The present work contributes effectively to the reduction of maternal and perinatal morbidity and mortality through the rational management of scar uterus deliveries in poorly endowed hospital settings. To achieve this, we carried out a prospective, multicentric, cross-sectional and analytical study of patients with scar uteri in four different secondary-level hospitals in the Democratic Republic of Congo. This study identified 4 determinants of fetomaternal outcome, uterine challenge and maternal and neonatal morbidity and mortality that define the PAUM score for predicting uterine challenge failure.The acronym PAUM was given to it in reference to the initials of its constituent keywords, namely: The use of this predictive score has the effect of improving quality in Caesarean section indications, increasing prophylactic Caesarean section rates and improving selection of patients undergoing uterine testing.