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Abstract
RÉSUMÉ
Introduction : Le décès maternel survient dans 17% de cas pendant le travail. Notre objectif était d’étudier les aspects épidémiologiques, cliniques et thérapeutiques du travail d’accouchement Bertoua au Cameroun. Matériel et méthodes : Nous avons mené une étude descriptive transversale avec collecte prospective des données du 22 Décembre 2017 au 30 Avril 2018 à la maternité de l’Hôpital Régional de Bertoua. Toutes les parturientes admises en salle de travail ont été incluses. L’échantillonnage était de type consécutif et exhaustif. L’analyse a porté sur les paramètres socio-démographiques, obstétricales et néonatales. La saisie et l’analyse des données ont été faites à l’aide des logiciels Epi info version 7.2.2 et Microsoft Office Excel 2013. Résultats : Au total, 153 parturientes ont accouché pendant l’étude avec un âge moyen de 24 ,7±6,9 ans. Elles étaient surtout ménagères (52,3%) de niveau d’instruction secondaire (49,3%) vivaient en union libre (47,1%). Les multipares étaient majoritaires 43,8% avec 27% de parturientes qui avaient pris des produits de la pharmacopée traditionnelle pour induire le travail. Elles arrivaient en phase active du travail (60%). L’incidence des dystocies était de 11,7%. L’accouchement était surtout par voie basse (89,8%) avec 5,8% d’épisiotomie. La césarienne représentait 10,2% d’accouchement indiquée pour souffrance fœtale aigue (42,8%). Les hémorragies du post-partum survenaient dans 2,7% de cas. Aucun décès maternel n’a été déploré. La mortalité néonatale précoce était de 3,2 pour 1000 naissances. Conclusion : Les accouchées de la maternité de l’Hôpital Régional de Bertoua sont jeunes et multipares, arrivent surtout en phase active du travail certaines ayant stimulé le travail par des produits de la pharmacopée traditionnelle. L’accouchement est surtout par voie basse. Les taux de césarienne et de mortalité néonatale sont faibles.
ABSTRACT
Background: Maternal death occurs in 17% of cases during labour. Objective: to study the epidemiological, clinical and therapeutic aspects of labour and delivery at Bertoua labour room in Cameroon. Materials and methods: We conducted a cross-sectional descriptive study with prospective data collection from December 22, 2017 to April 30, 2018 at the Bertoua Regional Hospital maternity ward. All parturients admitted to the labour room were included. The sampling was consecutive and exhaustive. The analysis focused on socio-demographic, obstetric and neonatal parameters. Data entry and analysis was done using Epi info version 7.2.2 and Microsoft Office Excel 2013 software. Results: A total of 153 parturient gave birth during the study period, with an average age of 24 .7-6.9 years. They were mostly housewives (52.3%) secondary education (49.3%), living with a male partner (47.1%). They were multiparous in the majority 43.8% with 27% of parturient who had taken products from traditional pharmacopoeia to induce labour. During admission in delivery room, 60% were in the active phase of labour. The incidence of dystocia was 11.7%. vaginal delivery occurred in 89.8% with 5.8% of episiotomy. Caesarean section accounted for 10.2% of reported delivery for acute foetal distress (42.8%). Postpartum haemorrhages occurred in 2.7% of cases. No maternal death was reported. Early neonatal mortality was 3.2 per 1000 births. Conclusion: The women who deliver at the maternity ward of the Bertoua Regional Hospital are young and multiparous, especially arriving in the active phase of labour, some of which have stimulated the onset by products of traditional pharmacopoeia. Childbirth is mostly through vaginally. Caesarean section and neonatal mortality rates are within normal range.
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References
- Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the un Maternal Mortality Estimation Inter-Agency Group. Lancet [Internet]. 2016;387(10017):462–74. Available from: http://dx.doi.org/10.1016/S0140-6736(15)00838-7
- Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob Heal. 2014;2(6):323–33.
