Latest news with #TOLAC
Medscape
12-06-2025
- Health
- Medscape
VBAC Success Overestimated With Induction of Labor
MINNEAPOLIS — The vaginal birth after cesarean (VBAC) calculator may overestimate the likely success rate of a VBAC following induction of labor (IOL), according to research presented at American College of Obstetricians and Gynecologists (ACOG) 2025 Annual Meeting. The VBAC calculator does not distinguish between IOL and spontaneous labor, noted Daniel Lorido, MD, MPH, of Montefiore Medical Center in the Bronx, New York, and his colleagues. 'TOLAC [trial of labor after cesarean] patients who are undergoing IOL are significantly less likely to have a successful VBAC as compared to TOLAC patients undergoing spontaneous labor,' Lorido and his colleagues concluded. 'When offering indicated or elective inductions of labor, careful, individualized counseling on the likelihood of VBAC success is essential because a failed trial of labor after cesarean may cause increased perinatal morbidity when compared to successful VBAC or scheduled repeat cesarean delivery.' Noting that TOLAC IOL has higher rates of failure than spontaneous TOLAC, the authors sought to determine the success rate for TOLAC IOL and how it compares to spontaneous IOL and to the VBAC calculator's estimation of success for IOL. The researchers retrospectively analyzed all cases of patients who had a history of one prior cesarean and were undergoing an IOL between January 2020 and December 2023. All 270 patients had full-term, live-born, head-first, singleton births. Just over half the patients (51.1%) had a successful VBAC, but the VBAC calculator had predicted that 63.6% of patients would be successful ( P < .0001). The national rate of successful VBAC is 74.3%, the authors noted, but that includes both IOL and spontaneous labor. Factors associated with a successful VBAC include a history of prior vaginal delivery ( P = .0008), history of a prior VBAC ( P < .0001), and no history of arrest disorder ( P = .0007). Specifically, 72% of patients with a prior vaginal delivery had a successful VBAC after IOL compared to 46% of patients without a previous vaginal delivery. Similarly, 82% of patients with a previous VBAC had a successful VBAC after IOL compared to 43% of patients without a previous VBAC. Among the patients who had a successful VBAC, only 22% had a history of arrest disorder. The researchers did not find any associations between successful VBAC and age, BMI, chronic hypertension, or diabetes — even though age, weight, and treated chronic hypertension are all variables in the VBAC calculator score. Notably, the VBAC calculator was documented as a part of TOLAC counseling in only 11.39% of cases. 'In spite of these findings, we encourage offering TOLAC to all eligible patients while cautioning that accurate success rates be determined and communicated properly,' the authors wrote. 'TOLAC patients should be counseled about lower success rates of VBAC post-IOL to assist in their decision-making process.' It's important to keep in mind when considering these findings that they are all from a single center, Audrey Merriam, MD, MS, an associate professor of obstetrics, gynecology, and reproductive science at Yale School of Medicine, New Haven, Connecticut, told Medscape Medical News . 'There may be practice patterns or preferences at this one center that could impact these results,' Merriam said. She also noted that the study was moderately sized, which also adds caution to interpretation of the findings. That said, the study's key takeaway is that 'the VBAC calculator may not be as accurate when predicting TOLAC success for women who have had any prior cesarean delivery, not just a cesarean delivery for an arrest disorder,' Merriam said. 'The calculator is still just an estimate, so the decision to attempt a VBAC is still between the pregnant person and their physician/provider.' While the calculator provides one piece of information for patients and providers to consider when deciding whether to attempt a TOLAC, 'ultimately, the decision is a shared decision involving risks and benefits between the patient and provider,' Merriam said. The authors did not report receiving any external funding or having any disclosures. Merriam reported having consulted for Lily Link.
