Le Mali medical · 2015
[Profile and prognosis of obstetrical emergencies in the labor room of the Bonzola maternity in Mbujimayi].
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Kadima Mutombo C, Mumba Mukandila A, Biayi Mikenji J
Аннотация
OBJECTIVES: To determine the prevalence, profile and prognosis of obstetrical emergencies in the labor room in our area.
METHODOLOGY: This study is retrospective, analytic based on a reference group, and monocentric and has been carried out at the maternity hospital of Bonzola, DRC, between January 1st 2012 and June 30th 2013. During this period we focused on 76 emergencies out of 1260 women in childbirth. The women having a severe emergency in the labor room or in the postpartum period and in whom the care taking has been requested constituted the cases studied, and any normal childbirth having preceded the emergency was considered as a reference case. The prevalence, the fetal and maternal prognosis were the parameters studied using the Epi Info 3.5.1(CDC,USA, 2002) software package after encoding data on an Excel software package spreadsheet. We calculated the frequency, proportion, odds ratio(OR), central tendency parameter and dispersion for the analysis of our results. The relationship between the studied parameters and the obstetrical emergencies has been assessed thanks to the test of Pearson's chi square and to the corrected test of Yatt. Proportions and averages were compared using a Z test.
RESULTS: The prevalence of obstetrical emergencies in Bonzola general reference hospital is of 6.03% with acute fetal distress in the foreground (3.01%) followed by pregnancy third trimester hemorrhages (2,30%) characterized by a wide proportion of placenta previa (68.97%). In most cases the woman in childbirth that has an emergency in the labor room is multiparous (38.20%) or a primiparous (30.30%) whose pregnancy was not at all followed (72.37%) and having a great deal of antecedents. The average age of occurrence of obstetrical emergencies is of 29.19 years (sd=6,10). The parity and extreme multigestation, lack of prenatal consultations, dystocic delivery antecedent, and cesarean sections are the chief factors associated with obstetrical emergencies in our area. In most cases, teenagers that were giving birth were primiparous (88.7%), of 17.2 years of age (Sd:0.3) on average and having followed prenatal consultations (79.2%) with at least an antecedent of abortion in 9.4% cases whereas the parturient of at least 35 years was multiparous (66.6%) whose average age was 38.5 years(Sd:2.4) having not followed prenatal consultations (51.2%) with at least one antecedent of abortion in one third case.
CONCLUSION: The rate of deliveries at extreme ages is very high in our area with a great predominance in older parturients in whom the pregnancy was followed. Given the many complications of late pregnancy, making popular the fact that pregnant women should consult as required is exceedingly important for a better pregnancy outcome.
METHODOLOGY: This study is retrospective, analytic based on a reference group, and monocentric and has been carried out at the maternity hospital of Bonzola, DRC, between January 1st 2012 and June 30th 2013. During this period we focused on 76 emergencies out of 1260 women in childbirth. The women having a severe emergency in the labor room or in the postpartum period and in whom the care taking has been requested constituted the cases studied, and any normal childbirth having preceded the emergency was considered as a reference case. The prevalence, the fetal and maternal prognosis were the parameters studied using the Epi Info 3.5.1(CDC,USA, 2002) software package after encoding data on an Excel software package spreadsheet. We calculated the frequency, proportion, odds ratio(OR), central tendency parameter and dispersion for the analysis of our results. The relationship between the studied parameters and the obstetrical emergencies has been assessed thanks to the test of Pearson's chi square and to the corrected test of Yatt. Proportions and averages were compared using a Z test.
RESULTS: The prevalence of obstetrical emergencies in Bonzola general reference hospital is of 6.03% with acute fetal distress in the foreground (3.01%) followed by pregnancy third trimester hemorrhages (2,30%) characterized by a wide proportion of placenta previa (68.97%). In most cases the woman in childbirth that has an emergency in the labor room is multiparous (38.20%) or a primiparous (30.30%) whose pregnancy was not at all followed (72.37%) and having a great deal of antecedents. The average age of occurrence of obstetrical emergencies is of 29.19 years (sd=6,10). The parity and extreme multigestation, lack of prenatal consultations, dystocic delivery antecedent, and cesarean sections are the chief factors associated with obstetrical emergencies in our area. In most cases, teenagers that were giving birth were primiparous (88.7%), of 17.2 years of age (Sd:0.3) on average and having followed prenatal consultations (79.2%) with at least an antecedent of abortion in 9.4% cases whereas the parturient of at least 35 years was multiparous (66.6%) whose average age was 38.5 years(Sd:2.4) having not followed prenatal consultations (51.2%) with at least one antecedent of abortion in one third case.
CONCLUSION: The rate of deliveries at extreme ages is very high in our area with a great predominance in older parturients in whom the pregnancy was followed. Given the many complications of late pregnancy, making popular the fact that pregnant women should consult as required is exceedingly important for a better pregnancy outcome.