TRIAL OF LABOR AT THE MATERNITY DEPARTMENT OF THE SOUROSANOU UNIVERSITY HOSPITAL (CHUSS): CLINICAL ASPECTS, THE MATERNAL AND PERINATAL PROGNOSTICS

Aims : We aimed at studying the clinical aspects and the maternal and perinatal prognostics during trial of labor at the Gynecology and Obstetrics Unit.

Patients and Methods : This is a transversal and Descriptive study over a period of 06 months from 1 ^st May to 30 ^th October 2016 in the Gynecology and Obstetrics Unit of the SourôSanou University Hospital (CHUSS). The data were collected and analyzed by the software Epi info version 3.4.5.

Results : During the period of study, 109 cases of trial of labor for a total of 2124 births were registered, with an overall frequency of 5.13%. The average age of the patients was 26.6 years. In 42.2% of cases, the patients were primiparious . Admission was direct in 85.5% of cases. The coverage rate for prenatal consultation was 100%. There was vaginal delivery for 108 patients, ie a success rate of 99.08% for trial of labor. An episiotomy was performed in 18.34% of those who delivered vaginally with a labor time less than 3 hours in 65.13% of cases. The indication of the cesarean section during the failure of the trial of labor was dominated by acute fetal distress in 0.91% of cases. Among the 14 patients who had complications during the postpartum period, 06 cases of postpartum hemorrhage of 22.85%, were noted, but did not occasion any maternal death. We registered 109 newborns including 106 alive (97.2%), 10 fresh stillborn, 02 perinatal deaths and 01 macerated stillborn. Among the 13 cases of perinatal morbidity, infections, neonatal suffering and hypotrophy were largely dominant with 5.5%, 38, and 5.34% of the cases.

Conclusion : The results of our study (99.08% of success) argue in favor of vaginal delivery after uterine scar, with little risk related to this scar when the pregnancies are followed closely. Indeed, with a normal and careful obstetric monitoring, a scarred uterus after one segmental cesarean section must be considered as a normal uterus that can allow the woman to deliver simply without her being exposed to any particular risk of uterine rupture.