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Valère MK, Etienne B, Phelix Adolphe E, et al. The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study. Eur J Obstet Gynecol Reprod Biol X. 2019;4:100078doi: 10.1016/j.eurox.2019.100078.
Valère, M. K., Etienne, B., Phelix Adolphe, E., Brice, T. F., & Tebeu, P. M. (2019). The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study. European journal of obstetrics & gynecology and reproductive biology: X, 4100078. https://doi.org/10.1016/j.eurox.2019.100078
Valère, Mve Koh, et al. "The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study." European journal of obstetrics & gynecology and reproductive biology: X vol. 4 (2019): 100078. doi: https://doi.org/10.1016/j.eurox.2019.100078
Valère MK, Etienne B, Phelix Adolphe E, Brice TF, Tebeu PM. The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study. Eur J Obstet Gynecol Reprod Biol X. 2019 Jul 05;4:100078. doi: 10.1016/j.eurox.2019.100078. eCollection 2019 Oct. PMID: 31517306; PMCID: PMC6728743.
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Eur J Obstet Gynecol Reprod Biol X. 2019 Jul 05;4:100078. doi: 10.1016/j.eurox.2019.100078. eCollection 2019 Oct.

The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings: A retrospective cohort study.

European journal of obstetrics & gynecology and reproductive biology: X

Mve Koh Valère, Belinga Etienne, Elong Phelix Adolphe, Toko Fokam Brice, Pierre Marie Tebeu

Affiliations

  1. Faculty of Medicine and Biomedical Sciences of University of Yaoundé, Yaoundé, Cameroon.
  2. University Teaching Hospital of Yaoundé, Yaoundé, Cameroon.
  3. Centre Hospitalier de Recherche et d'Application en Chirurgie Endoscopique et Reproduction Humaine (CHRACERH) Yaoundé Cameroon.
  4. Faculty of Health Sciences of the University of Buea, Buea, Cameroon.
  5. Buea Regional Hospital, Buea, Cameroon.

PMID: 31517306 PMCID: PMC6728743 DOI: 10.1016/j.eurox.2019.100078

Abstract

The prevalence of post-caesarean scar uterus, the most important risk factor of uterine rupture is increasing globally. Grand multiparity can also increase the risk of uterine rupture. The issue of grand multiparous with single post caesarean scar is poorly investigated.

OBJECTIVES: The purpose of this study was to assess the factors associated with the mode of delivery of grand multiparous with post caesarean single uterine scar in low resources settings.

PATIENTS AND METHOD: It was a retrospective cohort study conducted from the 1

RESULTS: We included 33 GMP with single lower segment uterine scar and 120 GMP without uterine scar. Induction of labor and acute fetal distress were not related to having a scar or not in grand GMP, but augmentation of labor was less likely to be conducted in case of GMP with scar uterus(p = 0.08). The frequency of vaginal delivery was 75.8 and 87.5% in grand multiparous with and without uterine scar respectively (OR 0.17-1.16; P = 0.085), with one case of instrumental delivery in scarless group. However, single scar multiparity status increased by 2.42 folds the risk of delivery by caesarian section (P = 0.066). Cephalo-pelvic disproportion increased the indication of caesarian section by 12-fold in the GMP with scar group (p = 0.031), but mechanical dystocia related indications (CPD, macrosomia,) were present in only 4 cases out of 8 caesarian sections in the exposed group. The Apgar score at the fifth minute was better in the GMP with scar group. (p = 0.037).

CONCLUSION: Grand multiparous with single post-cesarean uterine scar should be given a chance of vaginal delivery in the absence added feto-maternal morbidity.

Keywords: Cameroon; Grand multiparity; Scar uterus

Conflict of interest statement

The authors declare no conflict or competing interest; this work was not sponsored by any organization and was self-financed.

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