Objective: Pregnancy in a scarred uterus is considered to be high-risk, especially during parturition. Nevertheless, the literature favours vaginal delivery as long as obstetric conditions are favourable. The aim of our study was to contribute to the improvement of delivery management for women with scar uteri at the CHU Communautaire. Methodology: This was a cross-sectional study conducted over an 18-month period from 01 January 2020 to 30 June 2021 on women with scar uterus who came to give birth at the CHU Communautaire maternity unit. The sample was exhaustive; any parturient with a history of scarred uterus of more than one year with a clinically normal pelvis and whose fetus was in cephalic presentation. The following were excluded from the study: pregnant women with a uterine scar of less than one year, fetuses in a non-cephalic vertex presentation, pregnant women with antecedent complicated childbirth at the previous cesarean section, large fetuses informed consent had been obtained from the pregnant women. Anomynia was respected throughout the study. Results: During this period, we recorded 205 parturients with a scar uterus. The incidence of delivery with a scar uterus was 9.5%. Uterine testing was attempted in 85.9% of cases, with a success rate of 75.6%. Factors predictive of a successful uterine test was: maternal age less than 35 years (P = 0.0027), entry into labour at the reference maternity hospital (P < 0.001), previous vaginal delivery (P < 0.001) and a single uterine scarred. We noted 7 cases of uterine rupture occurring in a scarred uterus, representing 0.3% of deliveries and 2.9% of caesarean sections. The main factor in the occurrence of rupture was an inter-uterine interval of less than one year. Perinatal mortality accounted for 6.2% of live births. Conclusion: Delivery with a scarred uterus is an increasingly frequent occurrence at the Maternity Unit of the CHU Communautaire in Bangui. Uterine testing is the first option if conditions allow, but careful selection of candidates during antenatal care or at the very beginning of labour is necessary for this type of delivery.
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