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
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
13-18Informations de copyright
© 2023 The Union.
Déclaration de conflit d'intérêts
Conflits d’intérêt : rien à déclarer.
Références
BMC Pregnancy Childbirth. 2018 Nov 1;18(1):432
pubmed: 30382820
Am J Obstet Gynecol. 2015 Sep;213(3):382.e1-6
pubmed: 26026917
BJOG. 2005 Sep;112(9):1221-8
pubmed: 16101600
AJOG Glob Rep. 2022 Jun 11;2(3):100063
pubmed: 36276797
Am J Obstet Gynecol. 2002 Feb;186(2):311-4
pubmed: 11854656
Sci Rep. 2020 Oct 19;10(1):17603
pubmed: 33077758
BMJ Open. 2016 May 17;6(5):e010415
pubmed: 27188805
BJOG. 2009 Jul;116(8):1069-78; discussion 1078-80
pubmed: 19515148
BMJ Glob Health. 2019 Jul 1;4(Suppl 5):e000778
pubmed: 31354979
PLoS One. 2020 Nov 2;15(11):e0240675
pubmed: 33137135
Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:130-4
pubmed: 24965993
PLoS One. 2022 Apr 8;17(4):e0266062
pubmed: 35395033
Med Trop (Mars). 2002;62(5):517-20
pubmed: 12616945
Eur J Obstet Gynecol Reprod Biol. 2017 Oct;217:126-130
pubmed: 28892762
Med Trop Sante Int. 2021 Jan 29;1(1):
pubmed: 35586632