title: [National Survey of the management and delivery of the unicicatriciel uterus in France in 2009].
abstract: OBJECTIVE
  To audit French maternity units' obstetric procedures in delivering women who have undergone previous caesarean section.
  
  
  METHODS
  [corrected] Survey by questionnaire collecting the obstetrical practices about agreement and methods of delivery of women with previous caesarean section in France in 2009. The questionnaire was sent by email to 472 private and public maternity units of grades 1, 2 and 3.
  
  
  RESULTS
  One hundred and seventy-five units (37%) replied, about 305,710 new-borns representated, few private maternity units answered (12.6% of the answers), despite their accounting for 30.2% of obstetric work; 50.9% had no written policy for the management of patients with previous caesarean; 53.1% of units relied on written consent from women attempting vaginal delivery after previous caesarean. The documentation concerning previous caesarean section was considered important by 73.1% of units. Rates for acceptance of attempted vaginal delivery were as follows: after a transverse lower uterine segment incision - 100% of maternity units; after a transverse corporeal incision - 30.3% of units and after a vertical incision - 25.1% of units; 55.4% of maternities induced labour after a previous caesarean section, 29.9% of them with prostaglandin E2; 64% used internal tocometry. Radiopelvimetry was a routine examination for 55.9% of grade 1 units, compared with 13.5% of grade 3 (P=0.000035). Induction was practised by more grade 3 units (78.3%) than grade 1 units (44%) (P=0.009). No team acknowledged carrying out subsequent caesarean delivery as a matter of principle.
  
  
  CONCLUSIONS
  This national survey, statistically representative in terms of the numbers of deliveries, gives an objective view of different practices, according to type and grade of maternity unit in France, in 2009. The data indicate that it is desirable to devise specific recommendations in order to harmonise management, bearing in mind the frequency of caesarean sections.
authors.affiliation: Service de gynécologie obstétrique C, médecine materno-fœtale, faculté de médecine Montpellier-Nîmes, CHU Arnaud-de-Villeneuve, 371 avenue Doyen-Gaston-Giraud, Montpellier, France. ameliearzel@yahoo.fr
authors.forename: A
authors.initials: A
authors.lastname: Arzel
authors.forename: P
authors.initials: P
authors.lastname: Boulot
authors.forename: G
authors.initials: G
authors.lastname: Mercier
authors.forename: F
authors.initials: F
authors.lastname: Letois
mesh_terms: D002585:Cesarean Section; D017604:Cesarean Section, Repeat; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014219:Trial of Labor; D014597:Uterine Rupture; D016064:Vaginal Birth after Cesarean