Childbirth on a Scarred Uterus: Epidemiology and Maternal-Fetal Prognosis in Mbujimayi

Research Article

Abstract

A scarred uterus refers to a uterus bearing one or more incisions of the wall, most often following a cesarean section, a situation that has become increasingly frequent. This study at Grace Divine Hospital (Mbujimayi, DRC) aimed to determine the frequency of deliveries on a scarred uterus, describe the profile of the women, specify the causes/indications of the scars, and document the maternal-fetal prognosis.
We conducted a retrospective descriptive study from June 1, 2024, to May 31, 2025. Out of 850 deliveries, 122 involved a scarred uterus. Data were collected from medical records and analyzed using SPSS 20 (statistical tests, chi-square, p<0.05).
The frequency was 14.4%. The mean maternal age was 25 years (58.2% between 20–35 years). Cesarean section was the main cause (94.3%). Most women had a single uterine scar (72.1%). Regarding the mode of delivery, 96.7% delivered vaginally and 3.3% by cesarean section. Maternal complications occurred in 9% of cases, mainly uterine atony (36.3%) and rupture (27.3%). On the neonatal side, 83.6% had an Apgar score of 8–10 at the 5th minute, and 89.3% had a birth weight between 2500–4000 g.
Delivery on a scarred uterus is frequent at Grace Divine. Vaginal birth remains predominant, with an overall favorable prognosis, despite a non-negligible risk of maternal complications (uterine atony, rupture). Rigorous prenatal follow-up and careful selection of candidates for vaginal delivery are essential.