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 ute...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.展开更多
Introduction: The artificial induction of labor is increasingly common. Objective: Evaluate the maternal-fetal prognosis of artificial induction with misoprostol at the referral health center of the commune II. Method...Introduction: The artificial induction of labor is increasingly common. Objective: Evaluate the maternal-fetal prognosis of artificial induction with misoprostol at the referral health center of the commune II. Methods: This is a cross-sectional, prospective, descriptive and analytical study which took place from September 1, 2019 to December 31, 2020. Included in the study were pregnant women carrying an evolving or terminated single-fetal pregnancy of at least 28 WA in cephalic presentation on a healthy uterus. The trigger has been made with 50 μg misoprostol administered sublingually into the posterior vaginal fornix. The dose was renewed as needed every 6 hours, until sufficient uterine contractions were obtained without exceeding 200 μg. Results: The frequency of artificial induction of labor was 1.25%. Indications were dominated by premature rupture of membranes (29.8%), overdue (19.1%), high blood pressure (19.1%), suitability of pregnant women (14.9%) and terminated pregnancies (10.6%). The vaginal delivery rate was 85.1% The Apgar score was greater than or equal to 7 in 83.3% of cases at the 1stminute. Maternal morbidity was marked by postpartum hemorrhage due to uterine atony in 4.3% cases. No maternal and neonatal deaths were noted. Conclusion: Induction of labor with misoprostol is a safe and effective method if careful selection of patients is made.展开更多
文摘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.
文摘Introduction: The artificial induction of labor is increasingly common. Objective: Evaluate the maternal-fetal prognosis of artificial induction with misoprostol at the referral health center of the commune II. Methods: This is a cross-sectional, prospective, descriptive and analytical study which took place from September 1, 2019 to December 31, 2020. Included in the study were pregnant women carrying an evolving or terminated single-fetal pregnancy of at least 28 WA in cephalic presentation on a healthy uterus. The trigger has been made with 50 μg misoprostol administered sublingually into the posterior vaginal fornix. The dose was renewed as needed every 6 hours, until sufficient uterine contractions were obtained without exceeding 200 μg. Results: The frequency of artificial induction of labor was 1.25%. Indications were dominated by premature rupture of membranes (29.8%), overdue (19.1%), high blood pressure (19.1%), suitability of pregnant women (14.9%) and terminated pregnancies (10.6%). The vaginal delivery rate was 85.1% The Apgar score was greater than or equal to 7 in 83.3% of cases at the 1stminute. Maternal morbidity was marked by postpartum hemorrhage due to uterine atony in 4.3% cases. No maternal and neonatal deaths were noted. Conclusion: Induction of labor with misoprostol is a safe and effective method if careful selection of patients is made.
