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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 < 0.05. Study of risk factors, Odds ratios and their confidence 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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Socio-Demographic Factors, Clinical Characteristics and Maternal Prognosis of Hypertensive Disorders in Pregnancy at Panzi General Referral Hospital

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 860-873页

作者： Mushera Aganze Alain musese nguru marie constance Julien Bwama Botalatala Mbozi Andrea Andre Nakalonge Raha Maroyi Kenny Olivier Nyakio Department of Obstetrics and Gynaecology Panzi General Referral Hospital Bukavu Democratic Republic of the Congo School of Medicine and Public Health Evangelical University in Africa Bukavu Democratic Republic of the Congo The University Peace Centre Bukavu Democratic Republic of the Congo

Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.

关键词： Hypertensive Disorders Maternal Prognosis Socio-Demographic Factors Panzi General Referral Hospital

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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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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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