Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical cons...Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.展开更多
Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional obse...Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery.展开更多
Objectives: To specify the epidemiological and clinical profile of the patients, to determine the methods of management and to evaluate the maternal and perinatal prognosis in the association of arterial hypertension ...Objectives: To specify the epidemiological and clinical profile of the patients, to determine the methods of management and to evaluate the maternal and perinatal prognosis in the association of arterial hypertension and pregnancy (HTA) at the Institute of Social Hygiene of Dakar. Material and Methods: This was a retrospective, descriptive and analytical study on the management of the association of hypertension and pregnancy in the maternity ward of the Institute of Social Hygiene of Dakar between January 1<sup>st</sup>, 2019 and on December 31<sup>st</sup>, 2020. Results: During the study period, we recorded 326 cases of hypertension associated with pregnancy among the 4290 pregnant women, i.e. a frequency of 7.6%. The epidemiological profile of the patients was that of a woman with an average age of 29, nulliparous (48.2%), married (99.1%), at a low socioeconomic level (61.3%) and with a personal history preeclampsia (14.4%). Most patients (83.1%) were evacuated or referred with pre-ec- lampsia as the main reason (40.8%). The average gestational age was 37 weeks of amenorrhea (SA) with extremes of 20 SA 6 days and 41 SA 5 days. Term pregnancies were the most represented (76.7%). Prenatal follow-up (CPN) was carried out in 319 patients (97.8%) with an average number of CPN of 3 and extremes of 1 and 9. Severe diastolic and severe systolic hypertension concerned respectively 19.3% and 16, 9% of patients. One hundred and eighty patients (55.2%) presented with oliguria. Strip albuminuria was performed in 235 patients (72.1%). It found 3 or more crosses in 38.3% of cases. We recorded 53 cases of anemia (16.3%), 16 cases of significant proteinuria (5%), hepatic cytolysis in 22 patients (6.7%), thrombocytopenia in 37 patients (11.3%), and 43 cases of hyperuricaemia (13.2%). Obstetric ultrasound found 36 cases of severe oligohydramnios (11%), 8 twin pregnancies (2.4%) and an umbilical Doppler anomaly in 10 patients (3.1%). Pre-eclampsia was the most common clinical form (70.5%), followed by chronic hypertension (15.1%) and pregnancy-induced hypertension (14.4%). In our study, 32 patients (9.8%) had received resuscitation. The most used anti-hypertensives were alpha methyl-dopa (46.1%) and nicardipine (24.5%). The obstetrical treatment consisted of uterine evacuation which was most often done by caesarean section (63.1%). Maternal complications were dominated by retroplacental hematoma (16.3%) followed by eclampsia (7.4%) and HELLP syndrome (6.7%). We have not recorded any maternal deaths. Prematurity (19.3%) and intrauterine growth restriction (IUGR) (16.3%) were the most common perinatal complications. Severe and moderate neonatal asphyxia concerned respectively 14.8% and 14.4% of newborns. The birth weight was on average 2400 grams with extremes of 400 and 4500 grams. Low birth weight accounted for 49.5% of the sample. One hundred and twelve newborns (34.4%) were referred to neonatology most often for neonatal asphyxia (29.2%). We recorded 37 fetal deaths in utero (11.3%) and 10 neonatal deaths (3.1%), representing a perinatal mortality of 168.5 per 1000 live births. During the postnatal follow-up, we noted a normalization of the blood pressure figures in 98.8% of the patients. Contraception was instituted in 150 patients (46.1%). These were most often progestogen implants (32.2%) or intrauterine device (IUD) (11.7%). The choice of delivery route was significantly associated with the clinical form. Indeed, caesarean section was more frequent in case of preeclampsia compared to pregnancy-induced hypertension (p = 0.03). Maternal and perinatal complications such as HELLP syndrome (86.4%), PRH (64.2%), eclampsia (79.2%) and UFID (23.6%) were more frequent in cases severe preeclampsia (p = 0.028, p = 0.0001). Conclusion: The association of hypertension and pregnancy is frequent in our practice. Its prognosis is marked by the risk of prematurity, IUGR and maternal complications.展开更多
Background: The rising caesarean section rate worldwide is an increasing source of concern to all. A significant contributor to this is a previous caesarean delivery. One strategy in the armamentarium of obstetricians...Background: The rising caesarean section rate worldwide is an increasing source of concern to all. A significant contributor to this is a previous caesarean delivery. One strategy in the armamentarium of obstetricians for reducing this is vaginal birth after one caesarean section (VBAC). The safety, outcome and complications of this procedure in our Center which is in a developing country had never been studied hence the need for this work. Aim: To find out the outcome and complications of vaginal births after one caesarean delivery in our Center. Method: A retrospective study involving a ten-year review of all cases of trials