ABSTRACT
Objectifs : Cette étude vise à identifier les facteurs déterminants de la survenue d'une fausse couche spontanée précoce.Patients et méthodes : Il s'agit d'une étude cas-témoins effectuée à l'Hôpital Universitaire de Gynécologie Obstétrique de Befelatanana (HUGOB) (Antananarivo). Les cas sont constitués par toutes les femmes présentant une fausse couche spontanée précoce avec test de grossesse positif et les témoins sont constitués par des femmes ayant accouché.Résultats : Cette étude a permis de répertorier 75 cas et 150 témoins. La survenue d'une fausse couche spontanée précoce est déterminée significativement par la l'antécédent de fausse couche spontanée (OR = 2,31 [1,23-4,33], les habitudes toxiques (OR = 3,05 [1,17-7,94]), quelques facteurs professionnels à savoir : l'exercice d'une profession demandant un effort physique à 100% (OR = 2,68 [1,42-5,05]), la longue durée de travail dans la journée (> 8 heures) (OR = 3,08 [1,64-5,8]), le nombre de jour de travail dans la semaine (> 5 jours) (OR = 1,79 [0,95-3,38]), la position assise durant le travail (OR = 2,71 [0,97-4,88]).Conclusion : L'encouragement des femmes enceintes à réaliser régulièrement les consultations prénatales et l'amélioration des conditions de travail des femmes enceintes sont nécessaires pour diminuer les risques de la fausse couche spontanée précoce
Subject(s)
Abortion, Spontaneous/etiology , Case Reports , Madagascar , Risk FactorsABSTRACT
Background: Spontaneous abortion (miscarriage) is a source of pregnancy loss globally. Its management; especially in low resource countries remains hampered by inadequate facilities for evaluation. Objectives: To assess the clinical presentation; diagnosis; and treatment of cases of spontaneous abortion at a tertiary hospital in Ilorin; Nigeria. Methodology: A descriptive study of all spontaneous abortions (miscarriages) managed at the University of Ilorin Teaching Hospital; Ilorin; Nigeria between January 1; 2007 and December 31; 2011. The records were retrieved from the medical records department and necessary information retrieved. Results: There were 603 miscarriages with a prevalence of 4.2; incomplete miscarriage was the most common 254 (42.1); 356 (59.0) had no identifiable risk factor; 434 (72) of the women were 35 years; 361 (59.9) had first trimester miscarriages; 272 (45.1) were of low parity (Para 0-1) and 223 (37) were having a repeat miscarriage. Of the 141 managed for threatened miscarriage; pregnancy was salvaged in 90 (63.8); 244 (40.5) had surgical evacuation with 100 success rate while 218 (36.2) had medical management with 90.8 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6). Histology confirmed product of conception in 98 and molar gestation in 2 of the samples; no mortality was recorded in this study. Conclusion: More than half of women with miscarriages had no identifiable risk factors mainly due to limitation in facilities for evaluation; there is a need to improve facilities for investigating women with spontaneous abortions in developing countries to identify the causes of the losses