title: [Vaginal delivery of bi-scarred uterus].
abstract: Despite awareness of obstetricians to the constant increase in the number of caesarean sections in recent years, certain dogmas concerning uterine scar still persist in our practices and influence clinical decisions. Fear of a uterine scar rupture, a major obstetric complication, is always in mind. As for bi-uterine scar, it was considered, until recently in Belgium, as a full and definitive indication against an attempted vaginal delivery. However, several previous clinical studies clearly showed that, under certain conditions, vaginal birth after two caesarean sections was usually successful with very good results in terms of maternal and fetal morbidities. Even if such a clinical situation is not common, this article aims to sensitize obstetricians to the lack of objective clinical arguments to reject a vaginal delivery in a patient having a previous history of two caesarean sections. Such a patient must be motivated and followed up within a specific framework. Moreover, this type of delivery should receive optimal monitoring.
authors.affiliation: CHR Verviers, Belgique.
authors.forename: Y
authors.initials: Y
authors.lastname: Christiane
authors.affiliation: Service de Gynécologie-Obstétrique, CHU de Liège, Belgique.
authors.forename: P
authors.initials: P
authors.lastname: Emonts
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology; D016064:Vaginal Birth after Cesarean / Q000379:methods
keywords:  Uterine rupture ;  Uterine scar ;  Vaginal delivery; Caesarean section 