Prenatal Consultations Research Articles

Anesthesiology of Emergency Caesarean Section at Gabriel Toure CHU

Introduction: The aim of this study was to evaluate the anesthesiological management of emergency caesareans at the CHU Gabriel TOURE. Methodology: This was a prospective study that took place at the CHU Gabriel TOURE in the Anesthesia Resuscitation department and in the operating theater of the Gyneco-Obstetrics department from August 01 to October 31, 2021. It concerned all caesarean sections performed in the Gyneco-Obstetrics department of the CHU Gabriel TOURE during a period of three months. All patients who came urgently to the Gyneco-Obstetrics department during the study period with an indication for emergency caesarean section Patients operated for emergency caesarean in another center were not included: caesareans performed outside our study period, planned caesareans, ruptured GEU (ectopic pregnancy), haemostasis hysterectomy. The information obtained from the patients and in the prenatal consultation book is compiled on an individual data collection sheet on which the variables to be studied appear. Statistical analysis was performed using SPSS version 25 software. Microsoft Word software was used for word processing. Results: During the study period, we performed 168 emergency cesarean sections out of 389 cases of cesarean section, i.e. a frequency of 43.18%. Conclusion: The practice of emergency obstetric anesthesia poses organizational difficulties, linked to the absence of a post-operative monitoring room, information from the anesthesia team and availability of products. PRH was the most frequent surgical indication; for this reason, GA has been the most practiced technique. Many patients were transferred to intensive care, i.e. 38.69% of cases and we recorded 38.69% of complications.

Can the complementary feeding method be a strategy to reduce the offer of ultra-processed foods?

ObjectiveTo verify the prevalence of the offer of ultra-processed foods (UPFs), and to analyze their associated factors in the child's first year of life. MethodsCross-sectional study with 119 mother-infant pairs. At 5.5 months of the child, the mothers received guidance on complementary feeding (CF) according to three methods: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), or mixed (a combination of PLW and BLISS). At nine and 12 months, the mothers answered a questionnaire about the offer of UPFs. The NOVA classification, which classifies foods according to the nature, extent, and purposes of the industrial processes to which they are subjected, was used to list the UPFs. Descriptive statistics and multivariate Poisson regression, following a multilevel hierarchical model according to the proximity to the outcome, were used to estimate the association between dependent and independent variables. ResultsThe prevalence of UPF consumption was 63% (n = 75) in the first year of life. Receiving guidance on healthy CF in the BLISS method showed to be a protective factor for offering UPFs (RR 0.72; CI95 0.52-0.99). Attending less than six prenatal consultations was a risk factor for the UPFs provision (RR 1.39; CI95 1.07-1.80). ConclusionThe prevalence of UPFs offered in the first year of life in this study can be considered high, and future interventions aimed at avoiding UPFs offered in this population should consider the CF method.

O.37.2 - Autonomy supportive decision-making in prenatal consultations: An interaction analysis.: Presenter(s): Joyce Kors, Amsterdam UMC, Faculty of Medicine, Vrije Universiteit Amsterdam, Research in Education, Netherlands

O.37.2 - Autonomy supportive decision-making in prenatal consultations: An interaction analysis.: Presenter(s): Joyce Kors, Amsterdam UMC, Faculty of Medicine, Vrije Universiteit Amsterdam, Research in Education, Netherlands

Neonatologists' Perspectives on Exploring Parental Spirituality in Prenatal Consultations.

