[Information and facilities recommendations concerning trial of labour in the context of scarred womb]

Abstract

Objectives: To precise key elements concerning facilities and patient information prior to trial of labour in the context of scarred womb.

Method: Bibliographic search restricted to French and English languages using Medline database and recommendations of medical societies.

Results: Only expert's opinions are available. Patient information should present both trial of labour and elective cesarean section. Counselling should be influenced by individual risk of failed vaginal birth and uterine rupture. Mode of delivery should be planned the latest at 8 months of gestation. Patient should be aware of obstetrical and anesthetic facilities. Trial of labour should be presented as the first option for patients with no additional risk factors. Immediate presence of obstetrician and anesthesiologist is not required except in the context of increased risk for failed trial of labour or uterine rupture. Elective cesarean section on maternal request is acceptable after extensive counselling and delay of reflexion.

Conclusion: Individual patient information should be initiated early and mode of delivery should be planned at 8 months of gestation. Resources and facilities recommendations aim to facilitate prompt cesarean section.