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Neonatal Outcome of Induced Prematurity for Severe Preeclampsia in Four Great Kinshasa Maternities

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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1637-1643页

作者： Olive Yalala Ambambula Andy Muela Mbangama Therese Biselele Rashid Rahma Tozin dieudonné mushengezi sengeyi Department of Obstetrics and Gynecology University Clinics of Kinshasa Kinshasa DR Congo Department of Pediatrics University Clinics of Kinshasa Kinshasa DR Congo

Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death. Its treatment remains child birth that often is planned before term. However, this attitude can lead to fetal complications related to prematurity. Several studies on preeclampsia have already been studied in the DRC and several aspects have already been realized, but to date, the neonatal outcome has not yet been addressed. Methods: This is cross-sectional study performed in four public hospitals in Kinshasa (Democratic Republic of Congo). We included 400 cases of induced prematurity (IP) for SPE;the analysis compared pregnant women who gave birth before 34 weeks of amenorrhea (WA) and those after 34 WA. The comparison of the proportions was made by the Chi-square test and the calculation of Means by the Student’s test. The significance level was set at P Objective: To determine the frequency of induced prematurity for severe preeclampsia (SPE), to identify the indications and to evaluate neonatal outcome. Results: The IP frequency for SPE was 46.2%. The retro placental hematoma was the most indication in pregnancies before 34 WA 24.9%, while high blood pressure 54.5% in the after 34 WA group. In utero death was more common in pregnant women who gave birth before 34 weeks 25.4%;chroni

关键词： Preeclampsia Induced Prematurity Neonatal Outcome

Associated Factors with Vaginal Delivery on a Uni- or Bi-Scar Uterus in a Low-Resource Setting

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 499-515页

作者： Kongwa Madoli Eloge Ilunga-Mbaya Raha Maroyi Neema Nadine Omari Mukanga Denis Mukwege Nyakio Olivier dieudonné sengeyi mushengezi Amani Department of Gynecology and Obstetrics Panzi General Referral Hospital School of Medicine of Evangelical University of Africa Bukavu Democratic Republic of the Congo Department of Obstetrics and Gynaecology Kinshasa University Clinic University of Kinshasa Kinshasa Democratic Republic of the Congo SVS Statistics Department Panzi General Referral Hospital Bukavu Democratic Republic of the Congo

Introduction: Delivery in a scar uterus is one of the most debated topics in obstetrics. The objective was to determine the uterine test and the maternal-fetal outcome in patients with uni- and bi-scared uterus who received the uterine test at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of patients who delivered on a uni- or bi-scareduterus at Panzi Hospital, between January 1, 2021 and August 1, 2022. Results: The average age of the patients was 27.09 years, with an age range of 25 - 34 years, they were mostly married (88.3%), with secondary educational level (60.4%). Pauciparous women, with a history of previous caesarean delivery once, represented respectively 52.2%;7.2% of parturients with an intergenital space equal to 18 months. 63.9% were overweight, 58.6% had undergone more than three ANC sessions. We noted statistically significant associations between modes of admission, water sac, type of membranes rupture, uterine height and success of uterine test (p 0.05). We did not find significant associations between parturient age, gestational age, intergestational interval, pregnancy term, surgical history, number of ANC performed, number of previous caesarean sections, number of newborns. We did not record any cases of maternal death but one case of perinatal death with 0.9% in this study. Conclusion: A good selection of patients with uni- or bi-scared uterus would allow the reduction of the fetomaternal morbidity during the uterine test.

关键词： Uterine Test Prognosis Uni- and Bi-Scared Uterus Panzi Hospital

Pelvic Organs Prolapse in Low-Resources Countries: Epidemiology, Risk Factors, Quality of Life. Narrative Review

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Open Journal of Urology 2023年第7期13卷 238-250页

作者： Eloge Ilunga-Mbaya Dénis Mukwege Prosper Lukusa Tshilobo Kenny Raha Maroyi Rahma Rashid Tozin dieudonné sengeyi mushengezi Urogynecology Unity University Clinics of Kinshasa University of Kinshasa Kinshasa DRC Department of Gynecology and Obstetrics PANZI Hospital Evangelical University of Africa Bukavu DRC Department of Paediatrics Center for Human Genetics Research of University Clinic of Kinshasa and KU Leuven University of Kinshasa Kinshasa DRC Department of Gynecology and Obstetrics Urogynecology Unity PANZI Hospital Evangelical University of Africa Bukavu DRC Department of Gynecology and Obstetrics University Clinics of Kinshasa University of Kinshasa Kinshasa DRC

