Research
Rupture Prematuree Des Membranes Sur Grossesse A Terme : Prise En Charge, Au Centre Hospitalier Universitaire De Brazzaville
Objective: To describe the management of pregnant woman with premature rupture of membranes at term. Patients and methods: A Cross sectional study conducted during two months. Were included, pregnant women with a gestational age greater than or equal to 37 weeks who presented a Premature Rupture of Membranes (PROM). Those with associated fetal death in utero, were excluded. Results: The frequency of PROM was 4.25% of deliveries; the pregnant mean age was 29.5 years, ranging from 16 to 46 years. Thirty-seven pregnant or 80.4% have performed more than 4 prenatal consultations. Etiological research was unsuccessful in 42 cases (91.3%) At admission, we observed 13 pregnant (28.3%) not in labor. 23 pregnant in labor transition stage. Sixteen pregnant women (34.8%) had meconium. The duration PROM was 1 to 6 hours, with over a third of pregnant women. The Caesarean delivery was the mode of delivery the most common with 27 cases (58.7%). Thirty-two infants (69.6%) born from mothers who experienced rupture of membranes had a rating Apgar in the first minute of 7 to 10; this score was between 4 and 6 in 14 newborns (30.4%). When the Apgar was between 4 and 6 in the first minute, the Fisher test indicates no significant difference between mode of delivery and the color of the amniotic fluid. By cons when the Apgar was between 7 and 10, the difference was significant, and there are 68.2% of vaginal deliveries when the amniotic fluid is clear. For the Apgar score between 7 and10, 100% of vaginal deliveries. Conclusion: In case of PROM in term pregnancy with a favorable Bishop score, we practice a systematic labor induction. If local conditions are unfavorable, a wait of 24 hours is allowed, after which cervix maturation for a labor induction is performed.
Qualite De Vie Et Vcu De La Maladie, Avant Et Apres Hystrectomie Vaginale, Chez Les Femmes Admises Au Centre Hospitalier Universitaire De Brazzaville
Introduction: The disease is a trouble that must be eradicated; vaginal hysterectomy is beneficial to patients for this purpose but can also have a detrimental impact on the quality of life of women. Objective: To explore the impact of the disease on the quality of life before vaginal hysterectomy (VH) of women before and after surgery. Methods: This is a qualitative study, with clinical method during a 12-month period which involved women who underwent vaginal hysterectomy. Women who didn’t consent to participate and had no phone contact were not included. Results: During illness, women's experience was: sexual discomfort 26/40 (65%); genital bleeding 12/40 (30%); 13/40 pelvic pain (32.5%) After surgery, we noted transient dyspareunia 30/40 (75%); secondary headache due to anesthesia 4/40 (10%). The psychological experience before HV, has been dominated by the fear of surgery in all patients, sleep disorders38/40(95%), anxiety 30/40 (75%), shame and difficulty with the sexual intercourse because of prolapsed 26/40 (65%) even impossibility because of the genital bleeding 14/40(35%). The loss of femininity was reported by 26/40 women with uterine prolapsed (65%), the modification of selfesteem 26/40 (65%). If these items have been improved with the HV, by cons, they all lost the reproductive organ. No information was given by women to their families and members of the company prior to surgery. The cessation of symptoms was observed in all cases, although we noted one case of rectal injury (1.25%). as for sexual activity, all couples declared their satisfaction after therapy. Conclusion: The experience of the disease and the tragic perception of vaginal hysterectomy before, were improved significantly after surgery.
Impact Du JeAne Chez Les Parturientes Au Centre Hospitalier Universitaire De Brazzaville
Objective: To seek the impact of fasting on the outcome of labour. Methods: This was a cross-sectional study carried out in consenting parturients who had a singleton pregnancy at term, and who had been fasting for at least 10hours. The fasting was confirmed by appositive ketonuria test. The impact of fasting (attributable risk) was calculated using the Open Epi software. Results: No case of Mendelson syndrome was observed, vomiting in the non fasting parturients was not abundant, (4% of cases RR=0.3); fasting exposes the women 3.75 times more to risk of dynamic dystocia (40% of cases) and 3.5 times more to risk o f acute fe tal distress (18.6% of ca ses). Instrumental vaginal delivery was not significantly more frequent in fasting women (RR=1.5 ; p=0.12) and spontaneous vaginal delivery had a protective effect (RR=0.66 ; p=0.001). On the contrary, cesarean deliveries were significantly more frequent in these parturients (RR=3.7 ; p =0.0006). The impact of fasting on parturients is as follows: for every 100 fasting parturients, 73.3% may present with dynamic dystocia, 71.4% with acute foetal distress and 73.3% stand the risk of having a cesarean delivery. Conclusion: Fasting is detrimental to the outcome of labour and delivery, it is advisable to encourage feeding in parturients.
