Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

Abstract

Introduction: Delivery in a scar uterus is one of the most debated topics in obstetrics. The objective was to determine the uterine test and the maternal-fetal outcome in patients with uni-and bi-scared uterus who received the uterine test at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of patients who delivered on a uni-or bi-scareduterus at Panzi Hospital, between January 1, 2021 and August 1, 2022. Results: The average age of the patients was 27.09 years, with an age range of 25 -34 years, they were mostly married (88.3%), with secondary educational level (60.4%). Pauciparous women, with a history of previous caesarean delivery once, represented respectively 52.2%; 7.2% of parturients with an intergenital space equal to 18 months. 63.9% were overweight, 58.6% had undergone more than three ANC sessions. We noted statistically significant associations between modes of admission, water sac, type of membranes rupture, uterine height and success of uterine test (p < 0.05). We did not find significant associations between parturient age, gestational age, intergestational interval, pregnancy term, surgical history, number of ANC performed, number of previous caesarean sections, number of newborns. We did not record any cases of maternal death but one case of perinatal death with 0.9% in this study. Conclusion: A good selection of patients with uni-or bi-scared uterus would allow the reduction of the fetomaternal morbidity during the uterine test.