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Serum Calcium Ionised Rate and Materno-Perinatal Prognosis in Arterial Hypertension in Pregnancy at the Reference General Hospital of Panzi

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 422-434页

作者： Mushera Aganze Alain Raha Maroyi Kenny kakisingi mibi de joseph Musese Nguru Marie Constance Julien Bwama Botalatala Mbozi Andrea Koko Kasengire Euphrasie Imani Erahamoba Pince Olivier Nyakio department of Gynecology and Obstetrics Panzi General Referral Hospital Bukavu Democratic Republic of the Congo department of Medicine and Public Health Evangelical University in Africa Bukavu Democratic Republic of the Congo Biopharm Hospital Bukavu Democratic Republic of the Congo International Institute of Tropical Agriculture IITA Olusegun Obasanjo Campus Kalambo Station South Kivu Democratic Republic of the Congo School of Medicine Official University of Bukavu Bukavu Democratic Republic of the Congo

Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p dence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is patholog

关键词： Hypocalcaemia Arterial Hypertension During Pregnancy and Maternal and Perinatal Prognosis

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Mummified Ovarian Pregnancy at the General Reference Hospital of Panzi in Bukavu/DRC: A Case Report

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 252-258页

作者： de joseph kakisingi mibi Olivier Nyakio Ngeleza Ntakwindja Mukanire Éloge Ilunga Mbaya Émile Mapatano Shalamba Sylvie Nabintu Mwambali Dieudonné Kakusu Julien Bwama Botalatala denis Mukwege Mukengere Evangelic University of Africa Panzi Hospital Bukavu DRC Saint Vincent Hospital Bukavu DRC University of Kinshasa Kinshasa DRC

This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an abdomen of normal volume, soft and tender in the right iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted anteflexed position, regular surface with palpation at the right adnexa of a firm mass about 5 cm in diameter, irregular and tender. Free douglas. A diagnosis of infertility of 15 years was retained. Infertility workup showed a normal uterus. Right ovary normal volume, left ovary normal volume. Hysterosalpingography with and without opacification showed signs suggestive of bilateral hydrosalpinx predominating on the right. There was no obvious uterine anomaly. The blood biology did not show anything particular. An exploratory laparoscopy revealed multiple epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent to an adnexal mass. A large adhesiolysis allowed the release of the right tube, thus opening the possibility to explore the adnexal mass. The opening of the mass allowed to individualize bony structures corresponding to the forearm with the calcified hand, and other less distinct structures. The latter finding led to the diagnosis of calcified ovarian pregnancy.

关键词： Ovarian Pregnancy Ectopic Pregnancy Momified Panzi Bukavu DRC

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Knowledge and Level of Use of Misoprostol by Health Care Providers in the Maternity Wards of South Kivu in the Practice of Obstetrics

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Open Journal of Obstetrics and Gynecology 2023年第7期13卷 1234-1243页

作者： de-joseph kakisingi mibi Julien Bwama Botalatala Gloire Mubake Wabulakombe Dieudonné Kakusu Marie Constance Nguru Musese Omari Mukanga Luc Kalala Moïse Kiminyi Émile Mapatano Shalamba Mukanire Ntakwindja Olivier Nyakio 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 Saint Vincent Hospital Bukavu Democratic Republic of the Congo department of Statistics Panzi General Referral Hospital Bukavu Democratic Republic of the Congo

Post-partum haemorrhage (PPH) is one of the leading causes of maternal death in sub-Saharan Africa. In developing countries, PPH is responsible for about 30% of maternal deaths. The main causes of PPH are uterine atony, placental implantation anomalies and coagulation disorders. Acting on the causes of post-partum haemorrhage would significantly reduce maternal mortality. To prevent PPH, the World Health Organization (WHO) recommends the use of uterotonics as a preventive measure. Although parenteral Oxytocin is recommended as the first line Oxytocic for the prevention of PPH, the use of misoprostol is increasingly used in gynaecology and obstetrics, not only for the prevention of postpartum haemorrhage, but also for many other obstetric indications. The aim of this study was to assess the knowledge and level of use of misoprostol by healthcare providers in the gynaecology and maternity departments of South Kivu in the practice of gynaecology and obstetrics. Materials and methods We conducted a descriptive study from January 03 up to February 04, 2023. The study of population was made up of healthcare workers in South Kivu. A questionnaire containing questions relating to socio-demographic informations and knowledge of misoprostol was prepared and encoded in the kobo collect software. To access the questionnaire, it was compulsory to read the research protocol and give consent by ticking the “yes” button. All those who ticked “no” were denied access to the questionnaire. The link was sent, with a request to take part in the survey, to groups in the social networks of doctors and midwives in South Kivu. For areas not covered by the internet, a printed format was distributed and then encoded by data entry operators. For the paper format, respondents were also asked to indicate their consent by ticking the “yes” box. All the encoded data was automatically compiled on the server and then analysed and interpreted by the research team. Results: Nearly all (95.8%) healthca

关键词： Misoprostol Postpartum Haemorrhage Uterotonic

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Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1010-1017页

作者： Julien Bwama de-joseph kakisingi mibi Nsenga Bin Musa Jeff Andrea Mbozi Déborah Kambonesa Salire Dieudonné Kakusu Christine Amisi Tina Aroni Toto Tchass Chasinga Baharanyi denis Mukwege Mukengere Olivier Nyakio Ngeleza department of Gynaecology-Obstetrics Faculty of Medicine and Community Health Evangelical University in Africa Bukavu Democratic Republic of Congo Gynaecology-Obstetrics department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Saint Vincent Hospital Bukavu Democratic Republic of Congo Medical Imaging department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Anatomopathology department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Panzi Foundation Bukavu Democratic Republic of Congo department of Gynaecology-Obstetrics Faculty of Medicine Official University of Bukavu Bukavu Democratic Republic of Congo department of Gynaecology-Obstetrics Faculty of Medicine University of Kindu Kindu Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

关键词： Complete Hydatidiform Mole Menopause β-HCG Panzi Bukavu DRC

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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

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