Objective: Pelvic organ prolapse is an emerging public health problem affecting adult women of all ages with a negative impact on social, physical well-being, and psychological. Its presents several challenges in countries with low resources. This literature review aims to examine POP in its epidemiological aspects, risk factors, and staging by taking up the challenges associated with low-resource settings and identifying some avenues for future research. Methods: We searched the PubMed, Google Scholar, and Scopus databases. The other studies were identified by checking the secondary references in the original citation. We have collected studies on adult women published in English for the last 30 years. In total, 71 articles were read. We excluded studies from all newspaper articles, Studies presenting co-morbidities (fistulas, cervical cancer, pregnancy), those evaluating treatment, letters, comments, case reports, practice guidelines, news, historical articles, legal cases, published erratum, and congresses. Results: 16 studies examining the epidemiology have been identified with 11 in countries defined by the World Bank as limited or intermediate resources. 18 on risk factors whose 10 in countries with limited or intermediate resources, 10 on staging and 27 on physiopathology. Conclusion: POP affects the young more in low-resource settings. Its prevalence remains underestimated for several reasons. Several risk factors found are the same as those of women in countries with a high standard of living. However, there are some specific risk factors for these resource-limited settings.

关键词： Epidemiology Low Resources-Countries Pelvic Organs Prolapse Risk Factors

Profile of Pregnant Women and Success of the Uterine Test on a Uni or Bi-Scar Uterus at the Maternity Ward of Panzi Hospital, in the Democratic Republic of the Congo

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Open Journal of Obstetrics and Gynecology 2023年第7期13卷 1151-1162页

作者： Prosperine Kongwa Madoli Olivier Nyakio Raha Maroyi Éloge Ilunga-Mbaya Gloire Mwenze Julien Bwama Botalatala Omari Mukanga dieudonné sengeyi mushengezi Amani Department of Gynecology and Obstetrics Panzi General Referral Hospital Evangelical University in Africa Bukavu Democratic Republic of the Congo Department of Gynecology and Obstetrics University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of the Congo SVS Statistics Department Panzi General Referral Hospital Bukavu Democratic Republic of the Congo

Introduction: Trial of labor after a previous cesarean section (TOLAC) is a method that requires strict monitoring to decrease the cesarean section (CS) rate and improve the maternal and neonatal prognosis. The objective is to determine the profile and outcome of patients with one and two previous CSs who performed TOLAC at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of data of 111 patients with one and two previous CSs at Panzi Hospital from January 2021 to August 2022. Statistical Package for the Social Sciences SPSS version 23 software was used to analyze the collected data. The percentages of categorical variables were summarized in a frequency table. The mean or median with standard deviation was used to summarize quantitative variables. Results: The overall success rate of the TOLAC was 64%, with 63.8% following one previous CS and 64.3% following two CSs. The mean age of the patients was 27.09 years, with an age range of 25 - 34 years. They were mostly pauciparous (52.2%), married (88.3%), with a high school education (60.4%). The inter-delivery interval > 18 months was noted (64.1%) and overweight in 63.9%. More than three antenatal consultations were performed (58.6%). We found a mean gestational age of 38 (34 - 41) weeks. The perinatal mortality rate was 0.9%. However, we did not record any cases of maternal mortality during the study period. Conclusion: TOLAC after one and two previous CS is implemented in the maternity Unit of Panzi Hospital for well-selected patients. In addition, the success rate is similar after TOLAC with an acceptable maternal-neonatal prognosis.

关键词： One Previous Caesarean Panzi General Referral Hospital Trial of Labor after Cesarean Section Two Previous Caesarean Vaginal Birth after Cesarean Sec-tion

Comparative Study of the Efficacy of Misoprostol and Oxytocin Im in the Prevention of Post-Partum haemorrhage in a Low-Resource Setting

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 983-996页

作者： De-Joseph Kakisingi Mibi Olivier Nyakio Éloge Ilunga Mbaya dieudonné Kakusu Marie Constance Nguru Musese Julien Bwama Botalatala Omari Mukanga Tina Ndala Kasongo Gabrio Zacchè dieudonné sengeyi mushengezi Amani Mary T. White Mary Joséphine O’Sullivan Department of Gynecology and Obstetrics Panzi General Referral Hospital Bukavu Democratic Republic of the Congo Departement of Medicine and Public Health Evangelical University in Africa Bukavu Democratic Republic of the Congo Department of Gynecology and Obstetrics University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Statistics Panzi General Referral Hospital Bukavu Democratic Republic of the Congo Saint Vincent Hospital Bukavu Democratic Republic of the Congo Department of Medicine and Surgery University of Parma Parma Italy Medical Humanities Boonschoft School of Medicine Wright State University Dayton USA School of Nursing & Health Studies University of Miami Coral-Gable USA