Values of religion, spirituality, and faith (RSF) are central to decision making for many parents facing extremely preterm labor or prenatal diagnoses of potentially life-limiting congenital anomalies. Neonatologists' opinions and comfort with discussing parental RSF are not well known. We sought to understand neonatologists' current practices and perceptions of exploring parental RSF in prenatal consultations. A retrospective chart review was performed at a single U.S. academic institution to evaluate the inclusion of spiritual terminology in documentation. All mothers who were admitted with anticipated extremely preterm delivery as well as those with prenatal diagnoses of potentially life-limiting congenital anomalies were included in analysis. After chart review, an anonymous survey was distributed to neonatology attendings and fellows to examine perspectives on exploring parental RSF. The chart review indicated that RSF terminology was absent from the documentation of all prenatal consultations performed by neonatology. Sixty-five percent of survey respondents considered RSF important in their personal lives and 47% considered RSF important in clinical practice. The three most significant barriers to exploring RSF were lack of training or education in spiritual care, differences between physicians' and patients' personal beliefs, and insufficient time. Our study highlights a gap between the goal for prenatal counseling in cases of extreme prematurity and potentially life-limiting congenital anomalies and current practices that frequently exclude the values most important to many parents. Lack of training in spiritual care is a significant barrier to neonatologists exploring parental RSF.

Fetal and Perinatal Nephrology: Small but Mighty.

Fetal and Perinatal Nephrology: Small but Mighty.

Screening and prenatal diagnosis of survival motor neuron gene deletion in pregnant women in Zhaoqing city, Guangdong Province

ObjectiveA total of 5,200 pregnant women in Zhaoqing city, Guangdong Province, were screened to identify spinal muscular atrophy (SMA) mutation carriers to guide the prevention of SMA and prevent the birth of children with SMA.MethodsExons 7 and 8 (E7 and E8) of the survival motor neuron (SMN) 1 gene were detected in women using real-time fluorescence quantitative polymerase chain reaction. SMN1 and SMN2 copy numbers in those who were initially identified as carriers were verified via targeted region capture and next-generation sequencing. When both partners were identified as carriers, prenatal diagnosis of the fetus was performed.ResultsAmong the screened women, 75 SMA carriers (71 cases had both E7 and E8 heterozygous deletions and 4 cases only had an E7 heterozygous deletion) were identified, with a carrier frequency of 1.44% (95% confidence interval: 1.31–1.65%). Three couples where both spouses were identified as SMA carriers, and their three fetuses were subjected to prenatal genetic analysis. Of the three, one had homozygous deletions of E7 and E8 and the other two had heterozygous deletions of E7 and E8. After a detailed prenatal consultation, the former couple decided to terminate the pregnancy.ConclusionThrough screening and prenatal diagnosis of pregnant women in Zhaoqing city, Guangdong Province, the incidence of SMA can be reduced, prevention of birth defects can be improved, incidence of birth defects can be effectively minimized.

Isolated aberrant right subclavian artery: an underlying clue for genetic anomalies

Objective Aberrant right subclavian artery (ARSA) is known to be associated with specific chromosomal abnormalities. However, there is no agreement regarding clinical decisions related to isolated ARSA. This study evaluated the association between ARSA and genetic abnormalities to provide evidence for prenatal consultation and the postpartum management of isolated ARSA. Methods This single-center cross-sectional study involved fetuses diagnosed with ARSA between January 2014 and May 2021. A range of data was recorded for each patient, including screening ultrasound, fetal echocardiograms, genetic results, postnatal information, and follow-up records. Results ARSA was detected in 151 fetuses, of which 136 were considered isolated cases. The remaining 9.9% (15/151) of cases had cardiac and/or extracardiac abnormalities or soft markers. Data from karyotype analysis and chromosomal microarray analysis (CMA) were available for 56 and 33 (out of 56) fetuses, respectively. Genetic abnormalities were detected in 10.7% of fetuses (6/56). Of these, 4.4% (2/45) and 36.4% (4/11) were associated with isolated and non-isolated ARSA, respectively, with a significant difference between these two groups regarding the frequency of genetic abnormality (p = 0.011). The analysis detected Klinefelter Syndrome (47, XXY) and 16p11.2 microdeletion in two isolated cases. One case each of trisomy 21 and 22q11.2 deletion, and another case of 47, XXY, were detected in fetuses with cardiac anomalies. Partial 5q deletion was found in a fetus with extracardiac malformations. In total, 141 of the fetuses survived after birth; termination of pregnancy was performed for 10 fetuses; only two fetuses had mild symptoms of dysphagia. Conclusion ARSA may be an underlying ultrasonic clue for genetic anomalies even in isolated ARSA. Fetuses with isolated ARSA cannot be ruled out for invasive antenatal diagnosis.

