[Risk factors and management of uterine rupture in a 1st reference structure in Mali: case of the Bougouni health district].

Le Mali medical Pub Date : 2022-01-01

Seydou Fané, Amadou Bocoum, Soumana Oumar Traoré, Ibrahima Kanté, Cheickna Sylla, Abdoulaye Sissoko, Alassane Traoré, Mamadou Sima, Siaka Amara Sanogo, Aminata Kouma, Abdoulaye Sanogo, Mala Sylla, Adane Adiawiakoye, M Coulibaly, Ibrahima Teguété, Youssouf Traoré, Niani Mounkoro

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Abstract

The objective was to assess the risk factors for and to suggest therapeutic aspects.

Materials and methods: We carried out a case-control study at the Bougouni Reference health center in 2019.

Results: From January to December 31, 2019; out of 1161 deliveries, 43 uterine rupture were recorded, 3.7% corresponding to one uterine rupture for 27 deliveries. Patients 35 years and older were more affected by uterine rupture (44.2%) with OR_aIC95% = 6.3 [1.5 - 26.3]. Obstetric evacuations had an OR_aIC95% = 25.6 [7.8-83.7]. All of the patients were housewives (97.7%) versus (82.3%) controls with ORaIC95% = 8.9 (1.1-69). Pauciparous and multiparous had an OR_aIC95% = 6.2 [1.8 - 20.3] and 4.1 [1.3 - 12.9], respectively. The uterine scar (20.9%) of cases versus 8.1% of controls had a 95% OR_aIC95% = 2.9 [1.1 - 8.7]. Indeed the absence of ANC was a risk factor, OR_aIC95% = 3.0 [1.3 - 6.9]. The time to uterine rupture was < 6 hours in 95%. In fact 34 complete uterine rupture (79.1%) and 9 incomplete uterine rupture (20.9) were noted. Only 2.3% of cases gave birth vaginally. Treatment of uterine rupture was based on surgery (100%) supplemented by shock (51.2%) of cases and infection (100%) of cases.

Conclusion: Uterine rupture is common in our countries under medical care. Its effective prevention involves strategies aimed at acting on risk factors.

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[马里第一参考结构中子宫破裂的风险因素和管理：布古尼卫生区的案例]。

目的是评估其风险因素并提出治疗建议：我们于2019年在布古尼参考健康中心开展了一项病例对照研究：2019年1月至12月31日，在1161例分娩中，记录了43例子宫破裂，占3.7%，即27例分娩中有1例子宫破裂。35岁及以上的患者受子宫破裂的影响更大（44.2%），ORaIC95% = 6.3 [1.5 - 26.3]。产科排空的 ORaIC95% = 25.6 [7.8-83.7]。所有患者均为家庭主妇（97.7%），对照组为 82.3%，ORaIC95% = 8.9（1.1-69）。初产妇和多产妇的 ORaIC95% 分别为 6.2 [1.8 - 20.3] 和 4.1 [1.3 - 12.9]。病例中的子宫疤痕（20.9%）与对照组的 8.1%相比，其 95% ORaIC95% = 2.9 [1.1 - 8.7]。没有 ANC 的确是一个风险因素，ORaIC95% = 3.0 [1.3 - 6.9]。95%的患者子宫破裂时间小于6小时。事实上，有 34 例完全子宫破裂（79.1%）和 9 例不完全子宫破裂（20.9%）。只有 2.3% 的病例经阴道分娩。子宫破裂的治疗以手术（100%）为主，休克（51.2%）和感染（100%）为辅：结论：子宫破裂在我们国家的医疗护理中很常见。结论：在我们国家，子宫破裂在医疗护理中很常见，有效的预防措施包括针对风险因素的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Le Mali medical

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0.10

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