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Maternal-Fetal Pregnancy Complications of in Minors Raped with or without Physical Restraint in Eastern Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 1-12页

作者： Kiminyi Kalunga Eloge Ilunga-Mbaya Raha Maroy Yoyu Tunangoya Jonathan nyakio ngeleza olivier Faculty of Medicine Evangelical University in Africa (UEA) Bukavu Democratic Republic of the Congo General Reference Hospital of Panzi South-Kivu Bukavu Democratic Republic of the Congo Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Medical Works and Research Christ Church of Congo Goma Democratic Republic of the Congo

Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.

关键词： Post-Rape Pregnancy Minor Associated Complications Eastern DRC

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Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 882-895页

作者： Kiminyi Kalunga nyakio ngeleza olivier Raha Maroyi Eloge Ilunga-Mbaya Bwama Julien Kalala Kanyinda Luc Dénis Mukwege Faculty of Medicine Evangelical University in Africa (UEA) Bukavu Democratic Republic of the Congo Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of the Congo International Center for Advanced Research and Training South Kivu Democratic Republic of the Congo

Introduction: In conflicts such as the Democratic Republic of the Congo, sexual violence is systematically perpetrated against children and adolescent girls. Unwanted pregnancy is one of the complications with a myriad of consequences for the victim, the newborn, and society. This study aims to draw up characteristics and obstetrical outcomes of post-rape pregnancies of victims under 18 years old treated at Panzi General Referral Hospital (PGRH) in Eastern DR Congo. Methods: A single-centre prospective descriptive study was conducted at PGRH over two years (June 2020 to June 2022). This study included 140 adolescent girls who became pregnant post sexual assault. They were followed from confirmation of pregnancy to delivery. Sociodemographic, psycho-affective and clinical parameters were recorded and analyzed using XLSTAT 2014 software. Results: 76.4% came from rural areas, with a median age of 16 [13-17]. Pregnancy was continued in 50.7% and terminated in 20%. The victims were casual acquaintances of the perpetrators in 33.6% and unknown in 26.4%. 57.9% attended regular antenatal consultations. 74.3% had an individual birth plan/preparation for labor, with the primary route of delivery being vaginal (69.3%). The frequency of caesarean sections was 30.7%. Some psychological symptoms were identified during labor in 52.9% like agitation (10.7%) and hypersensitivity (8.6%). Conclusion: Pregnancy post rape is a public health problem affecting adolescents between 13 and 17 years of age. These pregnancies require closer follow-up with multi-disciplinary shared care, including psychology, obstetrics, and community input, to improve mother and newborn antenatal, intrapartum, and postpartum outcomes. In addition, long-term psychological sequelae of these pregnancies can be mitigated through supportive care in this high-risk period.

关键词： Sexual Violence Pregnancy Adolescent Victims Complications Prognosis Perpetrators Profile

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Maternal-Fetal Pregnancy Complications of in Minors Raped with or without Physical Restraint in Eastern Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第1期

作者： Kiminyi Kalunga Eloge Ilunga-Mbaya Raha Maroy Yoyu Tunangoya Jonathan nyakio ngeleza olivier

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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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Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第5期

作者： Kiminyi Kalunga nyakio ngeleza olivier Raha Maroyi Eloge Ilunga-Mbaya Bwama Julien Kalala Kanyinda Luc Dénis Mukwege

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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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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（妇产科期刊） 2024年第7期 1010页

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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（妇产科期刊） 2024年第3期 422页

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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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Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 162-182页

作者： nyakio olivier Kibukila Fabrice Tambwe Albert Kakudji Prosper Kalenga Prosper Kakoma Jean Baptiste Department of Gynecology and Obstetrics Faculty of Medecine Evangelical University in Africa (EUA) Bukavu Democratic Republic of the Congo Denis MUKWEGE Excellence Center Bukavu Democratic Republic of the Congo Department of Gynecology-Obstetrics Faculty of Medicine University of Lubumbashi Bukavu Democratic Republic of the Congo Department of Surgery Faculty of Medecine Official University of Bukavu (UOB) Bukavu Democratic Republic of the Congo Department of Surgery Faculty of Medecine University of Burundi Bujumbura Burundi

Background: Cervical cancer is one of the most common cancers in women in the world. The recrudescence of dysplastic lesions is increasing, especially in developing countries, because of the absence of screening. The objective of this work is to determine the prevalence of dysplastic lesions of the cervix in women who are sexually active in South Kivu province. Methods: It was a cross-sectional, descriptive and analytical study of 625 women who came for gynecological consultation, all of whom had cervical-uterine Pap smears, during the period from January 1st, 2017 to December 31st, 2018 at Panzi General Referral Hospital (South Kivu, DR Congo). Data analysis was done using Epi Info software version 7. Results: The median age of the respondents was 34 years, 47.0% of them were married, and 59.0% had a low socio-economic level. The majority had first sexual intercourse between the ages of 15 and 20 (67.5%), a number of former sexual partners estimated at 1 - 5 (87.8%), did not use tobacco (97.4%) and did not use contraception (78.1%). Pap smear was normal in 82.88% of cases, inflammatory in 2.4% of cases and with cytologic abnormalities in 14.72% of cases. Rates of dysplastic lesions were significantly higher among women aged ≥35 years (p = 0.0245), brides (p = 0.0183) and nulliparas (p = 0.0042). Multivariate analysis revealed the adjusted OR (95% CI) statistically insignificant (p Conclusion: Cervical cancer remains a real scourge in the world, especially in sub-Saharan Africa, where the diagnosis is often made when the pathology is at its stage alm

关键词： Dysplasic Lesions Cervix South Kivu DRC

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