MEDICS Dataset

This dataset contains granular patient-level data from the MEDICS randomized controlled trial comparing Foley catheter balloon mechanical induction and prostaglandin E2 induction in women undergoing trial of labor after one previous caesarean section. Core maternal demographics—age, BMI, ethnicity, parity, prior caesarean indications—and pre-induction cervical status are captured with precision, along with a systematic stratification framework based on history of previous normal vaginal delivery (NVD). Each participant is assigned a strata label: Pxx for those with a previous NVD and Nxx for those without. This stratification is clinically meaningful given the strong predictive value of prior vaginal birth for VBAC success and labour dynamics.
The dataset includes serial Modified Bishop Score assessments, induction-to-labour and induction-to-delivery intervals, oxytocin augmentation, analgesia use, and all intrapartum complications (fever, abnormal CTG, hyperstimulation, meconium, balloon issues). Delivery outcomes capture mode of birth, indications for emergency caesarean, and objective markers relevant to uterine scar performance. Maternal postpartum outcomes range from estimated blood loss and postpartum haemorrhage to readmission and wound complications. Neonatal outcomes include birthweight, APGAR scores, cord pH thresholds, NICU admission, and adverse neonatal events.
Patient-reported outcome measures—satisfaction, acceptability, and willingness to repeat or recommend the induction method—are also included, with >90% response rates. The structure of the data allows the replication of the trial’s core findings: higher cervical ripening success and fewer intrapartum complications with mechanical induction, similar VBAC and labour durations across arms, and no observed scar ruptures.
Overall, this is a high-fidelity, stratified clinical dataset enabling nuanced comparative analyses of induction efficacy, safety, labour trajectories, and patient experience in TOLAC populations. The Pxx/Nxx stratification enhances modelling accuracy for VBAC prediction, induction success, and risk-adjusted outcome benchmarking within the MEDICS analytical ecosystem.

本数据集源自MEDICS随机对照试验，包含针对既往有1次剖宫产史的产妇试产（trial of labor after cesarean, TOLAC）人群的精细化个体水平数据，该试验对比了Foley导管球囊（Foley catheter balloon）机械引产与前列腺素E2（prostaglandin E2）引产两种方案。研究精准采集了核心产妇人口统计学特征——年龄、身体质量指数（Body Mass Index, BMI）、种族、产次、既往剖宫产指征，以及引产前宫颈状态，并基于既往正常阴道分娩（normal vaginal delivery, NVD）史构建了系统分层框架。所有受试者均被赋予分层标签：既往有正常阴道分娩史者标注为Pxx，无该史者标注为Nxx。鉴于既往阴道分娩对剖宫产后经阴道分娩（vaginal birth after cesarean, VBAC）成功率及产程进程具有较强预测价值，该分层具备明确临床意义。

本数据集包含系列改良Bishop评分（Modified Bishop Score）评估结果、引产至临产及引产至分娩的时间间隔、缩宫素加强宫缩情况、镇痛药物使用情况，以及所有产时并发症（发热、电子胎心监护（cardiotocography, CTG）异常、子宫过度刺激、胎粪污染、球囊相关问题）。分娩结局涵盖分娩方式、急诊剖宫产指征，以及与子宫瘢痕状态相关的客观评估指标。产妇产后结局包括估计失血量、产后出血、再入院情况及手术切口并发症等。新生儿结局则包含出生体重、APGAR评分、脐带血pH阈值、新生儿重症监护病房（Neonatal Intensive Care Unit, NICU）入住情况及不良新生儿事件。

患者报告结局指标（Patient-Reported Outcome Measures, PROMs）——满意度、可接受性、重复使用或推荐该引产方式的意愿——也被纳入本数据集，其应答率超过90%。本数据集的结构可复现该试验的核心研究结果：机械引产组的宫颈成熟成功率更高、产时并发症发生率更低，两组的VBAC成功率及产程时长无显著差异，且未观察到子宫瘢痕破裂事件。

总体而言，本数据集为高保真度分层临床数据集，可针对TOLAC人群开展引产有效性、安全性、产程轨迹及患者体验的精细化对比分析。其中Pxx/Nxx分层可提升VBAC预测、引产成功率预测，以及MEDICS分析生态系统内风险校正结局指标基准分析的建模精度。