[Prevention of rupture of the uterus before or during birth in women with previous caesarian sections: report on 14 cases (author's transl)].

Based on 14 cases observed during 230 deliveries of women with previous caesarian sections, the authors attempt in define those factors that may weaken hysterotomy scars and provoke uterine rupture. Factors at risk are defined, and can be assessed from the medical history (parity, number of previous caesarians, period since last section, postoperative fever, placenta praevia as the indication for a caesarian, curettage after the operation), and the clinical findings during the present pregnancy (height of the uterus, placenta praevia). Hysterography is an excellent means of evaluating the state of cicatrisation, but this investigational method is rarely available. These elements are employed the define the attitude of the authors towards the end of a previous caesarian. They emphasize the need for early diagnosis of a rupture, and the validity of early emergency caesarian section. Any delay can considerably after fetal and maternal prognosis, which remains goods in the authors' experience.