PRISE EN CHARGE ANESTHÉSIQUE DES URGENCES OBSTÉTRICALES DANS LA VILLE DE LUBUMBASHI EN RD CONGO

ANESTHETIC MANAGEMENT OF OBSTETRIC EMERGENCIES IN THE CITY OF LUBUMBASHI IN DR CONGO

  • Sandra Sagboze Zalambo Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Wilfrid Mbombo Dibue Département d’Anesthésie-Réanimation, Faculté de Médecine / Cliniques Universitaires de Kinshasa/RD Congo
  • Rivain Iteke Fefe Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Berthe Barhayiga Nsimire Département d’Anesthésie-Réanimation, Faculté de Médecine / Cliniques Universitaires de Kinshasa/RD Congo
  • Olivier Kasongo Kitungwa Département de Gynéco-Obstétrique, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Wasso Milinganyo Eddy Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Teta wa Mwanza Ildephonse Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Yves Mukalay Banza Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Michel Manika Muteya Service d’Anesthésie-Réanimation, Faculté de Médecine/Université de Lubumbashi/RD Congo
  • Médard Bulabula Isokomwa Département d’Anesthésie-Réanimation, Faculté de Médecine / Cliniques Universitaires de Kinshasa/RD Congo
DOI: https://doi.org/10.53555/hsn.v8i4.5067
Keywords: Anesthesia, Obstetric emergencies, Lubumbashi

Abstract

Objective: To assess the problem of anesthetic management of obstetric emergencies in the city of Lubumbashi.

Material and methods: This is a bi-centric cross-sectional documentary study with an analytical component carried out at the university clinics of Lubumbashi and at the Jason Sendwe hospital from October 1, 2020 to March 31, 2021. All women who underwent anesthesia for an obstetric emergency were included by studying the socio-demographic, clinical, obstetrical, anesthetic characteristics, the maternal-fetal outcome as well as their determinants. Data were entered with Excel and analyzed with SPSS 21.0. The ethical standards in force were scrupulously respected.

Results: 160 were retained out of the 211 admitted (75.8%) with an average age of 29.7 ± 6.4 years. They were mostly married (92.5%), unemployed (87.5%), primiparous (60.6%) and ASA II (64.4%). These emergencies were relative at 51.2%, extreme at 25% and absolute at 23.8%. They had benefited from a caesarean section (96.9%). Locoregional anesthesia such as spinal anesthesia was the most practiced (75%) mainly with bupivacaine by junior doctors in anesthesia (96.2%). Extreme emergencies (25%) were mainly haemorrhagic. In multivariate analysis, maternal mortality (6.9%) was influenced by maternal age less than 18 years, delay in management, inadequate anesthetic management, pre-eclampsia and anemia, a consequence of haemorrhage. obstetrics. Neonatal deaths (10.6%) were associated with absolute and extreme urgency as well as high maternal blood pressure on admission.

Conclusion: The anesthetic management of obstetrical emergencies still poses a serious problem in our environment with multifactorial morbidity and mortality, the reduction of which would require the improvement of the referral system, the equipment as well as the continuous training of anesthetic personnel and obstetrics