Collaboration between Maternal-Fetal Medicine and Neonatology When Counseling at Extreme Prematurity.

Enhanced communication between maternal-fetal medicine (MFM)/obstetrics and neonatology regarding counseling at extreme prematurity remains an essential element of prenatal consultations. Together, the obstetrician and neonatologist can collaborate to provide timely and synergistic information to affected couples during a dynamic period, combining their expertise to elucidate values and formulate a plan that best supports the pregnant person and partner's goals. Such collaboration can help resolve differing perspectives between specialties, minimize redundancy and inconsistencies, and mitigate the impact of clinician bias. Best practices for joint-specialty collaboration include a precounseling clinician huddle, contemporaneous counseling by MFM specialists/obstetricians and neonatologists with the expectant parents or individualized sequential counseling if preferred by the couple, and a postcounseling clinician debrief. This approach can help establish a trusting relationship with families facing possible extremely preterm delivery and optimize the overall counseling experience. Future efforts focused on education and research, including a standardized approach to educational curricula among fellowship programs, should be emphasized.

A qualitative analysis of obstetric violence in rural Madagascar

In Madagascar, a country where maternal mortality remains high, the quality of obstetric care as perceived by users has been little explored. In this paper, we examine the perception of the quality of care in rural areas, by identifying women's experiences and expectations for basic and emergency obstetric care and how providers are meeting them. Data were collected in 2020, in three rural regions (Fenerive-Est, Manakara and Miandrivazo). 58 semi-structured interviews were conducted with women who had given birth in basic health centers or at home, and with other key informants including caregivers, birth attendants (known as matrones), grandmothers and community agents. 6 focus groups took place with mothers who had given birth at home and at a basic health centers and 6 observations took place during prenatal consultations. This article highlights the major dysfunctions perceived in the services offered and their influence on healthcare use. The women highlighted a lack of consideration of their expectations in obstetric care, with a defective caregiver/patient relationship, unforeseen costs and inadequate infrastructures incapable of guaranteeing intimacy. The women also complained of a lack of consideration of their fady (cultural prohibitions that can lead to misfortune) that surround pregnancy. These local practices conflict with the medical requirements of priority interventions in maternal care, and the respect of these practices by the women leads to reprimands and humiliation from caregivers. This obstetric violence, which emanates from the structure of society, gender relations and the biomedical practices governing pregnancy and childbirth in health facilities in Madagascar, constitutes an obstacle to the use of obstetric services. We hope that this description of the various dimensions of obstetric violence in Madagascar will make it possible to identify the structural obstacles limiting the capacity to provide quality care and to engender positive improvements in obstetric care in Madagascar.

Identification of micrognathia by prenatal ultrasound may improve timely diagnosis and management of infants with Robin sequence.

Robin sequence (RS) is a craniofacial anomaly characterized by small jaw (micrognathia) with associated tongue base airway obstruction. With advances in fetal imaging, micrognathia may be detected prenatally. This study aims to determine if prenatal recognition of micrognathia offers any advantage over being unaware of the condition until after delivery and to assess if prenatal consultation for micrognathia adds benefits beyond merely noting the presence of the condition. Retrospective chart review examining cases from 01/01/2010 to 12/31/2020 at an urban tertiary medical center. Forty seven infants with RS were included. 40.4% (n=19) had micrognathia/retrognathia noted on prenatal ultrasound. 47.4% (n=9) of those 19 pregnancies saw a maternal fetal medicine (MFM) program with craniofacial consultation. Compared to 28 infants not diagnosed with micrognathia until after birth, the 19 infants identified prenatally required fewer transfers from birth hospital (p=0.02). Additionally, those referred to MFM with craniofacial consultation had shorter lengths of stay when airway intervention was required (p=0.05). Prenatal recognition of micrognathia may lead to early detection and management of RS. When RS is suspected, prenatal consultation with MFM and craniofacial team may further optimize care of the infant following delivery.

The Prevalence of Neonatal Near Misses in Rabat, Morocco.

