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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

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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

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第5期 824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

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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（妇产科期刊） 2024年第1期

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Cohort Study on Benefit of Martial Supplementation with EDTA Sodium Iron in Management of Gravidic Anemia at the University Clinics of Kinshasa

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1738-1746页

作者： Andy Muela Mbangama Ndombasi Nelda Lemba Ambis Joëlle Lumaya Nkongolo Freddy Muamba Banza Jésual Lotoy Mubalamata Eugène-Patrick Lukusa Nkashama Bienvenu Kazadi otem christian ndesanzim Feruzi Michel Mangala Department of Gynecology and Obstetrics University Clinics of Kinshasa Kinshasa Democratic Republic of the Congo

Background: Anemia is mainly attributed to nutritional deficiency, especially iron deficiency, which predominates during pregnancy, and is associated with parasitic diseases such as malaria and intestinal parasitosis, acute or chronic diseases such as sickle cell disease, tuberculosis, HIV infection and various micronutrients disorders. It is associated with an increased risk of low birth weight and prematurity and can contribute to impaired cognitive development in early childhood, as well as to maternal mortality. The impact on the fetus is even greater if maternal anemia onset is at an early stage, or prior to pregnancy. Iron salts, such as sulfate or fumarate, are widely used in the treatment of gravidic anemia, but due to various gastrointestinal side effects, many pregnant women are not compliant with treatment. Sodium iron EDTA, on the other hand, is highly absorbable and bioavailable. The latter improves hematological values and appears to be free from the usual iron-related side effects, hence compliance with this supplementation. Objectives: To evaluate the evolution of hemoglobin levels after sodium iron EDTA supplementation at the university Clinics of Kinshasa, to determine the frequency of gravidic anemia, the dose-dependent benefit of sodium iron EDTA supplementation in pregnant women and to identify factors associated with insufficient hemoglobin gain after supplementation. Methods: This longitudinal cohort will take place in the gynecology department of the University Clinics of Kinshasa from September 2022 to August 2023 and will include at least 54 pregnant women with anemia. Conclusion: The study will enable us to better assess the benefits of sodium iron EDTA in improving hematological values, as well as its tolerability in pregnant women suffering from anemia during pregnancy in our environment.

关键词： Anemia Pregnancy EDTA Sodium Iron Martial Supplementation

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Rationale of a Cross Sectional Descriptive Study on Knowledge and Practices of Healthcare Providers on Postpartum Hemorrhage Management in Kinshasa, the Democratic Republic of the Congo

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1453-1459页

作者： Muela Andy Mbangama Mubalamata Eugène-Patrick Lukusa Ambis Joëlle Lumaya Nkongolo Freddy Muamba Banza Jésual Lotoy Nkashama Bienvenu Kazadi Ndombasi Nelda Lemba otem christian ndesanzim Feruzi Michel Mangala Department of Gynecology and Obstetrics University Clinics of Kinshasa Kinshasa The Democratic Republic of the Congo

Background: Healthcare Providers’ knowledge and practice of postpartum hemorrhage (PPH) management are essential to reduce maternal morbidity and mortality. PPH is a public health problem due to the high maternal mortality (MM) associated with it worldwide (25%). Improving the quality of PPH management is a major challenge in low-income countries where, despite the progress made in its management, PPH remains a major contributor to maternal morbidity and mortality. Objective: We will evaluate the level of knowledge and practices of providers in the PPH management in Kinshasa in the Democratic Republic of the Congo (DRC). Methods: This study will be descriptive and cross-sectional. The minimum sample size will be 86. Our study population will consist of delivery room care providers. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparisons of means between groups will be made using Student’s t-test and Pearson’s chi-square test. The test will be statistically significant for a p value 0.05. Data will be collected and processed anonymously and confidentially. Conclusion: Improving quality of care must be a priority in obstetrics. This evaluation requires us to determine the level of knowledge and practices of providers in the PPH management in Kinshasa.

