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Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)

Received: 21 March 2019     Accepted: 25 April 2019     Published: 20 May 2019
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Abstract

Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 2)
DOI 10.11648/j.jgo.20190702.16
Page(s) 56-59
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Scarred Uterus, Caesarean, Prognosis, Brazzaville

References
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[5] Koulimaya-Gombet CE, Diouf AA, Diallo M, Dia A, Sène C, Moreau JC, et al. Pregnancy and delivery of patients with a history of caesarean of Dakar: therapeutic and prognostic, epidemiological-clinical aspects. Pan Afr Med J 2017; 27: 135.
[6] Kitenge FM, Chenge FM, Kinenkinda XK, Luboya ON, Tshibangu CK, Mashinda DK, et al. Vital issue, maternal and perinatal morbidity and mortality on delivery with scar uterus in some hospitals in the Democratic Republic of Congo. Ann Afr Med 2017; 10: 2526-34.
[7] Traoré Y, Tegueté I, Dicko FT, Diallo A, Djiré MY, Sissoko A et al. Delivery in a cicatricial uterus context at Gabriel Touré University Hospital from January 2007 to December 2008: modalities and complications. Med Afr Noire 2012; 45: 512-6.
[8] Koh MV, Essome H, Sama DJ, Foumane P, Ebah BM. Delivery of scar uteri in low-ressource countries: management and maternal-fetal care circuit. Pan Afr Med J 2018; 30: 255.
[9] Kintege FM, Akilimali PZ, Chenge FM, Numbi OL, Tshibangu CK, Mashinda D, et al. Scarred uterine delivery in the Democratic Republic of Congo: uterine trial and determinants of outcome. Pan Afr Med J 2017; 27:71.
[10] Baldé IS, Sy T, Diallo A, Baldé O, Diallo MH, Diallo MC, et al. Childbirth in a context of scar uterus at the maternity ward of the Ignace-Deen National Hospital (Guinea). Rev Méd Périnat 2017; 9: 32-6.
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[14] Martel MJ, Mackinnon CJ. Guidelines for vaginal birth after previous caesarean birth. J Obstet Gynaecol Can 2005; 27: 164-88.
[15] Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBA-2): a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010; 117: 5-19.
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Cite This Article
  • APA Style

    Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. (2019). Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). Journal of Gynecology and Obstetrics, 7(2), 56-59. https://doi.org/10.11648/j.jgo.20190702.16

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    ACS Style

    Itoua Clautaire; Iloki Itoba Imongui Sandra; Buambo Gauthier Régis Jostin; Potokoue Mpia Samantha Nuelly; Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J. Gynecol. Obstet. 2019, 7(2), 56-59. doi: 10.11648/j.jgo.20190702.16

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    AMA Style

    Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J Gynecol Obstet. 2019;7(2):56-59. doi: 10.11648/j.jgo.20190702.16

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  • @article{10.11648/j.jgo.20190702.16,
      author = {Itoua Clautaire and Iloki Itoba Imongui Sandra and Buambo Gauthier Régis Jostin and Potokoue Mpia Samantha Nuelly and Mokoko Jules César and Ngakengni Nelie Yvette and Eouani Max Levy Eméry and Iloki Léon Hervé},
      title = {Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {7},
      number = {2},
      pages = {56-59},
      doi = {10.11648/j.jgo.20190702.16},
      url = {https://doi.org/10.11648/j.jgo.20190702.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190702.16},
      abstract = {Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)
    AU  - Itoua Clautaire
    AU  - Iloki Itoba Imongui Sandra
    AU  - Buambo Gauthier Régis Jostin
    AU  - Potokoue Mpia Samantha Nuelly
    AU  - Mokoko Jules César
    AU  - Ngakengni Nelie Yvette
    AU  - Eouani Max Levy Eméry
    AU  - Iloki Léon Hervé
    Y1  - 2019/05/20
    PY  - 2019
    N1  - https://doi.org/10.11648/j.jgo.20190702.16
    DO  - 10.11648/j.jgo.20190702.16
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 56
    EP  - 59
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20190702.16
    AB  - Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Neonatology Department, University Hospital of Brazzaville, Brazzaville, Congo

  • Gynecology Obstetrics Department, General Hospital of Loandjili, Pointe Noire, Congo

  • Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

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