Predictive Factors of Complications of Vaginal Delivery on Scarred Uterus at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital

Objective: This study was aimed at identifying predictive factors of complications during vaginal delivery on scarred uterus. Methodology: During 9 months, from October 1st, 2015 to June 30th, 2016, a case control study was carried out at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Eighty nine women each with a single scarred uterus who presented with complications during delivery (cases) were compared to eighty nine others who had a successfully trial of scar (control) during the study period. Data were analyzed using the CSPro version 6.0 and SPSS version 20.0 softwares with statistical significance set at P < 0.05. Results: We recruited 2 groups of 89 women, aged 17 to 40 years, with an average age of 29.05 years. The majority of women with complications were married (50.6%) and unemployed (42.8%). Following univariate analysis, predictive factors of complications were: prematurity (OR = 7.4), post-term (OR = 13.7), no history of vaginal delivery on scarred uterus (OR = 4.3), inter-pregnancy spacing period greater than 60 months (five years) (OR = 2.9), History of caesarian delivery indicated for cephalo-pelvic disproportion (OR = 6.6), less than four ante-natal consultations (OR = 3.6), antenatal consultations done in a Health Centre (OR = 2.7), ante-natal follow up conducted by a nurse (OR = 2.4; IC = [1.2 4.7]), referral from a different health unit (OR = 4.4, IC = 2.0 9.4), a Bishop score less than 7 on admission (OR = 12.4, IC = 5.6 27.4), a meconium stained amniotic fluid (OR = 9.9; CI = [3.6 26.8]). After logistic regression, the retained factors associated with complications were post-term (aOR = 34.5), absence of vaginal birth after caesarian delivery, (aOR = 11.7), previous caesarean section indicated for cephalo-pelvic disproportion (aOR = 6.1), a bishop score less than 7 (aOR = 12.0), meconium stained amniotic fluid (aOR = 13.6). Conclusion: Predictive factors of complications can help anticipate negative obstetric outcomes. How to cite this paper: Meka, E.N.U., Foumane, P., Essiben, F., Ngwesse, E.R., Sama, J.D. and Mboudou, E.T. (2016) Predictive Factors of Complications of Vaginal Delivery on Scarred Uterus at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital. Open Journal of Obstetrics and Gynecology, 6, 851860. http://dx.doi.org/10.4236/ojog.2016.613103 Received: November 8, 2016 Accepted: December 20, 2016 Published: December 23, 2016 Copyright © 2016 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access E. N. U. Meka et al.