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Background: The objective of the study is to compare the frequency, the socio-demographic characteristics, the indications, the fetal maternal prognosis and the Robson classification of prophylactic and emergency caesarean sections.Methods: This was a comparative study of prophylactic and emergency caesarean sections at the maternity of Ignace Deen national hospital. It was a 12 month (July 1, 2016 to June 30, 2017) descriptive and analytical study.Results: Prophylactic caesarean sections accounted for 12, 51% of caesarean sections and 3.96% of deliveries at the ward. Prophylactic caesarean sections involved pregnant women aged from 20 to 29, holder of higher education degrees (51.54%), married (92.76%) employed (56.83%) and whose prenatal visit was provided by the obstetrician (73.54%). While the emergency caesarean section concerned parturient aged between 20 and 34, mostly non-schooled (36.49%), transferred patients (80.22%) and nulliparous (58.5%). Surgical indications were mainly scarred uterus (32.32%) and maternal pathologies (18.11%) prophylaxis; bleeding in the last quarter (25.90%) acute fetal distress (20.33%) in emergency. Groups 6 and 5 of the Robson classification were the most represented with a 2.23% morbidity and a zero maternal lethality in prophylaxis versus groups 5 and 6 with a 10.03% morbidity and a 1.67% maternal lethality in emergency.Conclusions: Improving this prognosis would be achieved through an increase in the frequency of prophylactic caesarean sections.
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Background: The objective of this study was to determine the maternal-fetal prognosis of emergency caesarean sections on the scar uterus to contribute to the reduction of maternal-fetal morbidity and mortality.Methods: An analytical cross-sectional study of pregnant women who were observed from admission to discharge including their newborns at Panzi Reference General Hospital in gynecology and obstetrics department. The sample was comprehensive for convenience consisting of 150 deliveries by caesarean section who had previously delivered at least once by caesarean section. (In 4 months, from 01st December 2018 to 31st March 2019). A pre-established survey sheet allowed us to collect the data. For data analysis, SPSS software and Microsoft excel were used. The chi-square test was used at the 0.05 level.Results: A total 95.2% of newborns were found to be of normal weight, their mothers were emergency cesarized but should be programmed and macrosomia was noted in 4.8%; (p >0.05). In addition, 57.1% of urgent caesarean sections scheduled to be performed were performed in female children (p <0.05). We note the low Apgar in 26.2% of newborns whose mothers were emergency cesarized but should be programmed; (p <0.05). Afterwards, 33.3% of the emergency cesarized gestates, their newborns were transferred to neonatology with transfer reasons asphyxia light in 50%, moderate asphyxia in 28.5% and in 21.5% for the infectious risk. The neonatal prognosis at discharge, we noted two cases of neonatal deaths or 4.7% in pregnant emergency cesarized (p >0.05). On the maternal side, morbidity was dominated by puerperal infections in 16.7% and uterine rupture in 2.4% in the emergency caesarean section, and no maternal deaths occurred in both groups during the study period.Conclusions: Maternal-fetal prognosis was characterized by asphyxia, neonatal infection and two cases of neonatal death. Study did not register a maternal death but we noticed puerperal infections.
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Background: Vascular-renal syndrome, also known as pre-eclampsia, is a condition specific to pregnancy, usually occurring in the last trimester of pregnancy. Pregnant women are sometimes at risk of unpredictable obstetrical complications such as: hemorrhage, kidney failure, HELLP syndrome, sometimes even brain damage requiring prompt care and multidisciplinary collaboration. Vascular-renal syndromes are the third leading cause of maternal death and also the world's leading cause of perinatal death. Objectives of this study were to analyse the management of vascular-renal syndromes. Calculate their frequency, describe the sociodemographic characteristics of patients, describe the clinical and biological signs of patients, evaluate the maternal-fetal prognosis.Methods: The study was conducted in the department of obstetrics and gynecology of Donka National Hospital. It was a prospective, descriptive, cross-sectional, 6-month study from March 1st to August 31st, 2015, of pregnant women with pre-eclampsia.Results: The study included 217 cases of pre-eclampsia out of a total of 3054 patients, i.e. a proportion of 7.10%. The proportion of pre-eclampsia was high in patients aged between 15 and 19 years, housewife, married, primary. The predisposing factors were primigestitis, obesity and twinkling. The clinic was dominated by headaches and visual disturbances. Severe preeclampsia in 78.49%, eclampsia in 21.65% or simple hypertension in 1.75%. Maternal and fetal complications were dominated by eclampsia 26.26%, PPH (2.63%), eclamptic coma (0.46%), acute fetal distress 27.19%, and fetal death in utero (11.40%). In order to improve maternal and fetal prognosis it is necessary to provide multidisciplinary care, which unfortunately is not always available in our context.Conclusions: Obstetric emergency is a frequent situation for which a better management would improve the maternal-fetal prognosis.