The concept of near-miss neonatal (NMN) is a potentially useful approach in assessing the quality of newborn care. However, data collected on the status of NMN cases in Morocco is scarce. The objective of this study is to determine the prevalence of NMN cases among live births at the University Hospital of Rabat, Morocco. An observational cross-sectional study was conducted on 2676 newborns born at the University Hospital of Rabat, Morocco, and admitted to the National Reference Center of Neonatology and Nutrition (NRCN) from January 1 to December 31, 2021. The main inclusion criteria were the pragmatic and/or management markers of the definition of NMN. Data were extracted using a structured, pre-tested checklist, entered into EpiData, and exported to Statistical Software for the Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY), and descriptive statistics were performed. Among the 2676 selected live births, 2367 were NMN cases (88.5%; 95% CI: 88.3-90.7). More than half of new mothers (57.5%) were referrals, 59.9% of women were multiparous, and 78.5% had under four prenatal care consultations. Obstetric problems affected 373 of the women during pregnancy. A pragmatic criterion was met in 43.6% of NMN situations. Among the management criteria, the use of intravenous antibiotics was the most common factor at 56.0%. This study revealed a high prevalence of NMN. Therefore, concerted efforts are needed to improve maternal health care services, including early identification of complications and appropriate management.

Proportion and factors associated with Apgar less than 7 in the 5th minute of life: from 1999 to 2019, what has changed?

Although variation between observers in the assessment of the Apgar score, it remains a useful indicator of the general conditions of the newborn. This is a cross-sectional study based on population of live births in Brazil in 1999 and biennium 2018-2019. All declarations of live births (DNV) obtained from the Live Births System database were accessed. Frequencies were compared between groups using Pearson's chi-square test and multivariate logistic regression analysis was performed. A statistical significance level of 0.05 was considered. We included 9.050.521 DNVs in our research. We found that 2,1% of newborns had 5th minute Apgar < 7 in 1999 compared with 0,9% in 2018-2019. Multivariate analysis shows that twins and teenage pregnancy are no longer risk factors. Among risk factors, we observed an increase in prematurity, low birth weight and congenital anomalies. An improvement in maternal markers was observed, especially increase in the number of prenatal consultations and schooling. Such findings demonstrate the importance access and adequate prenatal care and improved socioeconomic conditions as effective strategy to reduce neonatal morbidity and mortality.

Quality of life deterioration and associated factors in prenatal care pregnant women: assessment with the WHOQOL-BREF scale

Introduction: Quality of life is a set of situations that contribute to people's well-being. In pregnant women, it is necessary to explore the emotional, social and physical aspects. Few studies in the Latin American population explore the quality of life of pregnant women. The objective was to establish the frequency of deterioration of the physical, psychological, social and environmental quality of life and to identify the associated factors in pregnant women residing in cities of the Colombian Caribbean who attended prenatal consultation. Material and methods: A cross-sectional study was conducted on 509 pregnant women who performed daily activities and participated voluntarily and anonymously after signing informed consent. They filled out a form that explored sociodemographic and clinical characteristics and applied the WHOQOL-BREF scale, identifying the poor quality of life. Adjusted logistic regression was performed to estimate the association between quality of life (dependent variable) and biopsychosocial factors (independent variables). Results: The age of the participants was 26.8 ± 6.2 years. In 250 (49.1%) physical or mental deterioration was identified, in 281 (55.2%) deterioration of the social relationship and in 270 (53.0%) of the environmental relationship. Diabetes OR:6.01[95%CI:1.20-18.42], depression OR:4.71[95%CI:1-20-18.42], living in a rural area OR:2.96[95%CI :1.78-4.91], anguish with pregnancy OR:2.87[95%CI:1.65-5.01], financial problems OR:2.61[95%CI:1.54-4.40 ] or couple OR:2.60[95%CI:1.03-6.69], were associated with impaired quality of life (p&lt;0.01). Being cohabiting, compared to being alone, and being a student/employee versus a housewife, were associated with a lower possibility of deterioration in quality of life (p&lt;0.01). Conclusions: Deterioration of each quality of life domain was identified in half of the pregnant women and several biopsychosocial factors were significantly associated. Antenatal care protocols should provide guidelines for intervention on obstetric and non-obstetric factors that impair quality of life. It is necessary to highlight deficiencies in the exploration of the mental, social and environmental health of pregnant women.