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References

1. OMS 2004. Prise en charge des complications de la grossesse et de l’accouchement : Guide destiné à la sage-femme et au médecin. 2ème Édition pp v.
2. Chamberlain, Geoffrey, and Phillip Steer. “Obstetrics Emergencies.” British Médical Journal. 318, n°7194 (May 1999) :1342.
3. Duflo F., Allaouichiche B., Chassard D. Urgences obstétricales. SFAR : Conférence d’actualisation. Paris Elsevier, 2000 : 43-60.
4. Mhyre Jill M., Pervez Sultan. General Anesthesia for Cesarean Delivery: Occasionally Essential but Best Avoided. ASA publications Anesthesiology June 2019, Vol. 130, 864-866.
5. OMS. Mortalité maternelle. 19 septembre 2019. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality. Consulté le 2 février 2021.
6. Hawkins J. L. et al. Anesthesia-related maternal mortality in the United States: 1979-2002. American College of Obstetricians and Gynecologists. January 2011 Vol 117 n°1, pp 69-74.
7. Neuhaus, S., Neuhaus, C., Fluhr, H et al. “Why mothers die” Anaesthesia 65, 281-294 (2016). https://doi.org/10.1007/s00101-016-0155-6. Consulté le 10 mai 2021.
8. Mhyre J. M. Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet Global Health Vol 4, Issue 5, May 2016 Pages e320-e327.
9. Bonkoungou et al. La prise en charge anesthésique des urgences obstétricales au centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou. Ramur Tome 18 n°2, 2013.
10. Essola L. Anesthésie pour Césarienne en urgence : expérience du centre hospitalier universitaire de Libreville. The Journal of Medicine and Health Sciences, Vol 21 n°1 2020.
11. Mbungu MR et al. Fréquence des urgences selon la classification de Robson dans trois maternités de la ville de Kinshasa en République Démocratique du Congo. Annales Africaines de Médecine. Mars 2017 Vol. 10 N°2, p2535-44.
12. Boyoma Bwana Masala. Etude de la fréquence des Urgences obstétricales à l'Hôpital Général de Référence de Kamina RDC. Mémoire on line. Juin 2011.
13. Kinenkinda X. et al. Césarienne à Lubumbashi, République Démocratique du Congo I : fréquence, indications et mortalité maternelle et périnatale. June 2017 Pan African Medical Journal 27(72) DOI :10.11604/pamj.2017.27.72.12147.
14. Mayhew D, Mendonca V, Murty BVS. A review of ASA physical status-historical prespectives and modern developments. Anaesthesia 2019; 74:373-9 Last amended on December 13, 2020.
15. Tonato Bagnan JA et al. Les urgences obstétricales à la clinique universitaire de gynécologie et d’obstétrique (CUGO) du centre national hospitalier et universitaire Hubert Kouroucou Maga (CNHU-HKM) de Cotonou : aspects épidémiologiques et pronostiques. Journal de la SAGO Vol 18 n°2 (2017).ISSN :2712-7230.
16. Houngnihin RA et Sossou AJ. Comprendre le renoncement à la référence obstétricale à la Clinique universitaire de gynécologie et d’obstétrique de Cotonou. Santé Publique 2017/5 (Vol. 29), Pages 719 à729.
17. Abbé CM, Binlen-Dadié R., Guattara A., N’guessan YF, Tetchi Y., Brouh Y. Délais de prise en charge anesthésique des urgences gynéco-obstétricales au centre hospitalier universitaire de Cocody-Abidjan. SARANF, Tome 18 n° 1, 2013 p35-39.
18. Imbert P, F. Berger, N. S. Diallo et coll. Pronostic maternel et pédiatrique des césariennes en urgence. Etude prospective à l’hôpital principal de Dakar Sénégal. Med trop 2003 ; 63 : 351-57.
19. Abe H et al. Br J Aneasth. 2018 Apr;120 (4) :779-789. Doi: 10.1016/j.bja.2017.11.101. Epub 2018 Feb 2.
20. Tchaou BA et al : Les urgences obstétricales à l’hôpital de Parakou au Bénin : Aspects cliniques, thérapeutiques et évolutifs. European Scientific Journal March 2015 Edition vol 11 n° 9 ISSN: 1857-7881(Print) e-ISSN 1857-7431.
21. Mobio MP et al. Pratique anesthésique pour urgences gynécologiques et obstétricales au CHU de Cocody. Mali médical 2021 Tome XXXVI n°1 pp31-34.
22. Otiobanba GF et al. Pratique anesthésique au cours des urgences obstétricales aux CHU de Brazzaville. Ramur Tome 18 N°4, 2013 p10.
23. Chaibou MS et al. Mortalité et morbidité maternelle en anesthésie obstétricale pour césarienne. Ramur Tome 18 n°4,2013 p9.
24. Açikel A et al. Comparison of patient satisfaction between general and spinal anaesthesia in emergency caesarean deliveries. Turkish Journal of Anaesthesiology and Reanimation. 2017 Feb; 45 (1): 41-46.
25. Jing Wu and Shang-Lang Yao. Obstetric anesthesia in China: Associated challenges and long-term goals. Chin Med J. 2020 Mar 5; 133 (5): 505-508.
26. Mamo W Kassa et al. Type of anaesthesia for caesarean section and failure rate in Princess Marina Hospital, Botswana’s largest referral hospital. African Health Sciences 2020 Sep; 20 (3): 1229-1236.
27. Marye A et al. Spinal anesthesia for caesarean delivery at two teaching hospitals in Addis Ababa, Ethiopia. Ethiop med J. Vol. 56 N°2. 2018, p133-140.
28. Manzomi J. et al. Anesthésie pour césarienne à la clinique Ngaliema de Kinshasa. Ramur Tome 18 n°4-2013, p12.
29. Australian institute of health and welfare. Maternal deaths in Australia. Web report. Last updated 14 Dec 2020.
30. Alkassoum I. et al. Risk factors for in-hospital maternal mortality in the region of Maradi, Niger (2008-2010: a retrospective study of 7 regional maternity units. Médecine et Santé Tropicales. February 2018, 28(1):86-91. Doi: 10.1684/mst.2018.0770.
31. Payne J. and John Cox. Maternal mortality. Obstetrics Last edited 19 May 2016.doi:10.1177/004947559602600202.
Published
2022-05-13
How to Cite
Zalambo, S. S., Dibue, W. M., Fefe, R. I., Nsimire, B. B., Kitungwa, O. K., Eddy, W. M., Ildephonse, T. wa M., Banza, Y. M., Muteya, M. M., & Isokomwa, M. B. (2022). PRISE EN CHARGE ANESTHÉSIQUE DES URGENCES OBSTÉTRICALES DANS LA VILLE DE LUBUMBASHI EN RD CONGO: ANESTHETIC MANAGEMENT OF OBSTETRIC EMERGENCIES IN THE CITY OF LUBUMBASHI IN DR CONGO. IJRDO -JOURNAL OF HEALTH SCIENCES AND NURSING, 8(4), 12-20. https://doi.org/10.53555/hsn.v8i4.5067
Issue
Vol. 8 No. 4 (2022): JOURNAL OF HEALTH SCIENCES AND NURSING (ISSN: 2456-298X)
Section
Articles

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