摘要
Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.
Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.
作者
Tidiani Traoré
Seydou Traoré
Seydou Z. Dao
Abdoul K. Ballo
Kassoum Sidibé
Brahima Donigolo
Babou Traoré
Famakan Kané
Adama Coulibaly
Abdrahamane Diarisso
Alima Sidibé
Adama Camara
Yacouba Dembélé
Thierno Boubacar Bagayoko
Alpha Sanogo
Adama Bah
Abdoulaye Kassogue
Hamidou Toungara
Seydina Alioun Beye
Agoustin Thera
Youssou Traoré
Ibrahima Teguété
Niani Mounkoro
Amadou Dolo
Tidiani Traoré;Seydou Traoré;Seydou Z. Dao;Abdoul K. Ballo;Kassoum Sidibé;Brahima Donigolo;Babou Traoré;Famakan Kané;Adama Coulibaly;Abdrahamane Diarisso;Alima Sidibé;Adama Camara;Yacouba Dembélé;Thierno Boubacar Bagayoko;Alpha Sanogo;Adama Bah;Abdoulaye Kassogue;Hamidou Toungara;Seydina Alioun Beye;Agoustin Thera;Youssou Traoré;Ibrahima Teguété;Niani Mounkoro;Amadou Dolo(Gynecology Department of Hospital Nianankoro Fomba, Segou, Mali;Gynecology Department of Reference Health Center of Koutiala, Koutiala, Mali;Gynecology Department of Reference Health Center of Commune II of Bamako, Bamako, Mali;Gynecology Department of Reference Health Center of Bla, Bla, Mali;Gynecology Department of Reference Health Center of Kayes, Kayes, Mali;Gynecology Department of Reference Health Center of Commune V of Bamako, Bamako, Mali;Gynecology Department of Reference Health Center of Sikasso, Sikasso, Mali;Gynecology Department of Mohamed VI Polyclinic of Bamako, Bamako, Mali;Gynecology Department of Point G Teaching Hospital, Bamako, Mali;Gynecology Department of Gabriel Touré Teaching Hospital, Bamako, Mali;Gynecology Department of Pasteur Clinic of Bamako, Bamako, Mali)