Genotypes and Phenotypes of Uygur Children With Xeroderma Pigmentosum: A Case Study in Xinjiang, China

Objective: Xeroderma pigmentosum (XP) is a rare autosomal recessive dermatosis caused by genetic defects of DNA repair. This study was performed to detect and analyze the genes of 2 Uygur patients with XP and their families and assess the patients’ phenotypes, which may enrich the understanding of the genetic skin disorder spectrum in Xinjiang area. Methods: We collected the clinical data from 2 patients with XP and peripheral blood samples from the patients and their family members. The patients’ DNA was sequenced and detected by Sanger sequencing, and gene mutations were screened. Results: The proband in family 1 presented with brown maculae at the exposure site and squamous cell carcinoma secondary to a facial rash. The proband had a homozygous nucleotide variation of XPC c.2251-2A&gt; G (A change from A to G in the penultimate position of the intron before the 2251 position in the coding region), which was a shear mutation. In this family, both parents were heterozygous, and no similar mutation detected in the sister. In family 2, the proband had scattered black brown spots and papules on the trunk and limbs. and his younger sister was also a patient. The proband and his younger sister had homonucleotide variation of XPA c.631C&gt; T, which was nonsense mutation, resulting in the codon for Arg No.211 being changed into termination codon (p.arg211X), thus terminating the peptide chain synthesis prematurely. All the normal individuals in the two families were heterozygotes, and homozygous mutations occurred in all the patients, which was consistent with the autosomal recessive inheritance. Conclusion: XP is rare in Uygur population. This study expanded the mutation spectrum of XP and provided a basis for early diagnosis, treatment, prognostic prediction, and prenatal genetic consultation.

Reduction in maternal anxiety following prenatal pediatric urology consultation

IntroductionFetal anomalies detected on prenatal ultrasound can elicit maternal psychological distress and may be associated with increased risk of adverse fetal outcomes. Prenatal consultation with pediatric specialists may allay parental worries by improving clarity surrounding a fetal diagnosis, establishing a postnatal management plan, and providing expert advice. We sought to determine whether maternal anxiety and worry decreased following prenatal pediatric urology consultations among a cohort of pregnant women whose fetuses were diagnosed with urologic anomalies.MethodsPregnant women referred to pediatric urologists for prenatal consultation through our Fetal Maternal Center following detection of a urologic anomaly were recruited from February 2021 to March 2022 inclusive. Participants completed questionnaires before and after prenatal pediatric urology consultation assessing maternal current state anxiety (S-Anxiety) on the State-Trait Anxiety Inventory (STAI) and self-reported worry surrounding the fetal diagnosis. Differences in anxiety and worry before versus after prenatal consultation were analyzed using paired t-tests and McNemar’s tests.Results26 pregnant women completed pre- and post-visit questionnaires. Most participants (92.3%) received prenatal pediatric urology consultation for anomalies of the fetal kidney(s), including hydronephrosis and suspected multicystic dysplastic kidney. The proportion of participants reporting extreme or moderate levels of worry surrounding the fetal diagnosis significantly decreased from 69.2% prior to prenatal pediatric urology consultation, to 30.8% after consultation (p=0.02). Reductions in worry after prenatal consultation were reported among 80.8% of participants. Average state anxiety on the STAI similarly significantly decreased from 35.2 ( ± 9.4) before prenatal consultation to 31.4 ( ± 11.1) after consultation. Differences in reductions in anxiety and worry did not significantly differ among participants attending prenatal consultations in-person or via telehealth.ConclusionsAmong a cohort of pregnant women diagnosed with fetal anomalies of the urinary tract, anxiety and worry surrounding the fetal diagnosis significantly decreased after prenatal in-person or telehealth consultations with pediatric urologists.

