Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)

Itoua Clautaire; Iloki Itoba Imongui Sandra; Buambo Gauthier Régis Jostin; Potokoue Mpia Samantha Nuelly; Mokoko Jules César; Ngakengni Nelie Yvette; Eouani Max Levy Eméry; Iloki Léon Hervé

doi:doi:10.11648/j.jgo.20190702.16

Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)

Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, Ngakengni Nelie Yvette, Eouani Max Levy Eméry, Iloki Léon Hervé

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 2)

Received: 21 March 2019 Accepted: 25 April 2019 Published: 20 May 2019

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Abstract

Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.

Published in	Journal of Gynecology and Obstetrics (Volume 7, Issue 2)
DOI	10.11648/j.jgo.20190702.16
Page(s)	56-59
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Scarred Uterus, Caesarean, Prognosis, Brazzaville

References

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[3]	CNGOF (Collège National des Gynécologues et Obstétriciens Français). Recommendations for clinical practice: delivery in the case of scar uteri. 2012; 91: 607-619.
[4]	Lucas DN, Yentis SM, Kinsella SM et al. Urgency of caesarean section: a new classification. J R Soc Med 2000; 93: 346-50.
[5]	Koulimaya-Gombet CE, Diouf AA, Diallo M, Dia A, Sène C, Moreau JC, et al. Pregnancy and delivery of patients with a history of caesarean of Dakar: therapeutic and prognostic, epidemiological-clinical aspects. Pan Afr Med J 2017; 27: 135.
[6]	Kitenge FM, Chenge FM, Kinenkinda XK, Luboya ON, Tshibangu CK, Mashinda DK, et al. Vital issue, maternal and perinatal morbidity and mortality on delivery with scar uterus in some hospitals in the Democratic Republic of Congo. Ann Afr Med 2017; 10: 2526-34.
[7]	Traoré Y, Tegueté I, Dicko FT, Diallo A, Djiré MY, Sissoko A et al. Delivery in a cicatricial uterus context at Gabriel Touré University Hospital from January 2007 to December 2008: modalities and complications. Med Afr Noire 2012; 45: 512-6.
[8]	Koh MV, Essome H, Sama DJ, Foumane P, Ebah BM. Delivery of scar uteri in low-ressource countries: management and maternal-fetal care circuit. Pan Afr Med J 2018; 30: 255.
[9]	Kintege FM, Akilimali PZ, Chenge FM, Numbi OL, Tshibangu CK, Mashinda D, et al. Scarred uterine delivery in the Democratic Republic of Congo: uterine trial and determinants of outcome. Pan Afr Med J 2017; 27:71.
[10]	Baldé IS, Sy T, Diallo A, Baldé O, Diallo MH, Diallo MC, et al. Childbirth in a context of scar uterus at the maternity ward of the Ignace-Deen National Hospital (Guinea). Rev Méd Périnat 2017; 9: 32-6.
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[12]	Arzel A, Boulot P, Mercier G, Letois F. National survey on the management of the delivery of uteri in France in 2009. J Gynecol Obstet Biol Reprod 2012; 41: 445-53.
[13]	Sans-Mischel AC, Trastour C, Sakarovitch C, Delotte J, Fontas E, Bongain A. State of play in France of the management of cicatricial uteri. J Gynecol Obstet Biol Reprod 2012 40: 639-50.
[14]	Martel MJ, Mackinnon CJ. Guidelines for vaginal birth after previous caesarean birth. J Obstet Gynaecol Can 2005; 27: 164-88.
[15]	Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBA-2): a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010; 117: 5-19.
[16]	Kayem G, Raiffort C, Legardeur H, Gavard L, Mandelbrot L, Girard G. Criteria for acceptance of the vaginal route according to the characteristics of the uterine scar. J Gynecol Obstet Biol Reprod 2012; 41: 753-71.
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Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. (2019). Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). Journal of Gynecology and Obstetrics, 7(2), 56-59. https://doi.org/10.11648/j.jgo.20190702.16

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ACS Style

Itoua Clautaire; Iloki Itoba Imongui Sandra; Buambo Gauthier Régis Jostin; Potokoue Mpia Samantha Nuelly; Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J. Gynecol. Obstet. 2019, 7(2), 56-59. doi: 10.11648/j.jgo.20190702.16

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AMA Style

Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J Gynecol Obstet. 2019;7(2):56-59. doi: 10.11648/j.jgo.20190702.16

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@article{10.11648/j.jgo.20190702.16,
  author = {Itoua Clautaire and Iloki Itoba Imongui Sandra and Buambo Gauthier Régis Jostin and Potokoue Mpia Samantha Nuelly and Mokoko Jules César and Ngakengni Nelie Yvette and Eouani Max Levy Eméry and Iloki Léon Hervé},
  title = {Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {2},
  pages = {56-59},
  doi = {10.11648/j.jgo.20190702.16},
  url = {https://doi.org/10.11648/j.jgo.20190702.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190702.16},
  abstract = {Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.},
 year = {2019}
}

