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Bibliographical entry (without author) : | Uterine rupture of pregnant uterus: study of a continuous series of 63 cases at the referral maternity of Niamey (Niger). Med Trop (Mars). 2002;62(6):615-8. |
Author(s) : | Vangeenderhuysen C, Souidi A. |
Year of publication : | 2002 |
URL(s) : | |
Résumé (français) : | La rupture utérine contribue de manière significative aux taux de mortalité maternelle élevés dans les pays en développement. Nous avons mené une étude prospective de 63 cas de rupture utérine pendant la grossesse à l’hôpital Gazobi de Niamey, au Niger, entre novembre 1977 et décembre 1998. L’incidence à la maternité était de 2,3%. La plupart des patients ont été transportés de l’intérieur des terres. L’âge moyen était de 29 ans et la parité moyenne de 5,7 ans. Plus de la moitié des patientes (53%) ont présenté des anomalies de la cicatrice utérine. Les deux tiers des patientes n’avaient bénéficié d’aucun soin prénatal. L’analyse des facteurs étiologiques iatrogènes a montré une forte corrélation avec l’utilisation d’oxytocine, la délivrance d’un forceps et la pression fundique. Dans 75% des cas, le diagnostic de rupture utérine était posé avant l’accouchement. Le symptôme principal était l’hémorragie. Le traitement chirurgical consistait en une hystérorraphie dans 79% des cas. La mortalité maternelle était de 4,7% et la mortalité périnatale de 76%. Les discussions portent sur la fréquence des ruptures utérines dans les pays en développement, les facteurs étiologiques, les modalités de diagnostic et les directives thérapeutiques. Plusieurs mesures préventives simples sont proposées pour réduire l’incidence de la rupture utérine dans les pays en développement. |
Abstract (English) : | Uterine rupture contributes significantly to high maternal mortality rates in developing countries. We conducted a prospective study of 63 cases of uterine rupture during pregnancy in the Gazobi Hospital in Niamey, Niger between November 1977 to December 1998. The incidence in the maternity department was 2.3%. Most of the patients were transported from inland areas. Mean age was 29 years, and mean parity was 5.7. More than half of patients (53%) presented uterine scar defects. Two thirds of patients had undergone no prenatal care. Analysis of iatrogenic etiologic factors demonstrated strong correlation with use of oxytocin, forceps delivery and fundal pressure. In 75% of cases, diagnosis of uterine rupture was made before delivery. The main symptom was hemorrhage. Surgical treatment consisted of hysterorraphy in 79% of the cases. Maternal mortality was 4.7% and perinatal mortality was 76%. Discussion focuses on the frequency of uterine rupture in developing countries, etiologic factors, diagnostic modalities, and therapeutic guidelines. Several simple preventive measures are proposed to reduce the incidence of uterine rupture in developing countries. |
Sumário (português) : |
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Resumen (español) : |
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Argument (français) : | Ruptures utérines associées à : syntocinon, forceps, et expression abdominale. |
Argument (English): | Uterine ruptures associated with: syntocinon, forceps, and abdominal expression. |
Argumento (português): | Rupturas uterinas associadas a: sintocinon, forceps e expressão abdominal. |
Argumento (español): |
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Keywords : | ➡ maternal age ; fundal pressure ; oxytocin ; forceps delivery ; hormones |
Author of this record : | Cécile Loup — 26 Jul 2004 |
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