Prevalence and associated factors of common mental disorders in primary care settings in Sofala Province, Mozambique.

In Mozambique, the prevalence of common mental illness in primary care is not well established. This study aimed to assess the prevalence of, and associated factors for, common mental illness in patients accessing primary care services in three Ministry of Health clinics in Mozambique. Adult patients were recruited from the waiting rooms of prenatal, postpartum and general out-patient consultations. A mental health professional administered a diagnostic interview to examine prevalence of major depressive disorder (MDD), generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and any substance misuse or dependence. Generalised linear mixed models were used to examine the odds of each disorder and sociodemographic associations. Of 502 patients interviewed, 74.1% were female (n = 372) and the average age was 27.8 years (s.d. = 7.4). Of all participants, 23.9% (n = 120) met diagnostic criteria for at least one common mental disorder; 8.6% were positive for MDD (n = 43), 13.3% were positive for GAD (n = 67), 4.8% were positive for PTSD (n = 24) and 4.0% were positive for any substance misuse or dependence (n = 20). Patients attending prenatal or postpartum consultations had significantly lower odds of any common mental disorder than patients attending out-patient primary care. Age was negatively associated with MDD, but positively associated with substance misuse or dependence. Over 20% of patients attending primary care in Mozambique may have common mental disorders. A specific focus on patients attending general out-patient visits, young people for depression, and older people and men for substance misuse/dependence would provide a targeted response to high-risk demographics.

Seroepidemiology of toxoplasmosis in pregnant women and detection of infection acquired during pregnancy in Cotonou, Benin.

Assessing the prevalence of toxoplasmosis in pregnant women and the associated risk factors is the first step in defining policy for the prevention of congenital toxoplasmosis in a given population. An epidemiological study was conducted during prenatal consultations at the CHU-MEL of Cotonou (Benin) between September 2018 and April 2021 and recruited 549 pregnant women to determine the seroprevalence and potential factors associated with Toxoplasma gondii infection. Toxoplasma gondii IgG/IgM antibodies were detected using an enzyme-linked fluorescence assay (ELFA) technique, an IgG avidity test and an IgG/IgM comparative Western blot to diagnose the maternal toxoplasmosis serological status, the possibility of an infection acquired during pregnancy and congenital infection, respectively. Concomitantly, the participants answered a questionnaire investigating potential risk factors. Toxoplasmosis seroprevalence was estimated at 44.4% (95% CI 40.3-48.6) and the factors significantly associated with T. gondii seropositivity were: age over 30years, multigravid women and contact with cats. The possibility of an infection acquired during the periconceptional period or the first trimester of pregnancy concerned six women [1.1% (95% CI 0.5-2.0)]. However, due to the low rate of serological controls in seronegative women, a significant proportion of women first tested during the 3rd trimester of pregnancy, and an insufficient sample size, the incidence of primary infection during pregnancy could not be determined. No cases of congenital transmission occurred in the newborns from the suspected cases of primary infection.

Analysis of the quality of prenatal data of pregnant women attended at Healthcare Services in the city of São Paulo between 2012 and 2020.

To analyze the quality of data collected during prenatal care recorded in the Integrated Health Care Management System (SIGA) of the Municipal Department of Health of São Paulo from 2012 to 2020. Descriptive study using SIGA data and the variables: maternal height (cm), weight (kg) measured throughout pregnancy, gestational age at prenatal consultation, systolic (SBP) and diastolic (DBP) blood pressure (in mmHg), and body mass index (BMI) at the beginning of pregnancy (up to 8 weeks). Quality analysis was carried out by calculating the indicators: percentage of incompleteness and zero values of all variables studied, percentage of implausible values for height, weight, BMI; preference for terminal digit of weight and height, and normality of distributions. The database of pregnant women made available for analysis included 8,046,608 records and 1,174,115 women. The percentage of incompleteness and zero values was low (<1%) in all original variables of the system. There are more records at the end of pregnancy. For the four original variables of interest in the database (weight, height, SBP, DBP), there is a clear preference for the terminal digit. The variables of interest did not present an approximately normal distribution during the evaluated period. The quality analysis showed the need for improving the standardization of information collection and recording, the rounding of measurements and the need for encouraging pregnant women to start prenatal care as soon as possible, in such a way that it is important to invest in data quality, through educational resources for professionals who work in health care.

