Accouchements sur utérus cicatriciel en République Démocratique du Congo: épreuve utérine et facteurs déterminants de l’issue

Momat, Félix Kitenge wa; Zalagile, Pierre Akilimali; Mukalenge, Faustin Chenge; Luboya, Oscar Numbi; Kalala, C.; Mashinda, Désiré Kulimba; Grangé, G.; Mukuku, Olivier; Kaj, Fanny Malonga; Lubamba, Chamy Cham; Bwama, Joseph Bagambe; Mukoko, Célestin Kayembe; Kakoma, Jean Baptiste; Kalungwe, Justin Kizonde

doi:10.11604/pamj.2017.27.71.12499

Cited by 3 publications

(4 citation statements)

References 31 publications

(37 reference statements)

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“…Status of the water sac: Most of our patients were admitted with intact membranes at 70.2% (OR = 5.65 [1.82 -17.56]) and with untimely rupture of membranes as a type. This corroborates with the study of Wa Momat et al [13].…”

Section: Discussionsupporting

confidence: 93%

Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

Madoli¹,

Ilunga-Mbaya²,

Maroyi³

et al. 2023

OJOG

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Introduction: Delivery in a scar uterus is one of the most debated topics in obstetrics. The objective was to determine the uterine test and the maternal-fetal outcome in patients with uni-and bi-scared uterus who received the uterine test at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of patients who delivered on a uni-or bi-scareduterus at Panzi Hospital, between January 1, 2021 and August 1, 2022. Results: The average age of the patients was 27.09 years, with an age range of 25 -34 years, they were mostly married (88.3%), with secondary educational level (60.4%). Pauciparous women, with a history of previous caesarean delivery once, represented respectively 52.2%; 7.2% of parturients with an intergenital space equal to 18 months. 63.9% were overweight, 58.6% had undergone more than three ANC sessions. We noted statistically significant associations between modes of admission, water sac, type of membranes rupture, uterine height and success of uterine test (p < 0.05). We did not find significant associations between parturient age, gestational age, intergestational interval, pregnancy term, surgical history, number of ANC performed, number of previous caesarean sections, number of newborns. We did not record any cases of maternal death but one case of perinatal death with 0.9% in this study. Conclusion: A good selection of patients with uni-or bi-scared uterus would allow the reduction of the fetomaternal morbidity during the uterine test.

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Section: Discussionsupporting

confidence: 93%

Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

Madoli¹,

Ilunga-Mbaya²,

Maroyi³

et al. 2023

OJOG

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“…Obstetrical history considered were gravida (paucigest, multigeste), para (primiparous, pauciparous, multiparous), number of ANC (≤1, 2, ≥3), number of previous cesarean sections (1,2), number of previous vaginal deliveries, previous indications), parameters related to the course of delivery including (gestational age, mode of admission (referral, single arrival), factors of success of uterine test in patients with uni-and bi-cicatricial uterus (age group, gestational age, para, intergenital interval, age of pregnancy, surgical history, delivery mode, ANC, number of previous caesarean sections), water pocket (intact, ruptured), type of rupture (none, early, untimely), height of the uterus, size of the uterus, etc, early, untimely),uterine height (<28 cm, 28 -33 cm, >33 cm), cervical dilatation (1 -3, ≥4), Neonatal prognosis associated with successful uterine testing in parturients with uni-and bi-scarred uteri: neonatal sex, birth weight.…”

Section: Criteria Includementioning

confidence: 99%

“…In the last two decades, the rate of caesarean sections has increased overall. One of the consequences is the increase in the number of patients with history of previous cesarean section (CS) [1], the main cause of morbidity is uterine rupture [2]. The management of a vaginal delivery after a CS is one of the most debated topics in modern obstetrics.…”

Section: Introductionmentioning

confidence: 99%

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Profile of Pregnant Women and Success of the Uterine Test on a Uni- or Bi-Scar Uterus at the Maternity Ward of Panzi Hospital, in the Democratic Republic of the Congo

