[Delivery after scarred uterus at the University Hospital Center of Dakar].

The objective of this retrospective study was to analyze the prognosis of delivery after previous cesarean section in Dakar University Hospital from January 1, 1996 to December 31, 1997. For 9,068 registered deliveries, 134 were on scarred uterus (1.5% of all deliveries). Average age of these women was 29 years. Prophylactic cesarean was performed in 61 cases (45.5%). The main indications were multi-scarred uterus, breach presentation and macrosomy. A trial of labor was undertaken in the 73 other patients (54.5%), 85% were successful. Vaginal delivery rate was 46.3% on scarred uterus. There were no maternal deaths. Only one case of uterin rupture occurred in the prophylactic cesarean group. There were no perinatal deaths caused by trial of labor. These results confirm that trial of labor on scarred uterus should be the rule whenever possible, even when electronic cardiotocographic monitoring is not available.