VBAC 成功评分（Flamm 模型）
用途适用： counselling for TOLAC when admission cervical exam and obstetric history are known.
分层Higher scores tracked higher VBAC success in the derivation cohort; low scores are not absolute failure predi…
局限不适用： classical/T incision, placenta previa, or other absolute TOLAC c… · 易错点： treating cohort % as an individual guarantee or skipping rupture… · Local resources for emergency cesarean matter as much as the score.
出处ACOG / SMFM TOLAC guidance (tool-page edition); China obstetrics TOLAC consensus on zh when cited
本班次下一步
评完分数后：进场景连算、看相邻评分、打开对应路径。本地参考，不写入 HIS。
方法学 · 公式代入、指南要点与完整说明
适用场景
适用： counselling for TOLAC when admission cervical exam and obstetric history are known.
需要填写的项目
- Maternal age < 40 years · 选项
- Vaginal birth history · 选项
- Prior cesarean for reason other than failure to progress · 选项
- Cervical effacement at admission · 选项
- Cervical dilation ≥ 4 cm at admission · 选项
计算方法与公式
Age <40 (2) + vaginal-birth history (0/1/2/4) + non-FTP indication (1) + effacement (<25%=0, 25–75%=1, >75%=2) + dilation ≥4 cm (1). Cohort success bands from Flamm 1997.
Score at admission for labor; do not invent Grobman logistic coefficients here — Flamm points only.
公式代入演示
下列数值取自本工具各输入项的示例值，用本页公式在服务端实际算出，供快速核对计算过程。仅演示代入方法，不构成临床建议，也不代表任何真实病例。
| Maternal age < 40 years | 否 (0) |
|---|---|
| Vaginal birth history | Vaginal birth before cesarean only (1) |
| Prior cesarean for reason other than failure to progress | No — failure to progress / CPD (0) |
| Cervical effacement at admission | 25–75% (1) |
| Cervical dilation ≥ 4 cm at admission | 否 (0) |
→Flamm VBAC2分
- Cohort success band：~49% success (score 0–2)
- Range：0–10 points (Flamm 1997)
| Maternal age < 40 years | 否 (0) |
|---|---|
| Vaginal birth history | No previous vaginal birth (0) |
| Prior cesarean for reason other than failure to progress | No — failure to progress / CPD (0) |
| Cervical effacement at admission | < 25% (0) |
| Cervical dilation ≥ 4 cm at admission | 否 (0) |
→Flamm VBAC0分
- Cohort success band：~49% success (score 0–2)
- Range：0–10 points (Flamm 1997)
结果判读与分层
Higher scores tracked higher VBAC success in the derivation cohort; low scores are not absolute failure predictions.
指南要点（原创整理）
- Public Flamm points 0–10.
- Low score ≠ mandatory repeat CS.
- 下一步： local TOLAC pathway; Grobman models are separate calculators.
以上为依据相应指南的关键推荐、由本站用自己的语言归纳整理（非指南原文）；完整内容请见下方官方来源。
注意事项与局限
- 不适用： classical/T incision, placenta previa, or other absolute TOLAC contraindications.
- 易错点： treating cohort % as an individual guarantee or skipping rupture counselling.
- Local resources for emergency cesarean matter as much as the score.
核对与出处 · 可验证治理
参考指南与出处
- [指南 / 主要来源]ACOG / SMFM TOLAC guidance (tool-page edition); China obstetrics TOLAC consensus on zh when cited
- Flamm BL, Geiger AM. Obstet Gynecol 1997 (VBAC scoring system) · 来源 ↗
指南全文版权归相应学会/期刊所有；本工具仅实现其决策算法并注明出处，全文请经上方官方来源获取。
依据文献年份见参考 · 数据集整理日 2026-10-08
常见问题
常见问题
- VBAC 成功评分（Flamm 模型）的计算是否上传患者数据？在哪里计算？
- 计算在浏览器本地完成，输入与结果不上传服务器；结果仅供执业医师参考，须结合病史、检查与本机构方案判断，不构成诊断或处方依据。
- VBAC 成功评分（Flamm 模型）怎么代入计算？能举个例子吗？
- 代入: Maternal age < 40 years 否 (0)、Vaginal birth history Vaginal birth before cesarean only (1)、Prior cesarean for reason other than failure to progress No — failure to progress / CPD (0)、Cervical effacement at admission 25–75% (1)、Cervical dilation ≥ 4 cm at admission 否 (0) → 结果: Flamm VBAC 2 分（Cohort success band: ~49% success (score 0–2)、Range: 0–10 points (Flamm 1997)） 代入: Maternal age < 40 years 否 (0)、Vaginal birth history No previous vaginal birth (0)、Prior cesarean for reason other than failure to progress No — failure to progress / CPD (0)、Cervical effacement at admission < 25% (0)、Cervical dilation ≥ 4 cm at admission 否 (0) → 结果: Flamm VBAC 0 分（Cohort success band: ~49% success (score 0–2)、Range: 0–10 points (Flamm 1997)）
核对流程与方法学
核对与依据
本工具的公式与计算方法已在本页明示、公开可逐一核查。其公式、系数与阈值依据上方「参考指南与出处」列出的权威来源核对。想了解本站对全部临床工具的核对流程与出处覆盖情况，见 临床工具核对表与方法学 →