Background: In developing countries, postpartum hemorrhage is responsible for 30% of maternal deaths. Although the World Health Organization recommends the use of oxytocin for the prevention of postpartum hemorrhage, the use of misoprostol is increasingly common. The objective of this study was to determine the frequency of postpartum hemorrhage in parturients delivering at Saint-Vincent Hospital and to compare the effectiveness of misoprostol use versus oxytocin in preventing postpartum hemorrhage. Material and Methods: We conducted a comparative longitudinal study at the Saint Vincent Hospital comparing 10 units of intramuscular oxytocin with 600 micrograms of sublingual misoprostol. The study was conducted from 01 January 2017 to 31 December 2019, a period of 3 years. The study population consisted of 2161 consenting women. Of these, 1289 received 10 IU of intramuscular oxytocin and 872 received 600 micrograms of misoprostol. The collected data were entered using Microsoft Excel 2013 and analysed using SPSS version 21 software. Results: The frequency of administration of Misoprostol and oxytocin in parturients was 40.4% and 59.6% respectively in this study. One hundred and fourteen cases of postpartum hemorrhage (114/2161 or 5.3%) were noted among the parturients. The average age of parturients who received oxytocin was 24.36 ± 4.45 years vs 24.63 ± 5.11 years among parturients who received Misoprostol;(p = 0.190). The mean parity was 2.52 ± 1.46 vs 2.66 ± 1.44;(p = 0.020). We noted a high proportion (78.3%) of postpartum hemorrhage from the oxytocin group vs. 21.7% from the Misoprostol group (OR 2.5-fold), with a statistically significant difference (p 0.001). We noted high proportions of uterine atony (92.3%) from the oxytocin group vs 7.7% from the Misoprostol group (p = 0.004). Uterine atony was the actual factor associated with postpartum hemorrhage (OR = 10.0895% CI: 1.78 - 57.10;p = 0.009). Conclusion: Misoprostol 600 Microgram administered sublingually im

关键词： Misoprostol Oxytocin Postpartum Hemorrhage Saint-Vincent Hospital

Rationale of a Cross Sectional Analytic Study on Determinants of Recurrent Preeclampsia at University Clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France)

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 824-831页

作者： mushengezi Amani dieudonné sengeyi Muela Andy Mbangama Mokambanda Cynthia Awena Goy Sambwa Christian Kelele Nkongolo Freddy Muamba Banza Jésual Lotoy Otem Christian Ndesanzim Department of Obstetrics and Gynecology University Clinics of Kinshasa Kinshasa Democratic Republic of Congo

Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.

关键词： Recurrent Pre-Eclampsia Risk Factor Determinants

A Clinical Study to Assess the Effectiveness of Oral Combination Kit Therapy in Syndromic Management of Abnormal Vaginal Discharge (FEMINE Study) in Kinshasa, Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 193-208页

作者： Feruzi Michel Mangala Muela Andy Mbangama Di-Mosi-Nkoy Roger Wumba Ambis Joëlle Lumaya Nkongolo Freddy Muamba Tshitadi Jean Mukendi Ndombasi Neilda Lemba Otem Christian Ndesanzim Nkashama Bienvenu Kazadi Banza Jesual Lotoy Umba Adrien Tandu mushengezi dieudonné sengeyi Mwimba Roger Mbungu Department of Gynecology and Obstetrics University Clinics of Kinshasa Kinshasa DR Congo Congolese Society of Gynecology and Obstetrics Kinshasa DR Congo Department of Gynecology and Obstetrics Kinshasa Provincial General Reference Hospital Kinshasa DR Congo Departement of Tropical Medicine University Clinics of Kinshasa Kinshasa DR Congo

Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS® combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS® combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.

关键词： Oral Combination Kit Therapy Syndromic Management Abnormal Vaginal Discharge

Dosage Formula in Anesthesia for Manual Intrauterine Aspiration Post-Abortion in Resource-Limited Settings

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Pharmacology & Pharmacy 2024年第4期15卷 71-80页

作者： Serge Ibula Rivain Iteke Berthe Barhayiga Doddie Tsansya Roger Cishugi Jean Jacques Kalongo Sandra Sagboze Jean Paul Cikwanine dieudonné sengeyi ISTM/Bukavu Anesthesia-Resuscitation Section CIMAC Hospital Center in Goma Goma The Democratic Republic of the Congo Department of Anesthesia-Resuscitation University of Lubumbashi Lubumbashi The Democratic Republic of the Congo Department of Anesthesia-Resuscitation University of Kinshasa Kinshasa The Democratic Republic of the Congo Department of Gyneco-Obstetrics University of Kinshasa Kinshasa The Democratic Republic of the Congo Anesthesia-Resuscitation Department Panzi Hospital Bukavu The Democratic Republic of the Congo

