Epidemio-clinical study of the first iterative cesarean in the gynecology-obstetric service at the teaching hospital of Cocody

Authors

  • Cassou R. Adjoby Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire
  • Soh V. Koffi Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire
  • Ibrahima S. Balde Department of Gynecology and Obstetrics, Ignace Deen Hospital, Conakry, Guinea
  • Denis Effoh Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire
  • Eleonore Gbary Lagaud Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire
  • Aya V. Angoi Department of Gynecology and Obstetrics, Teaching Hospital of Cocody Abidjan, Cote d’Ivoire
  • Nawa M. Mamy Department of Gynecology and Obstetrics, Ignace Deen Hospital, Conakry, Guinea
  • Ngolo A. Soro Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire
  • Zingbe Soumahoro Department of Gynecology and Obstetrics, Teaching Hospital of Angré/Abidjan, Cote d’Ivoire

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202350

Keywords:

Cocody’s teaching hospital, Iterative caesarean section, Scar uterus

Abstract

Background: The iterative caesarean section, is a caesarean section that is performed on a uterus already healed, therefore for fear of maternal and perinatal risks, is recognized as one of the main causes of the inflation of caesarean section in the world. One in three caesarean sections is performed because of a scar uterus. Objective of this study was to analyse the epidemiological and clinical factors of iterative caesarean sections in the gynecology-obstetrics department at the Teaching Hospital of Cocody (Abidjan).

Methods: This was a retrospective and descriptive study conducted from June 1st, 2018 to May 31st, 2019, including 349 iterative caesarean section cases.

Results: The first iterative C-section accounted for 16.1% of the C-section indications during the study period. The average age of the patients was 30 years. Nearly half of the patients practiced in the informal sector 47.9%, were uneducated in 38.1% of cases and lived with a partner in 73.1% of cases. The majority of patients in this series 75.1% performed at least 4 ANCs. Patients were followed by prenatal visits in 61% of cases by midwives and in 8.6% of cases had an inter-reproductive space of less than 18 months. This study patients were evacuated in 46.4% of cases. Acute fetal distress was the first indication of first iterative caesarean section with 20.3% of cases. Emergency caesarean sections accounted for 84.4% of the cases in this series. Authors found maternal death 0.3% and 6.7% perinatal mortality.

Conclusions: The iterative caesarean section is a caesarean section likely to cause difficulties and complications per- operative. Although in constant improvement the prognosis of the mother-child couple still remains a problem in this context, prenatal monitoring should be the prerogative of obstetrician gynecologists.

References

Quenum G, Memadji M, Konan BR, Nigue L, Welffens-Ekra C. Césarienne de qualité: analyse des facteurs et des déterminants au CHU de Yopougon. Rev Int Sce Méd. 2001;2:109-15.

Dessolle L, Daraï E. Évolutions techniques de la césarienne EMC - Gynécologie-Obstétrique; Février. 2005;2(1):110-24.

Boerma T, Ronsmans C, Melesse DY, Barros AJ, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. The Lancet. 2018;392(10155):1341-8.

Orfali K. Beyond Numbers. The Multiple Cultural Meanings of Rising Cesarean Rates Worldwide. Am J Bioeth. 2012;12(7):54-6.

Blondel B. Kermarrec M. Enquête nationale périnatale 2010: les naissances en 2010 et leur évolution depuis 2003. Paris: inserm-Drees-DgS; 2011:132.

Boatin AA, Schlotheuber A, Betran AP, Moller AB, Barros AJ, Boerma T, et al. Within country inequalities in caesarean section rates: observational study of 72 low- and middle-income countries. BMJ. 2018;360:k55.

Bretelle F, D’Ercole C, Cravelo L, Piehon L, Roger V, Boubli L, et al. Accouchement sur utérus bi-cicatriciel: place de l’épreuve de cicatrice. J Gynecol Obstet Biol Reprod. 1988;27(4):421-5.

Sima B, Bang J, Obame R, Bibang F, Mewie A, Nzongue JP, et al. Utérus cicatriciel: aspect épidémiologiques et mode d’accouchement à la maternité du CHU d’Owendo (Gabon); Bull Med Owendo, Année. 2017;15 N°43:45-51.

Koulimaya-Gombet CE, Diouf AA, Diallo M, Dia A, Sène C, Moreau JC, et al. Grossesse et accouchement des patientes ayant un antécédent de césarienne à Dakar: aspects épidémio-cliniques thérapeutiques et pronostiques. Pan African Med J. 2017;27(1):135.

Koffi A, Abauleth R, Bokassa E, Boni S, Bohoussou K, Koné N. Les césariennes itératives au CHU de Cocody: Indications et pronostic foeto-maternel. Journal de la SAGO. 2004;5(1):36-9.

Guihard P, Blondel B. Les facteurs associés à la pratique d’une césarienne en France. Résultats de l’enquête nationale de 1995. J Gynecol Obstet Biol Reprod. 2001;30:444-543.

Kouakou P, Djanhan Y, Doumbia Y, Djanhan L, Ouattara M. Les ruptures utérines: aspects épidémiologiques et pronostic foeto-maternel à la maternité du CHU de Bouaké (Côte d’Ivoire). Revue CAMES. 2007;5:11-9.

Miloš V, Martina P, Martina B, Valérie T, Pravoslav S. Naissance après césarienne. Med Sci Monit. 2011;17(2):CR97-CR103.

Dicle O, Kucukler C, Pirnar T, Erata Y, Posaci C. Magnetic resonance imaging evaluation of incision healing after cesarean sections. Eur Radiol. 1997;7(1):31-4.

Broche DE, Courtois L, Maillet R, Riethmuller D. Césariennes encyclopédie médico-chirurgicale, Edit. Elsevier Masson; EM-consulte/Obstétrique. 2008:5-102.

Ouédraogo C, Zoungrana T, Dao B, Dujardin B, Koné B. Quality cesarean at the yalgado ouédraogo hospital center in ouagadougou. Analysis of the determinants concerning 478 cases collected in the obstetrics and gynecology department. Med Afr Noire. 2001;48(11):443-51.

Deneux-Tharaux C, Carmona E, Bouvier-Colle MH, Breart G. Postpartum maternal mortality and cesarean delivery The American college of obstetricians and gynecologists. Obstet Gynecol. 2006;108(3):541-8.

Zongo A, Traoré M, Faye A, Gueye M, Fournier P, Dumont A. Effet de l’organisation des services de gynéco-obstétrique sur la mortalité maternelle hospitalière au Mali. Revue d'épidémiologie et de santé Publique. 2012;60(4):265-74.

Gerten KA, Coonrod DV, Bay RC, Chambliss LR. Cesarean delivery and respiratory distress syndrome: Does labor make a difference? Am J Obstet Gynecol. 2005;193:1061-4.

Le Ray C, Boithias C, Castaigne-Meary V, Foix l’Hélias L, Vial M, Frydman R. Caesarean before labour between 34 and 37 weeks: What are the risk factors of severe neonatal respiratory distress? Eur J Obstet Gynecol Reprod Biol. 2006;127:56-60.

Smith GCS, White IR, Pell JP, Dobbie R. Predicting caesarean section and uterine rupture among women attenmping vaginal birth after prior ceaseren section. Plos Med. 2005;2(9):e252.

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Published

2020-05-27

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Original Research Articles