Profile of primary caesarean section at Musienene Hospitalin North Kivu, Eastern DRC

Introduction. The rate of cesarean section has increased in recent decades and primary caesarean section (PCS) seems to be prominent. The objective of this study was to determine the rate and factors associated with PCS at Musienene Hospital.Methods. It was a retrospective cross-sectional study. It involved 466 singleton pregnancies with no previous Caesarean Section (CS) scar, in 2016. Data were analyzed with Epiinfo software version 7. Chi-square was used to test the independent variables that can influence the mode of delivery, the relative risk to evaluate the degree of influence of each of the variables to the mode of delivery of the laboring women. Results. The rate of PCS was 23.2%. Mothers aged less than 20 years were 3.9 times as likely to deliver by cesarean section. Nulliparous women were 2.54 times more likely to undergo cesarean than multiparous. Mothers admitted during the night-shift were 2.74 times more likely to undergo caesarean section than those who were monitored during daytime care.Conclusion. The general CS rate as well as the primary cesarean section rate is very high at Musienene HGR. Most frequent during night shift in adolescent and nulliparous. Staff level, especially at night needs to be improved. The staff needs to be introduced to current maternity guidelines, and introduction of CS Audit will help in reducing the high rate. Raising community awareness of the risks associated with early pregnancy

Obstetric hysterectomy in rural Democratic Republic of the Congo : an analysis of 40 cases at Katwa Hospital

The objective of this study was to determine the incidence, indication, and outcome of obstetric hysterectomy at an Eastern DRC rural hospital. This was a seven year retrospective study. The incidence was 0.28%. Mean age and parity of patients was 35.8 and 7 respectively. Trend to have Obstetric Hysterectomy increased with an age of = 35 years and parity of = 5. The main indications were Post-Partum Hemorrhage (PPH) (40%) and Ruptured Uterus (27.5%). Maternal mortality was 5% compared to 0.18% for Caesarean practiced at the same study period; and perinatal mortality 35.5%. Most indications could be avoided by improvement of Obstetric care. (Afr Reprod Health 2008; 12[1]:60-66)