Abstract
Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and evacuees (78.78%). The motives of consultation have been dominated by the hemorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal letalite of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete neonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the emergencies in the structures of superior level.
Highlights
The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and fœtal
It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea
Apr. 25, 2019 lowed by an iatrogenic uterine rupture 22.33%. The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the emergencies in the structures of superior level
Summary
The uterine rupture is an obstetric emergency defined like a solution of surgical, interesting continuity one or all tunics of the uterus, structural on the body and/or the lower segment of the uterus to the exclusion of the rips limited to the collar, the wounds by abdominal traumatism and perforations by abortive manœuvres [1]. In spite of the important progress recorded in the setting of the program of reduction of mortality and morbidity materno-fœtale, the women in the underequipped countries continue to pay a heavy tribe to the complications bound to pregnancy and the childbirth Among these complications, uterine rupture is one of the most serious since it immediately brings the maternal and fetal vital prognosis into interaction [4]. In Guinea, a hospitable survey achieved in Conakry gives like frequency 0.98% (36 uterine ruptures for 3663 childbirths) [10]. The prognosis of this affection is serious, 13% to 26% of maternal mortality and 75% to 90% of mortality fœtale in the countries underdeveloped [9]
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