in percent (0-100). <25 25-75 >75

cervical_dilation_cm

Numeric. Cervical dilation at admission in centimeters. (>=4 cm adds 1 point).

References

Flamm BL, Geiger AM. Vaginal birth after cesarean delivery: an admission scoring system. Obstet Gynecol. 1997;90(6):907-910. doi:10.1016/s0029-7844(97)00531-0

Examples

# Example 1: High Probability
# 30yo (+2), Prior VBAC (+2), Breech (+1), 80% effaced (+2), 5cm (+1)
# Score = 8
flamm_vbac_score(30, "after", "other", 80, 5)

# Example 2: Low Probability
# 41yo (0), No vaginal hx (0), Failure to progress (0), 0% effaced (0), 1cm (0)
# Score = 0
flamm_vbac_score(41, "none", "failure_to_progress", 0, 1)