- Fomulu FJN, Tchana TM, Nana NP, Mbu R, Kasia JM. Mortalité maternelle à l’hôpital général de Yaoundé : Etude rétrospective sur 5 années (2002 – 2006). Heal Sci Dis [Internet]. 2013;10(1). Available from: http://hsd-fmsb.org/index.php/hsd/article/view/48
- Sant M. Indicateurs Clés. 2019;
- Belinga E, Foumane P, Dohbit SJ, Um EMN, Kiyeck DK, Mboudou ET. Prognosis of referred patients with an obstetric emergency at the yaoundé gynaecology, obstetrics and pediatrics hospital. Pan Afr Med J. 2017;28.
- Ijaiya MA, Adesina KT, Raji HO, Aboyeji AP, Olatinwo AO, Adeniran AS, et al. Duration of labor with spontaneous onset at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Ann Afr Med. 2011;10(2):115–9.
- Ould El Joud D, Bouvier-Colle MH. Dystocia: A study of its frequency and risk factors in seven cities of west Africa. Int J Gynecol Obstet. 2001;74(2):171–8.
- Fouelifack FY, Tameh TY, Mbong EN, Nana PN, Fouedjio JH, Fouogue JT, et al. Outcome of deliveries among adolescent girls at the Yaoundé central hospital. BMC Pregnancy Childbirth. 2014;14(1).
- Belinga E, Foumane P, Dohbit SJ, Um EMN, Kiyeck DK, Mboudou ET. Prognosis of referred patients with an obstetric emergency at the yaoundé gynaecology, obstetrics and pediatrics hospital. Pan Afr Med J. 2017;28:1–7.
- Fokam J, Billong E, Nguefack-tsague G, Essi M, Fodjo R, Monebenimp F, et al. Open Access. 8688:1–9.
- Tebeu PM, Fezeu LY, Ekono MR, Kengne Fosso G, Fouelifack Ymele F, Fomulu JN. Postpartum hemorrhage at Yaoundé University Hospital, Cameroon. Int J Gynecol Obstet [Internet]. 2013;121(3):283–4. Available from: http://dx.doi.org/10.1016/j.ijgo.2013.01.010
- KjÆrgaard H, Olsen J, Ottesen B, Dykes AK. Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset. Acta Obstet Gynecol Scand. 2009;88(4):402–7.
- Lassana D. Partogramme Et Pathologie Dans La Surveillance Du Travail D ’ Accouchement a La Maternite Du Centre De Sante De. 2008.
- Albers LL. Original Article The Duration of Labor in Healthy Women. J Perinataolgy. 1999;19(2):114–9.
- Aka E, Horo A, Koffi A, Fomba M, Jmp K, Fanny M, et al. Ocytocique traditionnel : impact sur le deroulement du travail et l ’ accouchement sur une cohorte de 210 femmes a la maternite du chu de yopougon a abidjan. Rev int sc méd -RISM. 2016;224–9.
- Liu Y, Li G, Chen Y, Wang X, Ruan Y, Zou L, et al. A descriptive analysis of the indications for caesarean section in mainland China. BMC Pregnancy Childbirth. 2014;14(1):1–9.
- Koh M, Etienne B, Phelix E, Fokam T, Marie P. European Journal of Obstetrics & Gynecology and Reproductive Biology : X The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings : A retrospective cohort study. 2019;4:1–6.
- Technology A, Birth FOR. Appropriate technology for birth. Lancet. 1985;2(8452):436–7.
- Ye J, Betrán AP ila., Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth. 2014;41(3):237–44.
- El Masnaoui N, Barkat A, Hatou F, Kabiri M, Lamdouar Bouazzaoui N. Facteurs impliqués dans la mortalité périnatale des nouveau-nés issus de grossesses multiples de haut rang. J Pediatr Pueric. 2009;22(4–5):193–6.
References
Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the un Maternal Mortality Estimation Inter-Agency Group. Lancet [Internet]. 2016;387(10017):462–74. Available from: http://dx.doi.org/10.1016/S0140-6736(15)00838-7
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob Heal. 2014;2(6):323–33.