Management of Deliveries at the University Gynecology-Obstetrics Department of the institute of social hygiene hospital of Dakar

Objectives: Describe the epidemiological profile of patients, specify the characteristics of the delivery and evaluate the maternal and perinatal prognosis at the Maternity Hospital Institute of Social Hygiene in Dakar. Materials and Methods: This was a retrospective and descriptive study conducted over a period of six months from January 1 to June 30, 2019, involving all women who gave birth in the Gynecology-Obstetrics Department of the Institut d&#39;Hygiène Sociale Hospital in Dakar. Results: During the study period, we collected 689 delivery records, i.e., 8.2% of the department&#39;s overall activities and 69% of emergency activities. The epidemiological profile of the patients was that of a woman with an average age of 27 years, married (96%), with an average parity of 2, and residing outside the Southern Health District of Dakar (58%). More than half of the patients (58.1%) had received at least 4 prenatal consultations. The majority of parturients had a single pregnancy (97%) at term (72%). Uterine height measurement and fetal heart rate assessment were normal in 59% and 95.5% of the sample respectively. The vaginal touch revealed ruptured membranes in 34.5% of the patients with amniotic fluid that was mostly clear (68.1%) and a vertex presentation (96%). Clinical pelvimetry allowed the diagnosis of 19% of moderately narrowed pelvises and 2% of surgical pelvises. Slightly more than half of the parturients (56.6%) were in the latent phase of labor. We recorded 130 labor events (18.9%), 67 uterine events (9.7%), 76 directions of labor (11%), and 45 labor inductions (6.5%). In our series, 55.4% of the patients had benefited from labor monitoring by cardiotocograph and complications were found in 25.5% of the patients. These were mainly cases of non-reassuring fetal status (71.8%). More than half of the parturients (55.3%) had given birth by vaginal delivery. Caesarean sections and instrumental extractions represented 44.6% and 0.1% of deliveries respectively. Complications recorded (6.8%) were dominated by retroplacental hematoma (4%) and eclampsia (1.1%). We recorded 98% live births. Most newborns (87.4%) had an Apgar score of 7 or more at the first minute. We recorded 82% eutrophic, 13.3% hypotrophic, and 4.7% macrosomic newborns. Among the newborns transferred to neonatology (9.8%), 17.4% died during hospitalization. Stillbirth was estimated at 20‰ live births. Conclusion: Childbirth constitutes the main emergency activity at the Maternity Hospital of the Institute of Social Hygiene of Dakar with low maternal and perinatal morbidity and mortality.

Perfil epidemiológico em uma Unidade de Terapia Intensiva Neonatal na Região da Amazônia brasileira

AIM: To trace the epidemiological profile of newborns admitted to a Neonatal Intensive Care Unit in a region of the Brazilian Amazon. METHODS: Data were collected from 234 newborns admitted to the Neonatal Intensive Care Unit of the studied department between June 15, 2019 and June 15, 2020. RESULTS: The data pointed to a prevalence of males with adequate weight for gestational age, with main diagnosis on admission of respiratory tract comorbidity and prematurity. In 57.03% of the blood cultures there was no bacterial growth, and when there was growth, coagulase-negative Staphylococcus was present in 20.27%. The death rate calculated in the period was 19.74%. Regarding the maternal profile, 52.36% had six or more prenatal consultations, 73.39% had cesarean section and 32.76% had diabetes and/or hypertension. CONCLUSION: The profile found in this study corroborates the literature, demonstrating a high rate of death and cesarean delivery, with possibly preventable causes with better maternal-fetal care during prenatal care, as assessed in the neonatal near miss. More studies are necessary in relation to the epidemiological profile in Neonatal Intensive Care Units in the northern region because the scarcity and insufficiency of epidemiological data in this region make it difficult to develop public actions aimed at improving the quality of care in Neonatal Intensive Care Units.