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.

Background: Uterine rupture achieves a solution of continuity of the thickness of the wall of the womb. It can be spontaneous or provoked. It can occur during work (most often) or during pregnancy. In all cases, although this occurs in the third trimester of pregnancy, uterine rupture can also occur before this period of gestation, the second trimester of pregnancy. Case: A 29-year-old woman, gesture 8, par 8, with a history of in utero death and uterine incision presented a hemoperitoneum picture of a 26-year-old pregnancy. She consulted 8 hours after the sudden onset of severe abdominal pain and metrorrhagia. Uterine rupture was observed during laparotomy, and adequate maternal management was performed. Conclusion: The occurrence of uterine rupture should be suspected before any hemoperitoneum, hemodynamic instability or metrorrhagia, even before the third trimester of pregnancy. Early diagnosis could improve the fetal-maternal prognosis.

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.

Introduction: In utero death is one of the most common situations in obstetrical practice and is often poorly tolerated by pregnant and nursing staff. The objectives of this study were to determine its frequency and to identify the risk factors at the North Kivu Provincial Hospital in Goma. Methods: This was a cross-sectional and descriptive case-control study that determined the frequency of death in utero and identified risk factors. For this study period, 55 in utero deaths were recorded out of a total of 1218 deliveries. For risk factor research, the match ratio was 2 controls with live birth for a case of death in utero. Results: The frequency of death in utero at the North Kivu Provincial Hospital in Goma was 4.5%. After adjustment, celibacy (p = 0.004, 95% OR = 4.67), parity greater than 3 (p = 0.021, 95% OR = 2.45), CPN deficiency (p = 0.000, 95% OR = 6.23), the history of in utero death (p = 0.000, 95% OR = 16.71), and morbid diseases were identified as factors associated with the risk of onset of death. utero. Conclusion: The frequency of death in utero was 4.5%. Among the factors studied, the risk of death in utero in our environment is associated with celibacy, multiparity, lack of ANC, history of MIU and morbid maternal diseases.

Introduction: Uterine prolapse is a descent of the uterus into the small pelvis that can be associated with the descent of the vagina, the bladder and the rectum. In this study, our goal was to determine the prevalence and major risk factors for uterine prolapse in Kisangani, and to describe its management. Material and methods: A cross-sectional study with a descriptive and multicentric focus was carried out in 5 main general reference hospitals and university clinics in the town of Kisangani from 1st January 2005 to 1st January 2015. We selected 43 cases of uterine prolapse on 7039 cases of gynecological pathologies. Results: The prevalence of uterine prolapse is 0.61% in Kisangani; 93.02% had consulted for organ removal and 69.76% for abdomino-pelvic pain. 20.93% of these patients were aged 61-70 years, 18.6% were over 70 years of age with Extremes: 18 and 73 years, 76.73% had a parity greater than or equal to 4, 12.05% were obese and 32.53% of patients were HIV positive. The Dolleris-Pellonda was performed in 51.16% and the total hysterectomy at 34.88%. Recurrences were recorded in 16.27% of cases. Conclusion: Uterine prolapse remains a reality in medical practice in our town. If several risk factors are found, it is also appropriate to retain the role played by HIV / AIDS infection in the genesis of this disease.