Malgré toutes les politiques sanitaires mises en œuvre dans nos pays en développement, les ruptures utérines (RU) restent fréquentes. Elles revêtent des formes graves mettant en jeu le pronostic maternel et fœtal. Parmi les nombreux facteurs de risque, le plus fréquent cité par tous les auteurs est la cicatrice de césarienne. La plupart surviennent durant le travail ou en fin de grossesse. Les ruptures utérines au 1 e et 2 e trimestre restent exceptionnelles et leur expression clinique variable. Les auteurs rapportent un cas de rupture utérine spontanée sur grossesse de 15 semaines survenue chez une paucipare avec antécédent d'utérus cicatriciel. La clinique a été marquée par un tableau d'irritation péritonéale. L'exploration chirurgicale a révélé une rupture complète verticale allant du fond utérin au segment inférieur et ouvrant l'utérus en livre ouvert. La RU devrait donc être envisagée de principe devant un tableau douloureux abdominal avec signes d'hémopéritoine chez une gestante avec utérus cicatriciel, quel que soit le terme et même dans les deux premiers trimestres de grossesse, quel que soit l'âge (jeunes patientes) et la parité.

Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 -81.2; p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 -2027.6; p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 -1715; p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3; 0.8]; p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.

Objective: To determine the success rate of trial of labor after two cesarean sections (TOLA2C) in the low-resource setting of the Democratic Republic of Congo (DRC) and to describe factors associated with success and related complications. Methods: A prospective cohort study was conducted from 2015 to 2020 in a teaching hospital. Patients who underwent TOLA2C were followed across prenatal visits, onset of spontaneous labor, and delivery. Demographics and clinical characteristics How to cite this article: Maroyi R, Nyakio O, Buhendwa C, et al. Experience on trial of labor and vaginal delivery after two previous cesarean sections: A cohort study from a limited-resource setting.

Introduction: Delivery in a scar uterus is one of the most debated topics in obstetrics. The objective was to determine the uterine test and the maternal-fetal outcome in patients with uni-and bi-scared uterus who received the uterine test at Panzi General Referral Hospital. Methodology: This is a cross-sectional study with a prospective collection of patients who delivered on a uni-or bi-scareduterus at Panzi Hospital, between January 1, 2021 and August 1, 2022. Results: The average age of the patients was 27.09 years, with an age range of 25 -34 years, they were mostly married (88.3%), with secondary educational level (60.4%). Pauciparous women, with a history of previous caesarean delivery once, represented respectively 52.2%; 7.2% of parturients with an intergenital space equal to 18 months. 63.9% were overweight, 58.6% had undergone more than three ANC sessions. We noted statistically significant associations between modes of admission, water sac, type of membranes rupture, uterine height and success of uterine test (p < 0.05). We did not find significant associations between parturient age, gestational age, intergestational interval, pregnancy term, surgical history, number of ANC performed, number of previous caesarean sections, number of newborns. We did not record any cases of maternal death but one case of perinatal death with 0.9% in this study. Conclusion: A good selection of patients with uni-or bi-scared uterus would allow the reduction of the fetomaternal morbidity during the uterine test.

Introduction: In conflicts such as the Democratic Republic of Congo, sexual violence is systematically perpetrated against children and adolescent girls. Unwanted pregnancy is one of the complications with a myriad of consequences for the victim, the newborn, and society. This study aims to draw up characteristics and obstetrical outcomes of post-rape pregnancies of victims under 18 years old treated at Panzi General Referral Hospital (PGRH) in Eastern DR Congo. Methods: A cohort study was conducted at PGRH over two years (June 2020 to June 2022). This study included 140 adolescent girls who became pregnant post sexual assault. They were followed from confirmation of pregnancy to delivery. Sociodemographic, psycho-affective and clinical parameters were recorded and analyzed using XLSTAT 2014 software. Results: 76.4% came from rural areas, with a median age of 16 [13–17]. Pregnancy was continued in 50.7% and terminated in 20%. The victims were casual acquaintances of the perpetrators in 33.6% and unknown in 26.4%. 57. 9% attended regular antenatal consultations. 74.3% had an individual birth plan/preparation for labor, with the primary route of delivery being vaginal (69.3%). The frequency of caesarean sections was 30.7%. Some psychological symptoms were identified during labor in 52.9% like agitation (10.7%) and hypersensitivity (8.6%). Conclusion: Pregnancy post rape is a public health problem affecting adolescents between 13 and 17 years of age. These pregnancies require closer follow-up with multi-disciplinary shared care, including psychology, obstetrics, and community input, to improve mother and newborn antenatal, intrapartum, and postpartum outcomes. In addition, long-term psychological sequelae of these pregnancies can be mitigated through supportive care in this high-risk period.