[The characteristics of pregnancy-puerperium in central Africa. I. Cesarean section in 3 different areas in Zaire]. / Particularismes de la gravido-puerpéralité en Afrique centrale. I. Opération césarienne dans trois environnements différents au Zaïre.

A series of 5,127 deliveries carried out in rural (Boende), in semi-urban (Bonzola) and in the urban university teaching hospital units was studied from April to September 1986 to assess pregnancy and the puerperium in a Zairian population. In particular the Caesarean section rate was looked at. Two hundred and forty eight Caesareans were carried out--a rate of 4.8%. More were carried out in university centres (8.6%), than in semi-urban districts (2.2%) or in rural hospitals (1.3%). The maternal morbidity due to haemorrhage and infection and the mortality were also higher in the urban and teaching hospitals (5.9% and 2.3%) than in the other hospitals. In Bonzola it was 2.5% and 0.3%. These figures suggest overall that carrying out Caesarean operations in developing countries with poor equipment has to be considered much more seriously than in centres that are well equipped.

[Illicit abortion, a public health problem in Kinshasa (Zaire)]. / Avortement clandestin, problème de santé publique à Kinshasa (Zaïre).

Illegal (242), therapeutic (6), and spontaneous (836) abortions were treated in the years 1978 to 1979 in the University Clinics in Kinshasa (Zaire). Spontaneous abortions are more common after the age of 20, but their incidence diminishes as parity increases. As a whole, they did not have serious complications. In the illegal group, two categories of high risk women were discovered. The first, characterised in girls under the age of 20 with first or second pregnancies who were unmarried, at school or socially and economically poor. The second group were women of 20 years or more who were married, educated and professionally active. Illegal abortions were performed before the twelfth week of pregnancy, generally by unqualified people. Society seems to tolerate then more or less because only 5% are taken to court. Bleeding, infection, traumatic lesions and 13 maternal deaths show how common complications of illegal abortion were. Both at individual and national levels the cost is high. Sex education, improvement in contraception and revision of the abortion laws are suggested as prophylactic measures towards this public health problem.