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RÉSUMÉ
Introduction. Les accidents funiculaires (AF) sont associés à la mortalité périnatale au Cameroun. Le but de ce travail était de rechercher les facteurs associés aux accidents funiculaires à Yaoundé pour améliorer leur prise en charge. Méthodologie. Il s’agissait d’une étude cas témoin réalisée sur une durée de six mois, du 1er novembre 2017 au 30 Avril 2018 portant sur les dossiers d’accouchées et les accouchées consentantes admises à un âge gestationnel supérieur ou égal à 28 SA révolue présentant un accident funiculaire diagnostiqué au moment de l’accouchement. dans les services de maternité de l’hôpital central de Yaoundé, du centre hospitalier universitaire de Yaoundé (CHUY) et l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé (HGOPY). Résultats. Nous avons recruté 150 femmes présentant des accidents funiculaires, dont 123 cas pour 369 témoins. Les facteurs associés aux AF étaient : emploi dans le secteur privé [p=0,04], antécédent d’AF [p=0,02], suivi de la grossesse dans un centre de santé périphérique [p=0,00], réalisation de moins de 4 Consultations Prénatales (CPN) [p=0,04], statut de référence [p=0,00], hydramnios [p=0,00], Rupture Artificielle des Membranes (RAM) [p=0,00], sexe masculin [p=0,00], poids de naissance <2500g [p=0,01], insertion marginale du cordon [p=0,00], LC >70cm [p=0,00] et présentation de siège [p=0,00]. Conclusion. Les facteurs associés aux accidents funiculaires sont d’ordre clinique maternel, fœtaux et annexiels.
ABSTRACT
Introduction. Funicular accidents (AF) are associated with perinatal mortality in Cameroon. The aim of this study was to investigate the factors associated with funicular accidents in Yaoundé to improve their management. Methodology. This was a case-control study conducted over a period of six months, from November 1, 2017, to April 30, 2018, focusing on the records of women in labor and consenting women admitted at a gestational age of 28 weeks or more presenting with a diagnosed funicular accident at the time of delivery in the maternity services of the Central Hospital of Yaoundé, the University Teaching Hospital of Yaoundé (CHUY), and the Gynecological-Obstetric and Pediatric Hospital of Yaoundé (HGOPY). Results. We recruited 150 women with funicular accidents, including 123 cases and 369 controls. The factors associated with AF were: employment in the private sector [p=0.04], history of AF [p=0.02], receiving prenatal care at a peripheral health center [p=0.00], having less than 4 Antenatal Care (ANC) visits [p=0.04], referral status [p=0.00], hydramnios [p=0.00], Artificial Rupture of Membranes (ARM) [p=0.00], male sex [p=0.00], birth weight <2500g [p=0.01], marginal cord insertion [p=0.00], LC >70cm [p=0.00], and breech presentation [p=0.00]. Conclusion. The factors associated with funicular accidents are of maternal, fetal, and umbilical cord clinical nature.
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References
- WHO Ryan WD, Trivedi N, Beninschke K , LaCoursiere DY, Prast MM. Placental histologic criteria for diagnosis of cord accident: sensitivity and specificity. Pediatr dev pathol. 2012. [Epub ahead of print] [Pub Med]
- Jason H, Collins M, Charles L et al. Umbilical cord accidents. Pregnancy Institute. 2010.
- Doumbia Y, Djanhan Y, N’guessan K, Kouakou P, Kakou C, Kante A. Les anomalies funiculaires. Pronostic fœtal au cours du travail à la maternité du CHU de Bouaké. Médécine d’Afrique noir. 2007 Avril ;(5404)-189-192.
- Diallo M, Diouff A, Koulim C et al. funicular anomaly during childbirth: about 562 cases collected in pikine national hospital. International journal of reproduction, contraception, obstetrics and gynecology. 2016; 5(1200):4232-35.
- Kemfang JD ,Kasia JM , Nsangou I , Zedjom C , Domkam I , Morfaw F , et al. Nuchal cord and perinatal outcome at the Yaounde General Hospital, Cameoon. Clinics in Mother and Child Health.2011;8(1).
- Nana P N, Tebeu P M, Mbu R E, Fomulu J N, Maimouna, Leke R J. Cord prolapse, associated factors and fetal outcome: A report of 47 cases from Yaounde Central Hospital, Cameroun. [Thèse de doctorat en médecine]. Yaoundé. 2010.
