Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Mve Koh Valère, Mbombo A. Moctar, Metogo Junie, Essome Henri & Engbang Jean Paul
Macrosomia is no longer a contraindication of vaginal delivery in the context of uterine scar. A new fetal anthropometric factor seems promising.
Objective: The aim was to study factors associated with vaginal delivery of a Macrosomic New-born on Scarred Uterus (MNBSU).
Patients and Method: we conducted a case-control study over a period of 9 months in 2020, at two Yaoundé university teaching hospitals, from January 1st, 2013 to December 31st, 2019. Cases were files of women who gave birth vaginally to a singleton macrosomic baby on a single lower segment scarred uterus. Controls were those who gave birth by emergency cesarian section. Statistical analyses were performed using Epi-Info 7.2.2.6 software and Excel 2016.
Results: we included 31 cases matched to 62 controls. Independent factors increasing the vaginal delivery of MNBSU were : Past-History (PH) of vaginal delivery of a macrosomic baby (OR=20.48; p=0.014), PH of vaginal delivery before and/or after Cesarean Section (CS) (OR=5.07, OR=21.58 respectively; p<0.05), cervix effacement ≥ 75% (OR=10.58; p<0.001), or more than 7cm dilated on admission (OR=6.11; p=0.016) no dynamic dystocia (OR=11.57; p<0.001) and labor duration <4 hours (OR=27.59; p<0.001), newborn height ≥ 53 cm (OR=1.31; p=0.014).
Conclusion: safe vaginal delivery of macrosomic fetus on post cesarian single uterine scar is possible. In case of clinical proof of adequate pelvis, spontaneous onset of labor and admission at advanced stage of eutocic labor, labor should be allowed to proceed. New-born height ≥ 53cm is a new decision-making parameter to confirm.
Published Date: 2024-02-06; Received Date: 2023-12-13