Setting: Provincial General Reference Hospital of Bukavu, General Reference Hospital of Panzi, General Reference Hospital of Ciriri, General Reference Hospital of Nyatende and Biopharm Hospital Center. Objective: Contribute to the improvement of the anesthetic ECP of patients benefiting from MVA for incomplete abortion, Describe the methodology used for adoption of the dosage formula in Anesthesia for MVA, present the mathematical demonstration leading to the dosage formula in anesthesia for MVA. Materials and Methods: Our study was descriptive by mathematical demonstration of obtaining the equilibrium constant of the dosage formula of bipuvacaine 0.1% and Fentanyl 50 µg% adapted to the weight and specific size of patients treated anesthetically in MVA cases for incomplete abortion. We also carried out an operational research by first determining the interval where our equilibrium constant is included and secondly by means of the ends of the intervals found correlated to the ends of intervals of possible weights and sizes in the being normal human female of childbearing age to arrive at the real numerical value of the equilibrium constant of the BUKAVU Dosage Formula in the case of anesthesia for MVA during the management of incomplete abortions. Results: TWO-STAGE OPERATIONAL RESEARCH: • Determination of the interval where the equilibrium constant x = −0.95 x x by crossing the means between the extremes of volumes of anesthetic drugs giving a satisfactory sensory block without hemodynamic disturbance and the extremes of normal weight and height for women of childbearing age. We ended up with X = 0.37. Conclusion: At the end of our study which had the general objectives of contributing to the improvement of the anesthetic PEC of patients receiving MVA for incomplete abortion and specific objectives of describing the methodology used for adoption of the dosage formula in Anesthesia for MVA and present the mathematical demonstration which resulted in the dosage formul

关键词： Dosage Anesthesia Intrauterine Aspiration DR Congo

The Profile of Glycated Hemoglobin in Non-Diabetic Pregnant Women with Preeclampsia: A Case-Control Study in Kinshasa, the Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2020年第3期10卷 365-389页

作者： Guelord Mukiapini Luzolo Dophie Tshibuela Beya Daddy Kabamba Numbi Passy Kimena Nyota Placide Cyanga Ngandu Blaise Sumbu Matondo Manzambi Aliocha Nkodila Natuhoyila Mamy Ngole Zita Gustave Ilunga Ntita Mireille Nganga Nkanga Jérémie Muwonga Masidi Donatien Kayembe Nzongola-Nkasu dieudonné sengeyi mushengezi Arsene Mputu Lobota Baudouin Buassa-Bu-Tsumbu Cathy Ali Risasi Fons Verdonck Bernard Spitz Jean Pierre Elongi Moyene Département de Biologie Médicale Service de Biologie Clinique Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Médecine interne Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Gynécologie-Obstétrique Cliniques Universitaires de Kinshasa Kinshasa Congo Département de Biologie Clinique Hopital Général de Référence de Kinshasa Kinshasa Congo Department of Physiology KU Leuven Belgium Department of Gynecology-Obstetrics KU Leuven Belgium Département de Gynécologie-Obstétrique Hopital Général de Référence de Kinshasa Kinshasa Congo

Background: A disturbed glucose metabolism is quite common during pregnancy. It is due to the diabetogenic potential of pregnancy and responsible for many obstetric complications. The glycated hemoglobin is one of the markers used to depict these disorders. Higher concentrations of this marker would be associated with unfavorable results of pregnancy. Objective: To describe the profile of HbA1c in non-diabetic preeclamptic pregnant women and to establish the association between the values of this marker and the maternal and fetal complications. Materials and Method: This is a case-control study of 142 pregnant women in their second and third trimester. They were followed in the maternity hospitals of University Clinics and the General Reference Hospital in Kinshasa, Democratic Republic of Congo between May and October 2019. The sampling of preeclamptic pregnant women was exhaustive. Controls were healthy pregnant women carrying pregnancies of the same type and of the same gestational age as the cases. Ultimately, 71 were preeclamptic and 71 healthy (controls). HbA1c was determined by immunoturbidimetry. Results: A total of 142 pregnant women took part in this study consisting of 71 preeclamptic women (cases) and 71 healthy pregnant women (controls). The average age of these pregnant women was 28.8 ± 6.8 (28.2 ± 6.8 years vs 29.5 ± 6.8 years p = 0.559), with an average parity of 2.3 ± 1.5 (2.2 ± 1.7 vs 2.4 ± 1.2, p = 0.005). The majority were carriers of monofoetal pregnancy. Higher HbA1c values were observed in the preeclamptic pregnant women compared to the controls (5.7 ± 1.3% vs 4.8 ± 0.7%, p 0.001). The proportion of pregnant women with pathological HbA1c values (>5.6%) was also higher in the group of preeclamptic pregnant women (46.5% vs 9.9%, p Conclusion: This study established that 46.5% of non-diabetic pregnant women with preeclampsia have high HbA1c values, which moreover are associated with preeclampsia and its complications. Systematic screening is essen

关键词： HbA1c Preeclampsia Prognosis Congo