Résultat obstétricale des grossesses chez les adolescentes à Kano,

No abstract

Objective: This is a comparative prospective study of the risk factors for ruptured uterus in Aminu Kano Teaching Hospital, Kano, Nigeria, between 1 st January 2000 and 31 st December 2005. Materials and methods:Forty six women with ruptured uterus (cases) were compared with two hundred and thirty women who delivered without ruptured uterus (control). Chi-square (x 2 ) test was used for comparison of the data for statistical significance. The odds ratio (OR) and 95% confidence interval (CI) were determined. Results:The incidence of ruptured uterus was 1 in 278 deliveries (0.36%). The significant risk factors found were unbooked status (OR = 36.70, CI = 12.85 -112.94), low socioeconomic status (OR = 11.51, CI = 5.34 -25.10), 30-39 years of age (OR = 2.23, CI = 1.10 -4.50), grandmultiparity (OR = 8.25, CI = 3.88 -17.64), prolonged obstructed labour (OR = 5.92, CI = 2.57 -13.66). Poor supervision in labor (unbooked status) was found to be the commonest cause of ruptured uterus. Conclusion:In a predominantly Islamic community like ours where early marriage is common, female western education and employment, as well as education of their husbands, community and religious leaders on the importance of antenatal care and hospital delivery, will go a long way to improve its utilization and reduce the prevalence of ruptured uterus in our community.

Maternal mortality is nowadays more of a problem of developing countries especially those in Sub-Saharan Africa (SSA). Maternal mortality has to large extent been eliminated in developed countries and has drastically been reduced in many other regions of the world. The maternal mortality rate (MMR) available in the literature from Africa is not a true reflection of the actual MMR as it is derived from institutional studies. The causes of maternal mortality in SSA are the same as those in developed countries. The means of addressing maternal mortality used in developed countries are the same as those used in developing countries, however, the success levels are not the same. There are various impediments to reducing maternal mortality with roots in cultural, social, economic and systemic factors prevalent in SSA. An in-depth study of these factors will give an insight as to why maternal mortality reduction has remained an enigma in SSA. Analyzing these factors will guide us to design and implement measures that will in the long run lead to significant maternal mortality reduction in SSA. The aim of this review is to identify impediments to maternal mortality reduction in SSA and highlight measures that can lead to maternal mortality reduction.