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Background: Premature rupture of membranes (RPM) is defined by rupture of the amnion and chorion before entering labor within 24 hours leading to vaginal discharge of amniotic fluid without uterine contractions. Objective of this study was to improving the management of premature Ruptures of the membranes received in the service.Methods: This was a descriptive and analytical prospective study lasting six months from January 1 to June 30 2016.Results: During the study period, we collected 108 cases of RPM out of 1543 deliveries, representing a hospital frequency of 7%. RPM had more frequently concerned pregnant women aged 25-29 (37.04%), housewife (37.03%), primiparous (45.37%) and referral (52.78%). 95.37% were single pregnancies with cephalic presentation (80%) received between 37-42 weeks (84.26%). Management mainly consisted of antibiotic prophylaxis (100%), fetal pulmonary maturation and childbirth. The vagina was the main mode of delivery (62.04%). The maternal prognosis was dominated by chorioamnionitis (12.96%). The fetal one was made up of respiratory distress (40.71%) and prematurity (12.39%).Conclusions: RPM is frequent at the Matam municipal medical center. It is essential for its prevention to ensure health education of the population in general and genital hygiene in particular, to make a coherent prenatal follow-up while putting a particular accent on the detection and the treatment of genital infections.
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Background: Pregnant women may be at risk of unpredictable obstetric complications such as: bleeding, dystocia, acute fetal suffering, pre-eclampsia and eclampsia. This maternal-fetal prognosis of obstetric emergencies is influenced by factors that are most often related to complications that alter the course or outcome of a pregnancy and require prompt care. The objectives of this study are to analyze the factors that influence the maternal-fetal prognosis of obstetric emergencies; determine their frequency, describe the clinical profiles of patients and evaluate the maternal-fetal prognosis.Methods: The study was conducted at the Mamou Regional Hospital. It was a 6-month quantitative, descriptive and analytical study, from July 1st to December 31st, 2016, including all parturient women whose term is greater than or equal to 28 weeks of amenorrhoea.Results: The study covered 377 obstetric emergencies out of a total of 1273 deliveries, or 29.61%. Factors influencing the prognosis were: young age, parity, unfavorable socio-economic conditions and difficult baseline conditions. The main obstetric emergencies recorded were acute fetal suffering, disproportion and narrowed pelvis. The dominant mode of delivery was caesarean section with a frequency of 89.65%. Maternal lethality is 3.44% and fetal lethality is 5.14%.Conclusions: Obstetric emergency is a frequent situation where better management would improve the prognosis of the mother and fetus.
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The objective of this investigation was to carry out a literature review on the choroid plexus cysts and theirimportance in fetal prognosis with search on PubMed, Web of Science, LILACS and MEDLINE databases usingkeywords in English without time restrictions. Choroid plexus cysts, which are also termed intraventricularneuroepithelial cysts, choroid epithelial cysts or ependimary cysts, are structures localized within the interiorof the lateral ventricles, comprising secretory epithelium, the principal function of which is the production ofcerebrospinal fluid. Ultrasound images of the choroid plexuses within the lateral ventricles consist of hyperechogenicstructures at the level of the body, trigon and inferior horn of the ventricles. Between the 16th andthe 20th week of gestation, cystic structures in the interior of the ventricular plexuses may be observed at arate of 0.3-1.0% in an ultrasound examination of the fetal head, as is shown. Most choroid plexus cysts regressspontaneously without after effects, although there is a possible association with chromosomal abnormalities,notably trisomy 18 (Edwards syndrome) and less frequently cited, trisomy 21 (Down syndrome). The presenceof this kind of cyst is considered to be a lesser marker for them, except when combined with other morefrequently used and accepted ecographic markers, such as nuchal translucency, intracardiac echogenic focusand others. Its isolated presence as the sole characteristic of this aneuploidy is rare. The majority of choroidcysts are transitory and of little clinical significance, and may be identified through a computerized tomographyexamination. As such, the existence of isolated choroid cysts does not indicate the confirmation of chromosomalaneuploidies so much as an alarm that should trigger an investigation in greater depth in search ofother more important markers, emphasizing the importance of pre-natal monitoring.