- IDE A. Facteurs prédictifs de la mortalité périnatale en cas de circulaire du cordon : cas de trois hôpitaux de Yaoundé. The Journal of Medecine and Health Sciences. 2017 june.
- Kakou C, Raoul K, Koime H, et al: Prognosis of umbilical cord prolapse : Experiency of an African maternity. IJRCOG. 2017;6(10):4258-4262.
- Nkwabong E, Njoumbe Mballo J, Dohbit Sama J. Risk factors for nuchal cord entanglement at delivery. Int J Gynecol & Obstet. 2017 Dec;141,(1).
- Hershkovitz R, Silberstein T, Sheiner E, et al .Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol. 2001 sep;98(1): 36-39.
- Mwanjisi et al. (2019), "Quality of antenatal care and perinatal outcomes among pregnant women with fetal anomalies in Tanzania", BMC Pregnancy and Childbirth, DOI: 10.1186/s12884-019-2493-3.
- Bouayad S. Procidence du cordon ombilical : à propos de 97 cas au CHU HASSAN II de Fèse-Maroc. [Thèse de Doctorat en médecine]. Fès. 2011.
- Hershkovitz R, Silberstein T, Sheiner E, et al .Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol. 2001 sep;98(1): 36-39.
- Dessalegn N, Dagnaw Y, Seid K, Wolde A. Umbilical Cord Care Practices and Associated Factor Among Mothers of Neonates Visiting Mizan-Tepi University Teaching Hospital Southwest Ethiopia 2021. Pediatric Health Med Ther. 2022;13:227-234
- https://doi.org/10.2147/PHMT.S363252.
- Kalu CA , Umeora OU. Risk factors and perinatal outcome of umbilical cord prolapse in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. Niger.J Clin Pract. 2011 Oct-Dec;14(4):413-7. doi: 10.4103/1119-3077.91746.
- Angela Reitsmaa, Julia Simionia, Ginny Bruntonb, Karyn Kaufmana , Eileen K Hutton. Maternal outcomes and birth interventions among women who begin labour intending to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses. EClinicalMedicine 21 (2020) 100319 ; 1-20.
- Alouini S, Mesnard L, Megier P, Lemaire B, Coly S, Descroches A. Procidence du cordon:prise en charge obstétricale et néonatales. J Gynécol Biol Réprod.2010 oct; 39(6):471477.
- Rodriguez, A., Gómez-Álvarez, M., Francés-Herrero, E., Romeu, M., Ferrero, H., Seli, E., & Cervelló, I. (2022). Umbilical cord torsion as a predominant factor in umbilical cord accidents. American Journal of Obstetrics and Gynecology, 23(24), 15942.
- Rakotozanany B, Ramdriambololona D M A, Razafimadimby F, et al. Pronostic néonatal de la procidence du cordon ombilical pulsatil à l’hôpital de Befelatanana Madagascar. Médecine et santé tropicales 2015 ; 25 : 434-435.
- Bukowski R, Carpenter M, Conway D, et Al .The stillbirth Collaborative Research Network Writing Group. Causes of Death Among Stillbirths. JAMA. 2011 ; 306(22) :2459-2468.
- Jason H, Charles L, Candace C. Umbilical Cord Accidents. J Obstet Gynaecol.2010 [accessed 12/29/2010]. Disponible sur internet : htt://www.preginst. com/
- Alemayehu et al. (2018), "Socio-demographic factors associated with perinatal outcomes among women with fetal anomalies in Ghana", African Health Sciences, DOI: 10.4314/ahs.v18i1.20.
References
WHO Ryan WD, Trivedi N, Beninschke K , LaCoursiere DY, Prast MM. Placental histologic criteria for diagnosis of cord accident: sensitivity and specificity. Pediatr dev pathol. 2012. [Epub ahead of print] [Pub Med]
Jason H, Collins M, Charles L et al. Umbilical cord accidents. Pregnancy Institute. 2010.
Doumbia Y, Djanhan Y, N’guessan K, Kouakou P, Kakou C, Kante A. Les anomalies funiculaires. Pronostic fœtal au cours du travail à la maternité du CHU de Bouaké. Médécine d’Afrique noir. 2007 Avril ;(5404)-189-192.
