[ Pronostic d’accouchement chez les gestantes porteuses d’utérus cicatriciels dans la ville de Butembo en République Démocratique du Congo ]
Volume 24, Issue 4, November 2018, Pages 1750–1760
Philémon MUMBERE MATUMO1, Joël KAMBALE KETHA2, Aimé LUKWAMIRE VAHAMWITI3, and Jean-Jeannot JUAKALI SIHALIKYOLO VUYIAMBITE4
1 Département de Gynécologie et Obstétrique, Université Catholique du Graben, Butembo, RD Congo
2 Département d’Anesthésie et Soins Intensifs, College of Medicine, University of Rwanda - Kigali, Rwanda
3 Départémént de chirurgie, Université Catholique du Graben, Butembo, RD Congo
4 Département de Gynécologie et Obstétrique, Université de Kisangani, Kisangani, RD Congo
Original language: French
Copyright © 2018 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: The occurrence of pregnancy on a scar uterus is characterized by its high incidence, multiple complications, high rate of morbidity and maternal-fetal mortality. The aim of this work was to evaluate the maternal prognosis during delivery on scar uterus in a poorly equipped environment. Methodology: This is a retrospective and descriptive study with exhaustive sampling carried out in 2 years. Our study’s population was constituted by all pregnant women with previous caesarean section scarring uterus who gave birth in the obstetric department of Matanda Hospital in Butembo City. Results: Scarred uterus deliveries accounted for 20% of all deliveries; 26.8% of parturient had a antecedence of vaginal delivery; 39.6% of parturient had severe pelvic narrowing as an indication of anterior caesarean section; and 49.3% had uterus once scarred, 26.9% uterus twice scarred and 14.7% uterus thrice scarred. 72.8% of parturient had an inter-reproductive interval between 13 and 24 months; 98.1% had term pregnancies. Thirteen percent of parturient had a uterine test, among which 41.2% had given birth vaginally; 8.8% of cases of pre uterine rupture and 5.9% of cases had acute fetal distress. No maternal mortality were recorded. Early neonatal mortality was 1.5% of cases and half of the cause of death was acute fetal distress followed by respiratory distress and neonatal infections. Conclusion: The birth on scar uterus is common. The decision of the delivery modality to be proposed should take into account factors concerning the obstetrical antecedents, the data of the current pregnancy, but also the choice of the parturient after being informed of the risks and benefits of each delivery pathway. We propose here the application of the MOMAT score for the prediction of the failure of the uterine test.
Author Keywords: Scarred uterus, labour, uterine test, maternal-fetal prognosis, Butembo.
Volume 24, Issue 4, November 2018, Pages 1750–1760
Philémon MUMBERE MATUMO1, Joël KAMBALE KETHA2, Aimé LUKWAMIRE VAHAMWITI3, and Jean-Jeannot JUAKALI SIHALIKYOLO VUYIAMBITE4
1 Département de Gynécologie et Obstétrique, Université Catholique du Graben, Butembo, RD Congo
2 Département d’Anesthésie et Soins Intensifs, College of Medicine, University of Rwanda - Kigali, Rwanda
3 Départémént de chirurgie, Université Catholique du Graben, Butembo, RD Congo
4 Département de Gynécologie et Obstétrique, Université de Kisangani, Kisangani, RD Congo
Original language: French
Copyright © 2018 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction: The occurrence of pregnancy on a scar uterus is characterized by its high incidence, multiple complications, high rate of morbidity and maternal-fetal mortality. The aim of this work was to evaluate the maternal prognosis during delivery on scar uterus in a poorly equipped environment. Methodology: This is a retrospective and descriptive study with exhaustive sampling carried out in 2 years. Our study’s population was constituted by all pregnant women with previous caesarean section scarring uterus who gave birth in the obstetric department of Matanda Hospital in Butembo City. Results: Scarred uterus deliveries accounted for 20% of all deliveries; 26.8% of parturient had a antecedence of vaginal delivery; 39.6% of parturient had severe pelvic narrowing as an indication of anterior caesarean section; and 49.3% had uterus once scarred, 26.9% uterus twice scarred and 14.7% uterus thrice scarred. 72.8% of parturient had an inter-reproductive interval between 13 and 24 months; 98.1% had term pregnancies. Thirteen percent of parturient had a uterine test, among which 41.2% had given birth vaginally; 8.8% of cases of pre uterine rupture and 5.9% of cases had acute fetal distress. No maternal mortality were recorded. Early neonatal mortality was 1.5% of cases and half of the cause of death was acute fetal distress followed by respiratory distress and neonatal infections. Conclusion: The birth on scar uterus is common. The decision of the delivery modality to be proposed should take into account factors concerning the obstetrical antecedents, the data of the current pregnancy, but also the choice of the parturient after being informed of the risks and benefits of each delivery pathway. We propose here the application of the MOMAT score for the prediction of the failure of the uterine test.
