[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.

[Etiopathogenesis and type of congenital malformations observed in Kinshasa (Zaïre)]. / Etiopathogénie et type de malformations congénitales observées à Kinshasa, Zaïre.

The authors report on 115 malformed newborns, who are compared with 120 normal newborns from October 1985 up to September 1986 at the University Clinics of Kinshasa, Zaïre. There were 4,422 deliveries with 4,465 newborns, of whom 173 died during the perinatal period. The main results are: 1) the incidence of congenital defects is 2.5% births: a rate which is within the limits described by other authors: 2) polydactyly is the most frequent malformation; 3) two rare malformations were diagnosed: (1) a case of Arnold Chiari syndrome associated with polydactyly and (2) a case of temporal meningo-encephalocele; (4) factors for high risks of malformation are: advanced maternal age older than 35 years, consanguinity, a family history of birth defect and of stillbirths; 5) the diagnosis of even major congenital malformations is made macroscopically at birth in 95% because of lack of adequate instruments for antenatal diagnosis and the refusal of autopsy by the population (97%). For religious or mystical reasons, it is difficult to obtain a family's consent to perform autopsy in Kinshasa: people are convinced that life continues after death. So that a dead person needs the corporal integrity of his being.