Diallo M, Diouff A, Koulim C et al. funicular anomaly during childbirth: about 562 cases collected in pikine national hospital. International journal of reproduction, contraception, obstetrics and gynecology. 2016; 5(1200):4232-35.
Kemfang JD ,Kasia JM , Nsangou I , Zedjom C , Domkam I , Morfaw F , et al. Nuchal cord and perinatal outcome at the Yaounde General Hospital, Cameoon. Clinics in Mother and Child Health.2011;8(1).
Nana P N, Tebeu P M, Mbu R E, Fomulu J N, Maimouna, Leke R J. Cord prolapse, associated factors and fetal outcome: A report of 47 cases from Yaounde Central Hospital, Cameroun. [Thèse de doctorat en médecine]. Yaoundé. 2010.
IDE A. Facteurs prédictifs de la mortalité périnatale en cas de circulaire du cordon : cas de trois hôpitaux de Yaoundé. The Journal of Medecine and Health Sciences. 2017 june.
Kakou C, Raoul K, Koime H, et al: Prognosis of umbilical cord prolapse : Experiency of an African maternity. IJRCOG. 2017;6(10):4258-4262.
Nkwabong E, Njoumbe Mballo J, Dohbit Sama J. Risk factors for nuchal cord entanglement at delivery. Int J Gynecol & Obstet. 2017 Dec;141,(1).
Hershkovitz R, Silberstein T, Sheiner E, et al .Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol. 2001 sep;98(1): 36-39.
Mwanjisi et al. (2019), "Quality of antenatal care and perinatal outcomes among pregnant women with fetal anomalies in Tanzania", BMC Pregnancy and Childbirth, DOI: 10.1186/s12884-019-2493-3.
Bouayad S. Procidence du cordon ombilical : à propos de 97 cas au CHU HASSAN II de Fèse-Maroc. [Thèse de Doctorat en médecine]. Fès. 2011.
Hershkovitz R, Silberstein T, Sheiner E, et al .Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol. 2001 sep;98(1): 36-39.
Dessalegn N, Dagnaw Y, Seid K, Wolde A. Umbilical Cord Care Practices and Associated Factor Among Mothers of Neonates Visiting Mizan-Tepi University Teaching Hospital Southwest Ethiopia 2021. Pediatric Health Med Ther. 2022;13:227-234
https://doi.org/10.2147/PHMT.S363252.
Kalu CA , Umeora OU. Risk factors and perinatal outcome of umbilical cord prolapse in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. Niger.J Clin Pract. 2011 Oct-Dec;14(4):413-7. doi: 10.4103/1119-3077.91746.
Angela Reitsmaa, Julia Simionia, Ginny Bruntonb, Karyn Kaufmana , Eileen K Hutton. Maternal outcomes and birth interventions among women who begin labour intending to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses. EClinicalMedicine 21 (2020) 100319 ; 1-20.
Alouini S, Mesnard L, Megier P, Lemaire B, Coly S, Descroches A. Procidence du cordon:prise en charge obstétricale et néonatales. J Gynécol Biol Réprod.2010 oct; 39(6):471477.
Rodriguez, A., Gómez-Álvarez, M., Francés-Herrero, E., Romeu, M., Ferrero, H., Seli, E., & Cervelló, I. (2022). Umbilical cord torsion as a predominant factor in umbilical cord accidents. American Journal of Obstetrics and Gynecology, 23(24), 15942.
Rakotozanany B, Ramdriambololona D M A, Razafimadimby F, et al. Pronostic néonatal de la procidence du cordon ombilical pulsatil à l’hôpital de Befelatanana Madagascar. Médecine et santé tropicales 2015 ; 25 : 434-435.
Bukowski R, Carpenter M, Conway D, et Al .The stillbirth Collaborative Research Network Writing Group. Causes of Death Among Stillbirths. JAMA. 2011 ; 306(22) :2459-2468.
Jason H, Charles L, Candace C. Umbilical Cord Accidents. J Obstet Gynaecol.2010 [accessed 12/29/2010]. Disponible sur internet : htt://www.preginst. com/
Alemayehu et al. (2018), "Socio-demographic factors associated with perinatal outcomes among women with fetal anomalies in Ghana", African Health Sciences, DOI: 10.4314/ahs.v18i1.20.