Introduction: Velamentous insertion is one of the risk factors for Benckiser haemorrhagy, a several obstetric emergency that threatens the fetal prognosis. Her diagnosis by performing a transvaginal ultrasound with color Doppler is recommended in pregnant women with high risk of vasa previa. A caesarean section of convenience should be scheduled before labors begin when a vasa previa is diagnosed during the prenatal period. Case: a parturient aged 26, gesture 5, par 3, is admitted for labor of delivery on term pregnancy. After an artificial rupture of the water pocket, the amniotic fluid was not tinged with blood, and the delivery proceeded normally. The eutrophic newborn, male, had a good APGAR score. On macroscopic examination of the placenta, which had weighed 500 grams, the umbilical cord of normal length was inserted on the membranes, with no other abnormalities noted. The mother and newborn had evolved well and their stay in the hospital was only 48 hours. Conclusion: Velamentous insertion of the umbilical cord can be observed outside the most frequent risk factors in the literature. However, any placental insertion abnormality should guide the completion of an endovaginal ultrasound to exclude vasa previa in order to take precautions necessary for the prevention of haemorrhagy with poor prognosis for the fetus.
Introduction: Induced abortion remains a scourge in Africa where it exposes women to serious or life-threatening complications. Unplanned and unwanted pregnancies result in clandestine abortions carried out under unsuitable conditions. The purpose of this work was to study the prevalence, complications and outcome of clandestine abortions in the city of Kisangani in the Democratic Republic of Congo.
Methods: This was a descriptive, cross-sectional study. The data collection was retrospective, for the period from 1 January 2013 to 31 December 2016, and involved 63 cases of clandestine abortions followed in two general referral hospitals and at Kisangani University Clinics.
Results: The prevalence of clandestine abortions was 8.4%. These abortions were more prevalent among women aged 16 to 25 (61.9%), single women (85.7%) and those at the secondary level (49.2%). The pattern of admission was dominated by genital bleeding associated with pelvic pain (71.4%). This practice was more performed between 4 and 8 weeks of amenorrhea (58.7%), at home (63.5%), with Misoprostol (61.9%) and for reasons of unwanted pregnancy (44.4%). Management was medical in 71.4% of cases, anemia was the most observed complication (73.0%) and 8 cases of death were recorded (12.7%).
Conclusion: Clandestine abortion is a real public health problem in Kisangani. The only way to avoid the harmful consequences of maternal deaths is to make the population aware of the danger of this practice, which is illegal in our country, through the activities of the National Reproductive Health Program.