Pronostic obstetrical des gestantes Togolaises porteuses de cicatrice de cesarienne. A propos de 282 cas colliges au Chu de Lome(Togo)

Abstract

Objective: To assess the security granted to women delivering with a scarred uterus in a maternity where labour is monitored only by clinical examination.Methods: Retrospective study held from January 1st 1999 to December 31st 1999. We analysed delivering route, maternal complications, and perinatal prognosis in 282 pregnant women who previously had caesarean operations.Results: Scarred uteri represented 5.9% of all deliveries; caesareans were performed in 116 cases (41.1%); trial of labour was monitored in 166 cases (58.9 %), from which 104 (62.7 %) were deliveredvaginally. Favourable factors raising normal delivery rate were previous vaginal deliveries (p = 0.00001). We registered 1 maternal death (0.35%), 6 ruptures of scarred uterus (2.1%) including 2 frank rupturesand 4 dehiscences of scar. Perinatal mortality rate was 4 % and perinatal morbidity rate 8 % caused by perinatal anoxia (81.8%) especially in cases of failure of trial of labour.Conclusion: An adequate selecting to trial of scar and an adequate monitoring of labours should significantly reduce the likely risky outcomes observable in deliveries on scarred uterus