Childbirth by Vaginal Delivery in Double Scarred Uterus: Uterine Trial Conducted in the Borgou Department, Benin

Objective: To investigate the possibility of vaginal birth after two caesarean deliveries. Patients and methods: This was a cross-sectional analytical study with prospective data collection, conducted from March 1st to September 30th 2016, in three maternities in reference hospitals in the Borgou department, Republic of Benin. Results: Of the 162 patients registered, 87 (53.70%) began spontaneous labour and 75 (46.30%) benefited from a C-section before labour began. Of the 87 women who started spontaneous labour, 54 (62.07%) did not meet the requirements for vaginal birth, and benefited from a C-section; one patient (1.15%) gave birth in the course of referral, and 32 (36.78%) went through our trial. Of the 32 patients who went through the trial of scar, 28 (87.50%) delivered successfully; among them were two twin pregnancies. All four unsuccessful trials (12.50%) were due to the occurrence of acute fetal distress. Among the 28 successful cases, 03 (10.71%) developed to a vasculo-renal syndrome in the sequences of immediate layers. We encountered no case of scar dehiscence nor of child nor maternal death. Conclusion: Vaginal birth in double scarred uterus is possible and can be considered, with minimum damage to the mother and the fetus. Nevertheless, the recruitment of subjects must be rigorous and labour surveillance done in a surgical environment.