Mise à jour thérapeutique et pronostique de la rupture utérine dans une maternité à Bangui, CAR.

Journal

Public health action
ISSN: 2220-8372
Titre abrégé: Public Health Action
Pays: France
ID NLM: 101624961

Informations de publication

Date de publication:
01 Aug 2023
Historique:
received: 12 02 2023
accepted: 12 04 2023
medline: 2 8 2023
pubmed: 2 8 2023
entrez: 2 8 2023
Statut: ppublish

Résumé

Maternal mortality rates remain high (882/100,000 births) in the Central African Republic (CAR), primarily due to frequent obstetric complications. Médecins Sans Frontières supports a referral maternity ward in the capital, Bangui. To describe the prevalence, associated factors and fatality of one of the most severe complications, uterine rupture, as well as the effect of a history of uterine surgery. This is a cross-sectional study based on retrospectively collected data between January 2018 and December 2021 for women who delivered new-borns weighing over 1,000 g. Of 38,782 deliveries, 229 (0.6%) cases of uterine rupture were recorded. Factors associated with uterine rupture were parity ⩾5 (adjusted odds ratio [aOR] 7.5, 95% confidence interval [CI] 4.6-12.2), non-occipital foetal presentation (aOR 2.8, 95% CI 2.1-3.7) and macrosomia (OR 4, 95% CI 2.6-6.4). The fatality rate was 4.4%, and the stillbirth rate was 64%. Uterine rupture occurred in non-scarred uterus in 150 (66.1%) women. Adverse outcomes were more common in cases of uterine rupture on non-scarred uterus compared to scarred uterus, with higher maternal mortality (6% vs. 0%, Uterine rupture remains a major issue for maternal and perinatal health in the CAR, and efforts are needed to early detect risk factors and increase coverage of the comprehensive emergency obstetric and neonatal care.

Sections du résumé

BACKGROUND BACKGROUND
Maternal mortality rates remain high (882/100,000 births) in the Central African Republic (CAR), primarily due to frequent obstetric complications. Médecins Sans Frontières supports a referral maternity ward in the capital, Bangui.
OBJECTIVES OBJECTIVE
To describe the prevalence, associated factors and fatality of one of the most severe complications, uterine rupture, as well as the effect of a history of uterine surgery.
METHODS METHODS
This is a cross-sectional study based on retrospectively collected data between January 2018 and December 2021 for women who delivered new-borns weighing over 1,000 g.
RESULTS RESULTS
Of 38,782 deliveries, 229 (0.6%) cases of uterine rupture were recorded. Factors associated with uterine rupture were parity ⩾5 (adjusted odds ratio [aOR] 7.5, 95% confidence interval [CI] 4.6-12.2), non-occipital foetal presentation (aOR 2.8, 95% CI 2.1-3.7) and macrosomia (OR 4, 95% CI 2.6-6.4). The fatality rate was 4.4%, and the stillbirth rate was 64%. Uterine rupture occurred in non-scarred uterus in 150 (66.1%) women. Adverse outcomes were more common in cases of uterine rupture on non-scarred uterus compared to scarred uterus, with higher maternal mortality (6% vs. 0%,
CONCLUSION CONCLUSIONS
Uterine rupture remains a major issue for maternal and perinatal health in the CAR, and efforts are needed to early detect risk factors and increase coverage of the comprehensive emergency obstetric and neonatal care.

Identifiants

pubmed: 37529553
doi: 10.5588/pha.23.0004
pmc: PMC10380413
doi:

Types de publication

English Abstract Journal Article

Langues

fre

Pagination

13-18

Informations de copyright

© 2023 The Union.

Déclaration de conflit d'intérêts

Conflits d’intérêt : rien à déclarer.

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Auteurs

S Huyghe (S)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine.

S Telo (S)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine.

E Danwesse (E)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Mission en République Centrafricaine, Bangui, République Centrafricaine.

E Ali (E)

Ministère de la Santé, Direction de la Santé, Luxembourg, Luxembourg.

W van den Boogaard (W)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Luxembourg Operational Research Unit (LuxOR), Luxembourg, Luxembourg.

D Lagrou (D)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Département Médical, Bruxelles, Belgique.

S Caluwaerts (S)

Médecins Sans Frontières Centre Opérationnel de Bruxelles, Département Médical, Bruxelles, Belgique.

R N Ngbalé (RN)

Centre Hospitalier Universitaire Communautaire, Bangui, République Centrafricaine.

Classifications MeSH