关键词： Knowledge Practices Providers Management and PPH

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Rationale of Longitudinal Cohort Study on Obstetrical Outcomes of Trichomonas vaginalis Infection in Kinshasa, DR Congo

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1460-1468页

作者： Muela Andy Mbangama Banza Jésual Lotoy Ambis Joëlle Lumaya Nkongolo Freddy Muamba Mubalamata Eugène-Patrick Lukusa Nkashama Bienvenu Kazadi Ndombasi Nelda Lemba otem christian ndesanzim Feruzi Michel Mangala Department of Gynecology and Obstetrics University Clinics of Kinshasa Kinshasa The Democratic Republic of the Congo

Background: Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world, and the occurrence of this infection during pregnancy is responsible for adverse obstetrical outcomes like premature labor, premature rupture of membranes (PROM) and low birth weight (birth weight < 2500 g). The association with a number of factors (maternal age, low level of education, low socio-economic status and multiple sexual partners, etc.) that can be found in our environment suggest its probably high prevalence amongst vaginal infections that are responsible for adverse obstetrical outcomes, but up-to-date estimates are lacking. Objective: To assess the obstetrical risk associated with Trichomonas vaginalis (T. vaginalis) infection in our environment. Methods: We designed a protocol for a prospective cohort study which will take place in four medical facilities in the city of Kinshasa, where all pregnant women with a pregnancy of at least 20 weeks and who will give written consent will be included. Vaginal swab specimens will be collected for T. vaginalis research by direct microscopy wet mount. Follow-up will consist of recording the process of the pregnancy and obstetrical outcomes. Conclusion: Results from this study will allow to enhance management and also bring updated estimates on T. vaginalis prevalence and its obstetrical outcomes for infected pregnant woman in our environment.

关键词： Trichomonas vaginalis Infection Obstetrical Outcomes Kinshasa

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Rationale of a Cross-Sectional Descriptive Study on Temporal Evolution of Frequency, Risk Factors and Complications of Preeclampsia in the University Clinics of Kinshasa, DR Congo

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1469-1477页

作者： Muela Andy Mbangama otem christian ndesanzim Ambis Joëlle Lumaya Nkongolo Freddy Muamba Mubalamata Eugène-Patrick Lukusa Nkashama Bienvenu Kazadi Ndombasi Nelda Lemba Banza Jésual Lotoy Feruzi Michel Mangala Department of Gynecology and Obstetrics University Clinics of Kinshasa The Democratic Republic of the Congo

Background: Knowledge of temporal evolution of preeclampsia (PE) in its various aspects is essential in strategies to reduce maternal and perinatal morbidity and mortality. Preeclampsia is a public health problem due to maternal mortality associated with it worldwide (5.6%). Improving quality of its management is a major challenge in low-income countries where, despite progress made in this field, PE remains a major factor in maternal morbidity and mortality. Objective: To evaluate temporal evolution of frequency, risk factors and complications of PE at the University clinics of Kinshasa (UCK). Methods: Descriptive and cross-sectional study concerning minimum simple size of 119 pregnant women who consulted for antenatal care at the University clinics of Kinshasa from January 2012 to December 2022. Results will be reported as percentage proportion, mean and standard deviation. Comparison of proportion and means between groups will be made using Student’s t-test and Pearson’s chi-square test, respectively. The test will be statistically significant for a p value ≤ less than 0.05. Data will be collected and analysed anonymously and confidentially. Conclusion: This study will allow us to evaluate the effectiveness of different prevention and treatment modalities used over time in management of preeclampsia in our setting.

