[Scarred uterus: management]

Abstract

Uterine rupture was seen in a total of 1.1 per cent of 10,012 pregnancies involving scarred uteri. Rupture frequency during pregnancy was estimated as 0.4 per cent, although this is doubtless an underestimate due to the occasionally asymptomatic nature of the condition. Maternal mortality was nil. Fetal mortality related to uterine rupture was also nil, but psychomotor backwardness was seen in one case of uterine rupture after completion of 30 weeks of pregnancy. These results and those of the literature show that maternal and fetal risks linked to uterine rupture are significant during pregnancy and very small during confinement. The indications for systematic prophylactic cesarean section are discussed. An increased frequency of uterine tests could decrease the overall rate of cesarean sections without danger to mother or baby.