Management of Ectopic Pregnancy at the Brazzaville Hospital and University Centre

Abstract

Objective: To evaluate the current management of ectopic pregnancies (EPG) at the University Hospital Centre (UHC) in Brazzaville because the practice was usually limited to total salpingectomy by laparotomy. Patients and methods: This was a descriptive study, with retrospective data collection, conducted from July 30, 2015 to January 30, 2016. It included patient records admitted to the Obstetrical Gynecology Department of the Brazzaville University Hospital for an EP, a diagnosis made before visualization on ultrasound of an active embryo outside the uterine cavity or per laparoscopy, but often by exploratory laparotomy. Sociodemographic and clinical data, as well as the therapeutic modalities of the patients, were analyzed. Cases of women operated for EP in other health facilities and referred to the UHC for complication management and cases that were unusable were excluded. Results: We noted 39 EPs out of 4490 deliveries, representing a frequency of 0.86%. The average age of the patients was 28.9 years (extreme 18 -46 years). The transfusion of labile blood products concerned 84.6% of patients. There was no therapeutic abstention; medical treatment was performed in 3 patients (7.7% of cases). Diagnostic and therapeutic laparoscopy was performed in 9 patients (23.1%) and laparotomy was used in 26 patients (66.7% of cases) in which 35 Salpingectomies (89.7% of cases) were performed. The immediate postoperative period was marked by anaemia (32 cases or 82.1%), surgical site infection (1 case or 2.6%) and parietal suppuration (1 case or 2.6%). Conclusion: The dissemination of therapeutic advances in the management of EP is also possible in African settings.

The Fate of Newborns Delivered through Cesarian Section at Brazzaville University Hospital

“…Our assertions reflect results similar to previous work conducted in the same department, namely emergency Caesarean sections are 2.46 times more likely to have maternal complications and 6.03 times more likely to die in the fetus than non-urgent sections. Factors that aggravate maternal and fetal prognosis include: delay between the indication and performance of Cesarean section, evacuated patients, general anesthesia, some indications for Cesarean section such as acute fetal suffering, placenta previa, fetal-pelvic disproportion [20]. However, some authors link perinatal mortality during emergency Caesarean sections to intrapartum obstetric trauma, admission-surgical delay and prematurity [21].…”