Author Keywords: Scarred uterus, labour, uterine test, maternal-fetal prognosis, Butembo.
Abstract: (french)
Introduction: La survenue d’une grossesse sur un utérus cicatriciel se caractérise par son incidence élevée, ses complications multiples, son taux important de morbidité et de mortalité materno-fœtale. L’objectif de ce travail était d’évaluer le pronostique maternofoetal lors de l’accouchement sur utérus cicatriciel dans un milieu peu équipé. Materiel et Méthodes: Il s’agit d’une étude transversale à visée analytique avec échantillonnage exhaustif et recueil rétrospectif des données. La population d’étude est constituée de toutes les gestantes avec utérus cicatriciel pour césariennes antérieures qui ont accouché dans le service d’obstétrique de l’hôpital Matanda en ville de Butembo durant une période de 2 ans. Résultats: Les accouchements sur utérus cicatriciels ont représenté 20% de l’ensemble des accouchements; 26,8% des parturientes avaient un antécédent d’accouchement par voie basse ; 39,6% des parturientes avaient un rétrécissement pelvien sévère comme indication de la césarienne antérieure ; et 49,3% avaient un utérus uni-cicatriciel, 26,9% un utérus bi-cicatriciel et 14,7% un utérus tri-cicatriciel. 72,8% des parturientes avaient un intervalle inter génésique compris entre 13-24 mois ; 98,1% avaient des grossesses à terme. 13% des parturientes avaient fait l’objet d’une épreuve utérine parmi lesquels 41,2% avaient accouché par voie basse ; 8,8% de cas de pré-rupture utérine et 5,9% de cas de souffrance fœtale aiguë. La mortalité maternelle était nulle. La mortalité néonatale précoce était dans 1,5% de cas et la cause de leur décès était liée dans la moitié de cas à une souffrance fœtale aiguë, suivie de détresse respiratoire et infections néonatales. Conclusion: L’accouchement sur utérus cicatriciel est fréquent. La décision de la modalité d’accouchement à proposer devrait prendre en compte des facteurs concernant les antécédents obstétricaux, les données de la grossesse actuelle, mais aussi le choix de la parturiente après qu’elle ait été informée des risques et des bénéfices de chaque voie d’accouchement. Nous proposons ici l’application du score de MOMAT pour la prédiction de l’échec de l’Epreuve utérine.
Author Keywords: Utérus cicatriciels, Accouchement, Epreuve uterine, Pronostic maternofoetal, Ville de Butembo.
How to Cite this Article
Philémon MUMBERE MATUMO, Joël KAMBALE KETHA, Aimé LUKWAMIRE VAHAMWITI, and Jean-Jeannot JUAKALI SIHALIKYOLO VUYIAMBITE, “Prognosis of labour among pregnant women with scarred uteri in Butembo, Democratic Republic of the Congo,” International Journal of Innovation and Applied Studies, vol. 24, no. 4, pp. 1750–1760, November 2018.
