ABSTRACT
The objectives of this study were to compare perinatal outcomes in twin pregnancies where the first twin was in the breech presentation. To do so, we performed a 10-year retrospective cohort study in a single university center. All patients with a twin pregnancy with the first twin in breech presentation, a gestational age greater than or equal to 34 weeks' gestation, and a birth weight >= 1500 g were included. The main outcome measures were 5-minute Apgar score <7 and perinatal mortality. We included 353 pairs of twins which complied with the inclusion criteria. One hundred and fifty (150) patients delivered vaginally while 203 pairs of twins were delivered by caesarean section. Patients who delivered abdominally were similar to those who delivered vaginally with regard to age, parity, and gestational age. Six twins A delivered vaginally and 2 delivered by caesarean section had an Apgar score < 7 (p = 0.76) whereas 12 twins B delivered vaginally and 2 delivered abdominally had an Apgar score <7 (p = 0.001). Perinatal mortality did not differ significantly between twins delivered abdominally and those delivered vaginally. There was no evidence that vaginal delivery was risky with regards to depressed Apgar scores for Twin A and neonatal mortality for breech first twins that weighed at least 1500 g. However, Twin B delivered vaginally were more likely to present with a low 5-minute Apgar score. Along with the literature, the findings of this study do not currently allow to define a consensual obstetric attitude towards management of breech first twin deliveries. Until more prospective multicenter randomized controlled studies shed light on this problem, the skills, experience and judgment of the obstetrician will play a major role in the decision-making process. (Afr J Reprod Health 2022; 26[5]: 50-56).
Subject(s)
Cesarean Section , Vaginal Birth after Cesarean , Pregnancy, Twin , Senegal , Pregnancy Outcome , Perinatal DeathABSTRACT
Introduction: to investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. Methods: this was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. Results: the frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. Conclusion: pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus
Subject(s)
COVID-19 , Pregnant Women , SenegalABSTRACT
Objectifs : Evaluer la sensibilite et la specificite de l'echographie transperineale par rapport au toucher vaginal dans le diagnostic d'engagement de la tete foetale au cours du travail.Patientes et Methodes : Etude pilote prospective et descriptive menee a la maternite du CHN de Pikine; durant la periode allant du 01 Mars au 30 Juin 2012. Toute parturiente admise respectant les criteres d'inclusion avait beneficie a la fois d'un examen vaginal et d'une echographie transperineale afin de definir la notion d'engagement. Une distance seuil inferieure ou egale a 60 mm entre le perinee et la tete foetale avait ete retenue comme signe echographique de l'engagement Resultats : L'evaluation conjointe etait realisee chez 55 parturientes. L'age moyen etait de 26 ans; la parite moyenne de 1;47. L'echographie avait permis de poser le diagnostic d'engagement de la presentation avec une sensibilite de 93;1% et une valeur predictive positive de 81;25%. La specificite de cette exploration etait de 76;92% avec une valeur predictive negative de 90;91%. Le toucher vaginal permettait de predire l'accouchement par voie basse dans 96;4% des cas contre 77;2% pour l'echographie. Conclusion : Le toucher vaginal est un parametre subjectif et peut etre limite dans certaines situations (bosse sero-sanguine; oedeme vulvaire) et l'echographie peut s'averer interessante. L'echographie transperineale parait simple et reproductible. Une valeur seuil de 60 mm revet une bonne sensibilite et une bonne valeur predictive negative pour le diagnostic d'engagement. La diffusion de la technique doit aller de pair avec la vulgarisation de l'echographie en salle de travail dans les maternites de notre pays afin de valider cette technique sur un echantillon beaucoup plus significatif