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

Jean Alfred Mbongo,Delvie Ardèche Bitsangou,Peggy Mawandza,Gickelle Bitséné Mpika ,G Ekouya Bowassa ,C Itoua ,L H Iloki

doi:10.4236/ojog.2019.97104

Abstract

Objectives: To assess the fate of newborns born by emergency Cesarean section during the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving neonatal prognosis. Patients and methods: This was a descriptive and cross-sectional analytical study of exposed and unexposed type, which took place from 24 March 2018 to 24 May 2018. All cases of newborns born by Cesarean section were included. Children born by extreme emergency and urgent Cesarean section were considered as exposed, and the others not exposed. The variables studied were the epidemiological characteristics of the mothers, the history of pregnancy and its management, anthropometric data on the newborn, the state of the child at birth and monitoring up to the seventh day. The test for comparing the proportions of target groups related to the child’s condition was used. Results: The mothers were aged 20 to 29 years (extreme 16 to 44 years); 32 of them (22.5%) had a scarred uterus; 29 pregnant women (20.4%) had a pathology associated with pregnancy. The distance travelled to consult was between 5 and 10 Km (63 cases or 44.3%). Emergency Caesarean sections were performed in 110 patients (77.5%) and scheduled Caesarean sections in 32 pregnant women (22.5%). Localoregional anaesthesia by spinal anaesthesia predominated (78.9%), by the association Bipivancaine + Fentanyl (69 cases or 48.6%) whose practitioner was often the nurse anaesthetist (131 cases or 92.3%). No accidents have occurred intraoperatively. At birth we noticed: 4.2% stillbirth, 19.7% bad, requiring resuscitation of at least 5 minutes for 16 newborns (57.1%). 26 newborns (18.3%) required care in the Neonatology Department. Early neonatal morbidity was dominated by respiratory distress (10 cases or 38.5%), early neonatal infection (5 cases or 19.1%) and a lethality rate of 19.2%. Conclusion: The future of the newborn, born by emergency Cesarean section is mixed; emergency control can improve the situation.

Highlights

IntroductionEmergency Caesarean section includes extreme emergency Caesarean section (There is a vital risk to the mother and/or child); emergency Caesarean section (There is a risk to the mother and/or child not immediately vital); and Caesarean section decided during labour in a context that requires rapid extraction but without endangering the mother [1]
Emergency Caesarean section includes extreme emergency Caesarean section (There is a vital risk to the mother and/or child); emergency Caesarean section (There is a risk to the mother and/or child not immediately vital); and Caesarean section decided during labour in a context that requires rapid extraction but without endangering the mother [1].The Caesarean section performs the artificial delivery after opening the uterus surgically
To assess the fate of newborns born by emergency Cesarean section during the early neonatal period at the University Hospital Centre (UHC) in Brazzaville, with a view to improving neonatal prognosis

Summary

Introduction

Emergency Caesarean section includes extreme emergency Caesarean section (There is a vital risk to the mother and/or child); emergency Caesarean section (There is a risk to the mother and/or child not immediately vital); and Caesarean section decided during labour in a context that requires rapid extraction but without endangering the mother [1]. The fate of newborns born by emergency Cesarean section is severe in developing countries [3]. This is the case in Guinea Conakry, where a hospital frequency of 8.52% was found by Diallo in 1998 [4]. In a Senegalese series of 370 newborns born by emergency Cesarean section 53.5% were transferred to neonatology for various reasons: neonatal asphyxia (27.2%); premature infection (5.3%) and low birth weight (4.9%) increasing mortality in the first 7 days of life of the child to 7.8%; unlike European countries where rates are lower [3]. The objective of this work is to evaluate the fate of newborns born by emergency Cesarean section during the early neonatal period at the Centre Hospitalier Universitaire (CHU) in Brazzaville, with a view to improving neonatal prognosis

Patients and Methods

Results

Discussions

Conclusion