Introduction: The occurrence of pregnancy on a scar uterus is characterized by its high incidence, multiple complications, high rate of morbidity and maternal-fetal mortality. The aim of this work was to evaluate the maternal prognosis during delivery on scar uterus in a poorly equipped environment.
Methodology: This is a retrospective and descriptive study with exhaustive sampling carried out in 2 years. Our study’s population was constituted by all pregnant women with previous caesarean section scarring uterus who gave birth in the obstetric department of Matanda Hospital in Butembo City.
Results: Scarred uterus deliveries accounted for 20% of all deliveries; 26.8% of parturient had a antecedence of vaginal delivery; 39.6% of parturient had severe pelvic narrowing as an indication of anterior caesarean section; and 49.3% had uterus once scarred, 26.9% uterus twice scarred and 14.7% uterus thrice scarred. 72.8% of parturient had an inter-reproductive interval between 13 and 24 months; 98.1% had term pregnancies. Thirteen percent of parturient had a uterine test, among which 41.2% had given birth vaginally; 8.8% of cases of pre uterine rupture and 5.9% of cases had acute fetal distress. No maternal mortality were recorded. Early neonatal mortality was 1.5% of cases and half of the cause of death was acute fetal distress followed by respiratory distress and neonatal infections.
Conclusion: The birth on scar uterus is common. The decision of the delivery modality to be proposed should take into account factors concerning the obstetrical antecedents, the data of the current pregnancy, but also the choice of the parturient after being informed of the risks and benefits of each delivery pathway. We propose here the application of the MOMAT score for the prediction of the failure of the uterine test.