of labour after one caesarean delivery in our Center was done. Result: Of the 305 trials of labour after one caesarean delivery, 221 women had vaginal birth giving a vaginal birth after one caesarean section rate of 72.5%. Majority of the babies 303 (99.2%) were alive and had good Apgar scores while 2 (0.7%) died giving a perinatal mortality rate of 7 per 1000 babies. There were complications in 21 (6.7%) of the women with retained placenta, in 7 (2.3%) of the women as the commonest, followed by postpartum haemorrhage in 6 (1.96%). Five (1.62%) women had scar dehiscence while 3 (0.98%) had uterine rupture. Conclusion: Vaginal birth after one caesarean section is safe in well selected cases even in our resource poor settings. It offers our women a culturally-acceptable option of fulfilling long-held dreams of vaginal delivery even after one caesarean section and should be offered to our women whenever possible.展开更多
AIM: To report the safety of continued use of endoscopic retrograde cholangiopancreatography(ERCP) during pregnancy at various maternal ages.METHODS: A retrospective chart review of pregnant patients who underwent ERC...AIM: To report the safety of continued use of endoscopic retrograde cholangiopancreatography(ERCP) during pregnancy at various maternal ages.METHODS: A retrospective chart review of pregnant patients who underwent ERCP at a tertiary academic center was undertaken between 2002 and 2012. Pertinent past medical history and initial presenting laboratory data were collected. Review of the procedure note for each ERCP performed provided documentation of lead shielding, type of sedation, fluoroscopy time, and post-procedure complications. Patients' clinical courses were reviewed until the time of delivery and pregnancy complications with fetal outcomes were examined. Data was stratified based upon the mother's age at the time of ERCP: 18-21, 22-29, and ≥ 30 years of age.RESULTS: Twenty pregnant patients who underwent ERCP between 2002 and 2012 were identified. The mean age at the time of ERCP was 26.4 years(18-38 years) and the average trimester was the second. The indications for ERCP were choledocholithiasis in 17 patients, gallstone pancreatitis in 2 patients, and cholangitis in 1 patient. The mean fluoroscopy time of ERCP was 3.8 min(0.3-23.6 min). Sphincterotomy was performed in 18 patients with therapeutic intent and not as a prophylactic measure to prevent recurrences. Clinical documentation of use of protective shielding was found in only 8 notes(40%). Post procedure complications were limited to two cases of post-ERCP pancreatitis(10%). Elective cholecystectomy was performed shortly after ERCP in 11 of the pregnant patients. Birth records were available for 16 patients, of which 15 had fullterm pregnancies. Cesarean sections were performed in 5(31%) patients. Term birth weight was greater than 2500 g in all cases except one in which the mother had a known hypercoagulable state. CONCLUSION: ERCP during pregnancy is both safe and efficacious regardless of maternal age or trimester.展开更多
Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim ...Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.展开更多
Medulloblastoma is a rare brain malignant lesion, reported more in children with less prevalence among adults and rarely seen during pregnancy. The diagnosis of Medulloblastoma is a challenging clinical situation in p...Medulloblastoma is a rare brain malignant lesion, reported more in children with less prevalence among adults and rarely seen during pregnancy. The diagnosis of Medulloblastoma is a challenging clinical situation in pregnancy as surgery;radiotherapy and chemotherapy are the choices of management.展开更多
The aim of this study was to highlight the importance of knowledge of idiopathic dilated cardiomyopathy (IDC) in pregnancy and its complications, with the order to establish early diagnosis and treatment. We report th...The aim of this study was to highlight the importance of knowledge of idiopathic dilated cardiomyopathy (IDC) in pregnancy and its complications, with the order to establish early diagnosis and treatment. We report the case of a primigravida aged 17, previously healthy, 18 weeks of gestation with dyspnea at rest, which started 2 weeks ago. During the investigation, the echocardiogram (ECO) showed left ventricle (LV) dilation with impaired systolic and diastolic function, LV ejection fraction of 20%. We did not identify a cause for the patient’s clinical condition, being diagnosed with IDC. The patient remained in obstetrics and cardiology monitoring for up to 23 weeks of gestation, when it was decided by the interruption of pregnancy by caesarean section due to hemodynamic instability. The newborn came to death four days after the procedure. The patient evolved to clinical improvement, 16 days after the resolution of gestation, was discharged for outpatient monitoring.展开更多
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 object...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 implemented in the maternity Unit of Panzi Hospital for well-selected patients. In addition, the success rate is similar after TOLAC with an acceptable maternal-neonatal prognosis.展开更多
文摘Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.
