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[Obstetrical prognosis of the post-cesarean uterus. 641 cases]
1Service de Gynécologie-Obstétrique, Maternité du Pavillon Victor-Olivier, CHRU, Lille.
Objectives:
A retrospective study of decisions made in a gynaecology department between January 1990 and December 1993 were analyzed in order to assess management of the post-cesarean uterus.
Method:
Among 9092 women who delivered in the department during the study period, there were 641 patients with a post-cesarean uterus, due to a single prior cesarean section in 451. Results were analyzed and compared with those reported in the literature.
Results:
Among the 451 patients with a single scar, 184 (41%) delivered by elective cesarean section and in 267 (59%) a decision was made during labour. In this group of 267 patients with a single cicatrix who underwent a labour tests, 227 (85%) had a vaginal delivery compared with 40 (15%) in which the decision for cesarean section was made during labour.
Conclusion:
The results observed were comparable with those found in the literature. Management of pregnancy with post-cesarean uterus is now quite similar to that of a normal uterus. Epidural anaesthesia and ocytotin therapy as well as epidural labour triggering have had an important effect.