Madoli,

Nyakio,

Maroyi

et al. 2023

OJOG

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Introduction: Trial of labor after a previous cesarean section (TOLAC) is a method that requires strict monitoring to decrease the cesarean section (CS) rate and improve the maternal and neonatal prognosis. The objective is to determine the profile and outcome of patients with one and two previous CSs who performed TOLAC at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of data of 111 patients with one and two previous CSs at Panzi Hospital from January 2021 to August 2022. Statistical Package for the Social Sciences SPSS version 23 software was used to analyze the collected data. The percentages of categorical variables were summarized in a frequency table. The mean or median with standard deviation was used to summarize quantitative variables. Results: The overall success rate of the TOLAC was 64%, with 63.8% following one previous CS and 64.3% following two CSs. The mean age of the patients was 27.09 years, with an age range of 25 -34 years. They were mostly pauciparous (52.2%), married (88.3%), with a high school education (60.4%). The inter-delivery interval > 18 months was noted (64.1%) and overweight in 63.9%. More than three antenatal consultations were performed (58.6%). We found a mean gestational age of 38 (34 -41) weeks. The perinatal mortality rate was 0.9%. However, we did not record any cases of maternal mortality during the study period. Conclusion: TOLAC after one and two previous CS is imple-

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Facteurs prédictifs de l’issue de l’accouchement sur utérus cicatriciel au service de gynécologie obstétrique EHS Batna, Algérie

2022

Batna J Med Sci

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Introduction. La pratique de césariennes est en ‎augmentation constante dans le monde, soulevant la ‎problématique de la gestion des femmes enceintes ‎ayant un utérus cicatriciel. L’objectif de notre travail ‎était d’identifier les facteurs significativement ‎associés au succès de l’épreuve utérine au sein de ‎notre service, afin de réaliser une sélection ‎rigoureuse des candidates à la tentative de voie ‎basse. Méthodes. Nous avons mené une étude ‎épidémiologique descriptive, rétrospective, mono ‎centrique au niveau de l'EHS mère – enfant Batna du ‎‎1er janvier 2018 au 31 décembre 2019 ayant ‎intéressé les femmees porteuses d’un utérus ‎cicatriciel d’origine obstétricale avec un âge de ‎grossesse supérieur à 22 SA. Résultats. Au cours de ‎notre étude nous avons recensé 3002 ‎accouchements sur utérus cicatriciel. Le taux de ‎tentatives de voie basse après césarienne était de ‎‎46,84 % avec un taux de succès de 89,19 %. Les ‎principaux facteurs qui favorisent le succès de la ‎tentative de voie basse après césarienne étaient : un ‎antécédent d’accouchement par voie vaginale après ‎la césarienne (p<0,001), la multiparité (p=0,0002), ‎une césarienne précédente pour présentation ‎podalique (p<0,001), un intervalle inter génésique ‎de 12 mois et plus (p<0,001), des conditions locales ‎favorables (dilatation du col supérieure à 4 cm ; ‎p=0,02 et la rupture artificielle des membranes ; ‎p=0,03). Les facteurs qui défavorisent le succès de la ‎TVBAC étaient : un antécédent de césarienne pour ‎stagnation ou non-engagement à dilatation complète ‎‎(p<0,001), un terme d’accouchement supérieur à 40 ‎SA (p=0,002), un poids de naissance supérieur à ‎‎4000 g (p<0,001). Les facteurs qui ne semblent pas ‎influencer l’issue de l’épreuve utérine étaient : l’âge ‎maternel, l’âge de réalisation de la première ‎césarienne, la présence de pathologies maternelles ‎et la réalisation de radiopelvimétrie. Conclusion. Les ‎facteurs de succès et d’échec d’une TVBAC sur ‎utérus cicatriciel sont importants à relever pour les ‎décisions ultérieures de la voie d’accouchement, la ‎situation obstétricale doit être soigneusement ‎évaluée et en cas de doute, faire appel à une décision ‎collégiale.‎

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Accouchements sur utérus cicatriciel en République Démocratique du Congo: épreuve utérine et facteurs déterminants de l’issue

Cited by 3 publications

References 31 publications

Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

Profile of Pregnant Women and Success of the Uterine Test on a Uni- or Bi-Scar Uterus at the Maternity Ward of Panzi Hospital, in the Democratic Republic of the Congo

Facteurs prédictifs de l’issue de l’accouchement sur utérus cicatriciel au service de gynécologie obstétrique EHS Batna, Algérie

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