文摘Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery.
文摘Objectives: To specify the epidemiological and clinical profile of the patients, to determine the methods of management and to evaluate the maternal and perinatal prognosis in the association of arterial hypertension and pregnancy (HTA) at the Institute of Social Hygiene of Dakar. Material and Methods: This was a retrospective, descriptive and analytical study on the management of the association of hypertension and pregnancy in the maternity ward of the Institute of Social Hygiene of Dakar between January 1<sup>st</sup>, 2019 and on December 31<sup>st</sup>, 2020. Results: During the study period, we recorded 326 cases of hypertension associated with pregnancy among the 4290 pregnant women, i.e. a frequency of 7.6%. The epidemiological profile of the patients was that of a woman with an average age of 29, nulliparous (48.2%), married (99.1%), at a low socioeconomic level (61.3%) and with a personal history preeclampsia (14.4%). Most patients (83.1%) were evacuated or referred with pre-ec- lampsia as the main reason (40.8%). The average gestational age was 37 weeks of amenorrhea (SA) with extremes of 20 SA 6 days and 41 SA 5 days. Term pregnancies were the most represented (76.7%). Prenatal follow-up (CPN) was carried out in 319 patients (97.8%) with an average number of CPN of 3 and extremes of 1 and 9. Severe diastolic and severe systolic hypertension concerned respectively 19.3% and 16, 9% of patients. One hundred and eighty patients (55.2%) presented with oliguria. Strip albuminuria was performed in 235 patients (72.1%). It found 3 or more crosses in 38.3% of cases. We recorded 53 cases of anemia (16.3%), 16 cases of significant proteinuria (5%), hepatic cytolysis in 22 patients (6.7%), thrombocytopenia in 37 patients (11.3%), and 43 cases of hyperuricaemia (13.2%). Obstetric ultrasound found 36 cases of severe oligohydramnios (11%), 8 twin pregnancies (2.4%) and an umbilical Doppler anomaly in 10 patients (3.1%). Pre-eclampsia was the most common clinical form (70.5%), followed by chronic hypertension (15.1%) and pregnancy-induced hypertension (14.4%). In our study, 32 patients (9.8%) had received resuscitation. The most used anti-hypertensives were alpha methyl-dopa (46.1%) and nicardipine (24.5%). The obstetrical treatment consisted of uterine evacuation which was most often done by caesarean section (63.1%). Maternal complications were dominated by retroplacental hematoma (16.3%) followed by eclampsia (7.4%) and HELLP syndrome (6.7%). We have not recorded any maternal deaths. Prematurity (19.3%) and intrauterine growth restriction (IUGR) (16.3%) were the most common perinatal complications. Severe and moderate neonatal asphyxia concerned respectively 14.8% and 14.4% of newborns. The birth weight was on average 2400 grams with extremes of 400 and 4500 grams. Low birth weight accounted for 49.5% of the sample. One hundred and twelve newborns (34.4%) were referred to neonatology most often for neonatal asphyxia (29.2%). We recorded 37 fetal deaths in utero (11.3%) and 10 neonatal deaths (3.1%), representing a perinatal mortality of 168.5 per 1000 live births. During the postnatal follow-up, we noted a normalization of the blood pressure figures in 98.8% of the patients. Contraception was instituted in 150 patients (46.1%). These were most often progestogen implants (32.2%) or intrauterine device (IUD) (11.7%). The choice of delivery route was significantly associated with the clinical form. Indeed, caesarean section was more frequent in case of preeclampsia compared to pregnancy-induced hypertension (p = 0.03). Maternal and perinatal complications such as HELLP syndrome (86.4%), PRH (64.2%), eclampsia (79.2%) and UFID (23.6%) were more frequent in cases severe preeclampsia (p = 0.028, p = 0.0001). Conclusion: The association of hypertension and pregnancy is frequent in our practice. Its prognosis is marked by the risk of prematurity, IUGR and maternal complications.