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TY  - JOUR
T1  - Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)
AU  - Itoua Clautaire
AU  - Iloki Itoba Imongui Sandra
AU  - Buambo Gauthier Régis Jostin
AU  - Potokoue Mpia Samantha Nuelly
AU  - Mokoko Jules César
AU  - Ngakengni Nelie Yvette
AU  - Eouani Max Levy Eméry
AU  - Iloki Léon Hervé
Y1  - 2019/05/20
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190702.16
DO  - 10.11648/j.jgo.20190702.16
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 56
EP  - 59
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190702.16
AB  - Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.
VL  - 7
IS  - 2
ER  -

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Author Information

Itoua Clautaire

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo
Iloki Itoba Imongui Sandra

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo
Buambo Gauthier Régis Jostin

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo
Potokoue Mpia Samantha Nuelly

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo
Mokoko Jules César

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo
Ngakengni Nelie Yvette

Neonatology Department, University Hospital of Brazzaville, Brazzaville, Congo
Eouani Max Levy Eméry

Gynecology Obstetrics Department, General Hospital of Loandjili, Pointe Noire, Congo
Iloki Léon Hervé

Gynecology Obstetrics Department, University Hospital of Brazzaville, Brazzaville, Congo

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APA Style

Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. (2019). Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). Journal of Gynecology and Obstetrics, 7(2), 56-59. https://doi.org/10.11648/j.jgo.20190702.16

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ACS Style

Itoua Clautaire; Iloki Itoba Imongui Sandra; Buambo Gauthier Régis Jostin; Potokoue Mpia Samantha Nuelly; Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J. Gynecol. Obstet. 2019, 7(2), 56-59. doi: 10.11648/j.jgo.20190702.16

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AMA Style

Itoua Clautaire, Iloki Itoba Imongui Sandra, Buambo Gauthier Régis Jostin, Potokoue Mpia Samantha Nuelly, Mokoko Jules César, et al. Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo). J Gynecol Obstet. 2019;7(2):56-59. doi: 10.11648/j.jgo.20190702.16

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@article{10.11648/j.jgo.20190702.16,
  author = {Itoua Clautaire and Iloki Itoba Imongui Sandra and Buambo Gauthier Régis Jostin and Potokoue Mpia Samantha Nuelly and Mokoko Jules César and Ngakengni Nelie Yvette and Eouani Max Levy Eméry and Iloki Léon Hervé},
  title = {Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {2},
  pages = {56-59},
  doi = {10.11648/j.jgo.20190702.16},
  url = {https://doi.org/10.11648/j.jgo.20190702.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190702.16},
  abstract = {Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.},
 year = {2019}
}

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TY  - JOUR
T1  - Caesarean in Case of Scar Uterus: Indications and Maternal and Neonatal Prognosis at the University Hospital of Brazzaville (Republic of Congo)
AU  - Itoua Clautaire
AU  - Iloki Itoba Imongui Sandra
AU  - Buambo Gauthier Régis Jostin
AU  - Potokoue Mpia Samantha Nuelly
AU  - Mokoko Jules César
AU  - Ngakengni Nelie Yvette
AU  - Eouani Max Levy Eméry
AU  - Iloki Léon Hervé
Y1  - 2019/05/20
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190702.16
DO  - 10.11648/j.jgo.20190702.16
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 56
EP  - 59
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190702.16
AB  - Objective: Caesarean section in case of cicatricial uterus generates a real epidemiological and prognostic obstetric problem. It is a real concern for the obstetrician with regard to all the factors that can influence the maternal and perinatal prognosis. The aim of this study is to analyze indications for caesarean section in cases of uterine scarring and to establish maternal and neonatal pronotics at the University Hospital of Brazzaville. Methods: A cross-sectional analytical study conducted from January 1, 2015 to June 30, 2017 at the University Hospital of Brazzaville in Congo, comparing 150 deliveries by caesarean to 300 by vaginal route. Results: one hundred and fifty cesarized were recorded among 1212 women giving birth with scar uterus (12.3%). They were different from vaginal deliveries with uterine scarring in age (31 vs 28 years, p <0.05) and mostly referred (70% vs 20.7%, p <0.05). Caesareans were performed more urgently (52.7%) than prophylactically (47.3%). The risk of being caesarized was higher in the case of multiple scar (OR = 9.8 [4.5-21.1]), less than 16 months (OR = 10.2 [2.2-47.6]), and without evidence of strength in connection with a previous vaginal delivery (OR = 4.5 [1.7-11.8]). Emergency caesarean were dominated by acute fetal asphyxia (OR = 7.3 [3.6-14.5]) and dynamic dystocia (OR = 13.3 [10.1-26.6]). Maternal morbidity in cesarized patients was related to parietal suppuration (14, 9.3%) and was associated with a low risk of endometritis (3.4% vs 12%, OR = 0.2 [0.1-0.6], p <0.05). Newborns born to caesarean mothers were more resuscitated (17.2% vs 4%, OR = 4.9 [2.4-10.2], p <0.05), transferred to neonatology (19.8% vs 7.6%, OR = 2.9 [1.6-5.3 p <0.05) and died in the neonatal period (2.6% vs 0.3%, OR = 8.1 [1.2-52], p <0.05]. Conclusion: Caesarean section indications for cicatricial uterus are dominated by obstetric emergencies involving maternal and neonatal prognosis.
VL  - 7
IS  - 2
ER  -

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