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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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Rationale of a Cross-Sectional Descriptive Study on Associated Factors and Prognosis Maternal-Fetal Links to Early Onset Preeclampsia at the University Clinics of Kinshasa, DR Congo

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Open Journal of Obstetrics and Gynecology 2023年第11期13卷 1869-1880页

作者： Muela Andy Mbangama Mbuwe Yves Bozeme Mushengezi Dieudonné Sengeyi Mbenza Benjamin Longo Vangu Roland Vangu Sado Jacques Mokassa Mbaya Eloge Ilunga sendeke patrick mogwo Yangbo Sonia Sabanga Feruzi Michel Mangala Kebela Thésée Kogomba Malu Merveille Kinanga Departement of Gynecology and Obstetrics Univeristy Clinics of Kinshasa Kinshasa The Democratic Republic of Congo Departement of Internal Medicine Univeristy Clinics of Kinshasa Kinshasa The Democratic Republic of Congo Departement of Gynecology and Obstetrics Univeristy of President Joseph KASA-VUBU Boma The Democratic Republic of Congo Pharmaceutical Sciences Faculty University of Kinshasa Kinshasa The Democratic Republic of Congo

Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.

关键词： Early-Onset Preeclampsia Associated Factors Prognosis University Clinics of Kinshasa

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The Evolution of Infertile Couples’ Profiles in a Congolese Population during Sixteen Years of Observation

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1786-1794页

作者： Charlie-Junior Bikuelo Bikuelo Justin Esimo Mboloko Emmanuel Ngoma Nzau Junior Mata Mboloko Mwad Mwang Yolande Kapend Guy Sibo Monzango patrick mogwo sendeke Sandrine Putshu Wangange Modia Department of Obstetrics and Gynaecology University Clinics of Kinshasa Kinshasa Democratic Republic of the Congo

Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post abortum or postpartum origin is the most frequent. Worldwide we are witnessing the transition of pathologies: from infectious to non-communicable ones. Objective: To analyze the evolution of infertile couples’ profiles over time to improve management in the future. Setting: University clinic of Kinshasa and a private clinic, the Edith Medical Center. Design: A cross-sectional analytical study. Patients: A total of 4456 patients who sought care for infertility from January 1999 to December 2014 were enrolled. Main Outcome: The evolution of socio-demographic, clinical and paraclinical parameters of infertile couples over time. Results: The average age of female patients was 33.1 ± 5.7 years and it increased by 36 days every year and the male partner by 29 days per year. The average number of cigarette rods consumed decreased by 5% per year. The average intercourse frequency per week decreased by 2% every year. A fifth of patients (21.8%) were obese. And the average BMI increased by 0.04 kg/m2 per year. Tubal occlusion was the main lesion found in hysterosalpingogram and diagnostic laparoscopy. Conclusion: Patients were more and more aged and gaining weight. A part from infection which is the main cause of infertility this day;in the future, infertility care providers will be facing non-communicable diseases, namely obesity.

关键词： Infertility Infertility in Sub-Saharan Area Infertility in Low-Income Setting Etiology of Infertility

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Ovarian Reserve in a Population of Obese Infertile Patients in Kinshasa

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Open Journal of Obstetrics and Gynecology 2024年第10期14卷 1657-1669页

作者： Charlie-Junior Bikuelo Bikuelo Dan Ngoyi Kabengele Justin Mboloko Esimo Athéna Mwakila Asana Guy Monzango Sibo Charles Moangi Bapanzi patrick mogwo sendeke Pathou Mampuya Ipanga Annie Egbolo Azima Department of Obstetrics and Gynaecology University Clinic of Kinshasa Kinshasa Democratic Republic of the Congo Department of Obstetrics and Gynecology University Hospital of Kinshasa Kinshasa Democratic Republic of the Congo

Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.

关键词： Ovarian Reserve Obesity Infertility AMH FSH

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