Zawya
08-03-2025
- Sport
- Zawya
Economic Community of West African States (ECOWAS) unites 11 Member States in historic gender-inclusive African Wrestling tournament
The 13th ECOWAS African Wrestling Tournament (TOLAC) officially commenced today, March 6, 2025, at the Velodrome, MKO Abiola National Stadium in Abuja, Nigeria, bringing together wrestlers from 11 ECOWAS Member States in a display of strength, heritage, and unity. This year's tournament is particularly significant, as it marks the first-ever inclusion of female wrestlers, reinforcing ECOWAS' commitment to gender equality and the promotion of traditional sports as a unifying force for West Africa. Organized on behalf of ECOWAS by its Youth and Sports Development Centre (EYSDC) in collaboration with Nigeria's National Sports Commission (NSC), the tournament is a key event in ECOWAS' 50th Anniversary Celebrations, reflecting the organization's broader mission to foster regional integration through culture, youth engagement, and sports diplomacy. Declaring the tournament open, Chairman of the National Sports Commission, Mallam Shehu Dikko, commended ECOWAS for its dedication to leveraging sports for regional integration. He emphasized Nigeria's pride in hosting TOLAC for the first time, describing it as a major step in strengthening youth participation and economic development through sports. He stated, 'Traditional wrestling is a symbol of our heritage, a sport that binds us together as a people. This tournament not only celebrates our shared identity but also provides an avenue for our athletes to excel, develop, and gain international recognition.' Representing the ECOWAS Commission, Director of the ECOWAS Youth and Sports Development Centre, Ambassador Francis Chuks Njoaguani, delivered the speech on behalf of ECOWAS Commissioner for Human Development and Social Affairs, Prof. Fatou Sow Sarr. He highlighted the tournament's strategic role in promoting youth development and gender inclusion, stating, 'For the first time in history, we welcome female athletes to this prestigious tournament, breaking barriers and setting a precedent for gender inclusivity in traditional sports. This is a defining moment for West African sports, and ECOWAS is proud to lead the way.' He further underscored the importance of sports diplomacy, emphasizing that ECOWAS sees traditional wrestling not just as a competition but as a cultural heritage that must be preserved and elevated. He added, 'Sport is a powerful tool for peacebuilding, economic empowerment, and regional cooperation. By investing in traditional wrestling, we are investing in our youth, in their future, and in the continued unity of our Member States.' The opening ceremony set the stage for what promises to be a thrilling three-day competition, blending the rich tradition of African wrestling with a renewed vision for sports development in the region. Athletes from 11 ECOWAS countries proudly marched with their national flags, showcasing their cultural heritage. The tournament torch was lit in a symbolic act marking the spirit of competition and regional unity. Traditional wrestling demonstrations featured techniques unique to each participating country, highlighting the depth of talent and diversity in West African wrestling. Cultural performances celebrated ECOWAS' rich artistic heritage, with performances from Nigerian and regional musical groups. Following the opening ceremony, the first round of matches commenced, as wrestlers competed across various weight categories in a round-robin team elimination format. The finals will be held on March 8. ECOWAS has introduced significant cash prizes to motivate athletes and elevate the competition's prestige. The winning team will receive $10,000, the second-place team $6,000, and the third-place team $3,000. Individual winners will also be rewarded, with gold medalists receiving $2,500, silver medalists $1,500, and bronze medalists $1,000. Beyond competition, the ECOWAS African Wrestling Tournament serves a greater purpose—advancing the organization's strategic vision for development, inclusion, and peacebuilding. Through this initiative, ECOWAS aims to promote traditional African sports globally, securing long-term recognition and institutional investment. The tournament also seeks to create employment and economic opportunities for athletes and sports professionals, ensuring sustainable careers in wrestling. Furthermore, it aims to strengthen regional diplomacy and cooperation, fostering stronger ties among Member States through cultural exchange and sportsmanship. Director of the ECOWAS Youth and Sports Development Centre, Ambassador Francis Chuks Njoaguani, also emphasized the importance of sports as an economic enabler, urging governments and private sector actors to invest in traditional sports. He stated, 'The ECOWAS Vision 2050 is about fostering a region where culture, economy, and development align. Sports must be a part of this conversation, ensuring that young athletes have opportunities beyond competition. Traditional wrestling is not only a sport—it is a way of life, a career path, and a bridge to international recognition.' ECOWAS has placed a strong emphasis on media coverage, calling on journalists and broadcasters to maximize the tournament's visibility across West Africa and beyond. The organization urges media professionals to tell the stories of resilience, excellence, and unity emerging from the competition, ensuring that African wrestling takes its rightful place on the global stage. As the 13th ECOWAS African Wrestling Tournament continues, the coming days promise thrilling matchups, cultural celebrations, and unforgettable moments. This tournament stands as a landmark achievement in ECOWAS' mission to blend tradition with progress, proving that regional integration is not just a vision but a lived reality. With strong representation from 11 Member States, a historic leap in gender inclusion, and an unwavering commitment to cultural preservation, TOLAC 2025 is set to leave a lasting impact on African sports development. Distributed by APO Group on behalf of Economic Community of West African States (ECOWAS).