关键词： Temporal Evolution Preeclampsia Frequency Risk Factors Complications

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Benefit of Iron Supplementation with Ferric Sodium EDTA (NaFe <sup>3+</sup>-EDTA) in the Treatment of Anemia during Pregnancy in Democratic Republic of Congo (FERARI Study)

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Open Journal of Obstetrics and Gynecology 2021年第10期11卷 1411-1424页

作者： Muela Andy Mbangama Difunda Victor Muela Mwimba Roger Mbungu Moyenne Jean Pierre Elongi Ambis Joëlle Lumaya Ndombasi Nelda Lemba Umba Adrien Tandu otem christian ndesanzim Nkashama Bienvenu Kazadi Litambelo Serge Etana 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

Background: Oral iron supplements, usually in the form of ferrous salts, are associated with gastric side effects, poor compliance and failure of anemia treatment. To make iron more bioavailable, reduce the gastric side effects and increase the patient compliance, newer iron form, Ferric Sodium EDTA, has become available on the market. Objective: To assess the change in hemoglobin level after iron supplementation with Ferric Sodium EDTA during pregnancy. Materials and Methods: This is a longitudinal study concerning 337 women attending antenatal care in maternity hospitals in the Democratic Republic of Congo from May to December 2020. The study included sociodemographic and anthropometric variables along with type of feed, hemoglobin level at recruitment and after three weeks of taking iron supplement with Ferric Sodium EDTA (Hemoforce Plus Zinc® syrup). For statistical analysis, we used t-test or ANOVA and chi-square test, the significance being stated at p Results: The frequency of pregnancy anemia was 51.4%. The mean hemoglobin value of the overall study group was 8.7 ± 0.5 g/dL. The mean maternal age and weight were 28.9 ± 6.2 years and 65.3 ± 11.7 kg, respectively. Most pregnant women (83.1%) had a diet consisting of food of plant and animal origin in equal proportions. Mean of Body Mass Index (BMI) was 24.6 ± 4.6 Kg/m2 and 44.3% were overweight and obese. The co-morbidities associated were malaria and intestinal parasitosis found in 45% and 5.9% of cases, respectively. After iron treatment with Ferric Sodium

关键词： Iron Supplementation Ferric Sodium EDTA NaFe3+-EDTA Anemia Pregnancy

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Rationale of the Cross-Sectional Descriptive Study on Factors Associated with Failure of Vaginal Delivery Trial after Cesarean Section in the University Clinics of Kinshasa, DR Congo

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1659-1665页

作者： Muela Andy Mbangama Nkashama Bienvenu Kazadi otem christian ndesanzim Ambis Joëlle Lumaya Nkongolo Freddy Muamba Mubalamata Eugène-Patrick Lukusa Ndombasi Nelda Lemba Banza Jésual Lotoy Feruzi Michel Mangala Sendeke Patrick Mogwo Mwimba Roger Mbungu Department of Gynecology and Obstetrics University Clinics of Kinshasa Kinshasa The Democratic Republic of the Congo

Background: Delivery in a scarred uterus is nowadays a real problem in Obstetrics practice, due to the inflation in the number of caesarean sections and the non-unanimous attitude of Obstetrics’ teams towards uterine scars. The factors associated with failed vaginal birth attempts after caesarean section (VBAC) are crucial information that would contribute effectively to deciding on the most appropriate mode of delivery for the mother and her fetus. Their identification would enable us to detect pregnant women at high risk of failure to attempt vaginal birth after caesarean section, and thus contribute to reducing the complications associated with this failure. Objective: We will study the factors associated with failure to vaginal delivery trial after caesarean section at the University Clinics of Kinshasa (UCK). Methods: This study will be a cross-sectional descriptive study with analytical aims. The minimum sample size will be 239. Our study population will consist of records of pregnant women with unicatricial uterus who underwent attempted vaginal delivery after caesarean section at UCK from January 2014 to June 2023. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparison of means between groups will be made using Student’s t-test, and of proportions using Pearson’s Chi-square test. Logistic regression will be used to generate Odds Ratios to measure the strength of association between variables. The test will be statistically significant for a p value 0.05. Data will be collected and processed confidentially and anonymously. Conclusion: This study will identify the factors associated with the failure of attempted vaginal delivery after caesarean section in order to contribute to the reduction of complications related to its failure in our setting. .

关键词： Associated Factors VBAC Failure Scarred Uterus

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