文摘Background: The rising caesarean section rate worldwide is an increasing source of concern to all. A significant contributor to this is a previous caesarean delivery. One strategy in the armamentarium of obstetricians for reducing this is vaginal birth after one caesarean section (VBAC). The safety, outcome and complications of this procedure in our Center which is in a developing country had never been studied hence the need for this work. Aim: To find out the outcome and complications of vaginal births after one caesarean delivery in our Center. Method: A retrospective study involving a ten-year review of all cases of trials of labour after one caesarean delivery in our Center was done. Result: Of the 305 trials of labour after one caesarean delivery, 221 women had vaginal birth giving a vaginal birth after one caesarean section rate of 72.5%. Majority of the babies 303 (99.2%) were alive and had good Apgar scores while 2 (0.7%) died giving a perinatal mortality rate of 7 per 1000 babies. There were complications in 21 (6.7%) of the women with retained placenta, in 7 (2.3%) of the women as the commonest, followed by postpartum haemorrhage in 6 (1.96%). Five (1.62%) women had scar dehiscence while 3 (0.98%) had uterine rupture. Conclusion: Vaginal birth after one caesarean section is safe in well selected cases even in our resource poor settings. It offers our women a culturally-acceptable option of fulfilling long-held dreams of vaginal delivery even after one caesarean section and should be offered to our women whenever possible.
文摘AIM: To report the safety of continued use of endoscopic retrograde cholangiopancreatography(ERCP) during pregnancy at various maternal ages.METHODS: A retrospective chart review of pregnant patients who underwent ERCP at a tertiary academic center was undertaken between 2002 and 2012. Pertinent past medical history and initial presenting laboratory data were collected. Review of the procedure note for each ERCP performed provided documentation of lead shielding, type of sedation, fluoroscopy time, and post-procedure complications. Patients' clinical courses were reviewed until the time of delivery and pregnancy complications with fetal outcomes were examined. Data was stratified based upon the mother's age at the time of ERCP: 18-21, 22-29, and ≥ 30 years of age.RESULTS: Twenty pregnant patients who underwent ERCP between 2002 and 2012 were identified. The mean age at the time of ERCP was 26.4 years(18-38 years) and the average trimester was the second. The indications for ERCP were choledocholithiasis in 17 patients, gallstone pancreatitis in 2 patients, and cholangitis in 1 patient. The mean fluoroscopy time of ERCP was 3.8 min(0.3-23.6 min). Sphincterotomy was performed in 18 patients with therapeutic intent and not as a prophylactic measure to prevent recurrences. Clinical documentation of use of protective shielding was found in only 8 notes(40%). Post procedure complications were limited to two cases of post-ERCP pancreatitis(10%). Elective cholecystectomy was performed shortly after ERCP in 11 of the pregnant patients. Birth records were available for 16 patients, of which 15 had fullterm pregnancies. Cesarean sections were performed in 5(31%) patients. Term birth weight was greater than 2500 g in all cases except one in which the mother had a known hypercoagulable state. CONCLUSION: ERCP during pregnancy is both safe and efficacious regardless of maternal age or trimester.
文摘Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.
文摘Medulloblastoma is a rare brain malignant lesion, reported more in children with less prevalence among adults and rarely seen during pregnancy. The diagnosis of Medulloblastoma is a challenging clinical situation in pregnancy as surgery;radiotherapy and chemotherapy are the choices of management.
文摘The aim of this study was to highlight the importance of knowledge of idiopathic dilated cardiomyopathy (IDC) in pregnancy and its complications, with the order to establish early diagnosis and treatment. We report the case of a primigravida aged 17, previously healthy, 18 weeks of gestation with dyspnea at rest, which started 2 weeks ago. During the investigation, the echocardiogram (ECO) showed left ventricle (LV) dilation with impaired systolic and diastolic function, LV ejection fraction of 20%. We did not identify a cause for the patient’s clinical condition, being diagnosed with IDC. The patient remained in obstetrics and cardiology monitoring for up to 23 weeks of gestation, when it was decided by the interruption of pregnancy by caesarean section due to hemodynamic instability. The newborn came to death four days after the procedure. The patient evolved to clinical improvement, 16 days after the resolution of gestation, was discharged for outpatient monitoring.
文摘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 implemented in the maternity Unit of Panzi Hospital for well-selected patients. In addition, the success rate is similar after TOLAC with an acceptable maternal-neonatal prognosis.
