Rizzo G, Bitsadze V, Khizroeva J, et al. - In this study, researchers examined the role of antepartum ultrasound in predicting the probability of vaginal birth in women undergoing a trial of labor after caesarean section. In addition, they sought to develop a multiparametric prediction model including pregnancy and ultrasound characteristics that may aid in prediction of vaginal birth and compared its diagnostic performance with previously developed models based exclusively upon clinical and pregnancy characteristics. They conducted a prospective study of consecutive singleton pregnancies that were scheduled for trial of labor and undergoing a dedicated antepartum ultrasound assessment at 36-38 weeks of gestation. Among a total of 161women undergoing trial of labor, 114 (70.8%) had successful vaginal birth. Findings support the feasibility of antepartum prediction of vaginal birth after a caesarean section. They suggest independent association and predictive value of fetal head circumference, subpubic angle and cervical length for vaginal birth. They noted improved diagnostic accuracy of vaginal birth with adding these variables to a multiparametric model including maternal parameters vs using those based only on maternal characteristics.