Fomulu FJN, Tchana TM, Nana NP, Mbu R, Kasia JM. Mortalité maternelle à l’hôpital général de Yaoundé : Etude rétrospective sur 5 années (2002 – 2006). Heal Sci Dis [Internet]. 2013;10(1). Available from: http://hsd-fmsb.org/index.php/hsd/article/view/48
Sant M. Indicateurs Clés. 2019;
Belinga E, Foumane P, Dohbit SJ, Um EMN, Kiyeck DK, Mboudou ET. Prognosis of referred patients with an obstetric emergency at the yaoundé gynaecology, obstetrics and pediatrics hospital. Pan Afr Med J. 2017;28.
Ijaiya MA, Adesina KT, Raji HO, Aboyeji AP, Olatinwo AO, Adeniran AS, et al. Duration of labor with spontaneous onset at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Ann Afr Med. 2011;10(2):115–9.
Ould El Joud D, Bouvier-Colle MH. Dystocia: A study of its frequency and risk factors in seven cities of west Africa. Int J Gynecol Obstet. 2001;74(2):171–8.
Fouelifack FY, Tameh TY, Mbong EN, Nana PN, Fouedjio JH, Fouogue JT, et al. Outcome of deliveries among adolescent girls at the Yaoundé central hospital. BMC Pregnancy Childbirth. 2014;14(1).
Belinga E, Foumane P, Dohbit SJ, Um EMN, Kiyeck DK, Mboudou ET. Prognosis of referred patients with an obstetric emergency at the yaoundé gynaecology, obstetrics and pediatrics hospital. Pan Afr Med J. 2017;28:1–7.
Fokam J, Billong E, Nguefack-tsague G, Essi M, Fodjo R, Monebenimp F, et al. Open Access. 8688:1–9.
Tebeu PM, Fezeu LY, Ekono MR, Kengne Fosso G, Fouelifack Ymele F, Fomulu JN. Postpartum hemorrhage at Yaoundé University Hospital, Cameroon. Int J Gynecol Obstet [Internet]. 2013;121(3):283–4. Available from: http://dx.doi.org/10.1016/j.ijgo.2013.01.010
KjÆrgaard H, Olsen J, Ottesen B, Dykes AK. Incidence and outcomes of dystocia in the active phase of labor in term nulliparous women with spontaneous labor onset. Acta Obstet Gynecol Scand. 2009;88(4):402–7.
Lassana D. Partogramme Et Pathologie Dans La Surveillance Du Travail D ’ Accouchement a La Maternite Du Centre De Sante De. 2008.
Albers LL. Original Article The Duration of Labor in Healthy Women. J Perinataolgy. 1999;19(2):114–9.
Aka E, Horo A, Koffi A, Fomba M, Jmp K, Fanny M, et al. Ocytocique traditionnel : impact sur le deroulement du travail et l ’ accouchement sur une cohorte de 210 femmes a la maternite du chu de yopougon a abidjan. Rev int sc méd -RISM. 2016;224–9.
Liu Y, Li G, Chen Y, Wang X, Ruan Y, Zou L, et al. A descriptive analysis of the indications for caesarean section in mainland China. BMC Pregnancy Childbirth. 2014;14(1):1–9.
Koh M, Etienne B, Phelix E, Fokam T, Marie P. European Journal of Obstetrics & Gynecology and Reproductive Biology : X The Mode of delivery of grand multiparous with post-cesarean single uterine scar in low resources settings : A retrospective cohort study. 2019;4:1–6.
Technology A, Birth FOR. Appropriate technology for birth. Lancet. 1985;2(8452):436–7.
Ye J, Betrán AP ila., Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth. 2014;41(3):237–44.
El Masnaoui N, Barkat A, Hatou F, Kabiri M, Lamdouar Bouazzaoui N. Facteurs impliqués dans la mortalité périnatale des nouveau-nés issus de grossesses multiples de haut rang. J Pediatr Pueric. 2009;22(4–5):193–6.