Prevalence of fetomaternal Rhesus incompatibility at the tertiary care hospital: a cross-sectional study.

Background: Fetomaternal Rhesus incompatibility is a medical condition that affects the pregnant woman [of blood group (A, B, AB, O) and a negative Rhesus] and the foetus (of positive Rhesus). The objective of this study is to determine the prevalence and to present the clinical characteristics of fetomaternal Rhesus incompatibility in a tertiary care hospital. Methods: The authors conducted a retrospective cross-sectional study and 37 participants were recorded during the study period of 4 years. Results: A total of 11 898 pregnant women admitted to the maternity and 37 of them (women with blood groups A, B, AB or O and with a negative Rhesus) participated in our study, including a frequency of 0.31%. Thirty cases of fetomaternal Rhesus incompatibility were recorded in new-borns. 27 (73%) of the women are from the urban region and the age group between 21 and 25 is the most affected with 37.8%. Twenty-two (59.5%) of pregnant women have blood group O (and negative Rhesus) and primiparous women are the most affected with 64.9%. For the discovery of allo-immunization, 43.2% of women discovered it during the second pregnancy and 48.7% women received a single infusion of Anti-D serum during the first pregnancy. Twelve (40%) new-borns developed jaundice as a perinatal prognosis. Conclusion: Fetomaternal Rhesus incompatibility remains a major problem of maternal health because it is likely to lead to the formation of antibodies in women, which by crossing the placental barrier, they destroy red blood cells and thus cause serious complications.

A cross-sectional study exploring the characteristics of female survivors of sexual violence living with HIV/AIDS in the eastern region of Democratic Republic of Congo.

BACKGROUND: Sexual violence remains a persistent and devastating issue in eastern Democratic Republic of Congo (DRC). AIM: To elucidate the sociodemographic, sexual, and obstetrical characteristics associated with the experiences of victims of sexual violence (VSV) among women in the region. MATERIALS AND METHODS: A cross-sectional study was conducted involving 625 women from eastern DRC. Participants provided self-reported data, collected through interviews conducted by trained female interviewers in secure environments. Associations between VSV and various sociodemographic and reproductive health factors were examined. RESULTS: Of the respondents, 26.1% reported experiences of sexual violence. VSV were predominantly younger, with 56.44% aged between 15 and 24 years. Single women comprised 57.67% of VSV, and 37.42% identified as farmers. There were 33.13% of VSV who were illiterate, and 81.60% belonged to the low socio-economic stratum. Early physiological and reproductive milestones characterised VSV: 52.15% experienced menarche at or before 13 years, 34.97% initiated sexual intercourse before age 15, and 18.70% reported their first pregnancy before age 15. Higher nulliparity was observed in VSV (29.45%) compared to non-VSV (9.31%). A lower prevalence of HIV infection was found among VSV (11.04%) relative to non-VSV (25.76%). CONCLUSION: Sexual violence in the eastern DRC exhibits multifactorial associations. Younger women, those in certain occupations, and those with specific reproductive histories appear more vulnerable. The findings underscore the urgency for targeted interventions, enhanced access to education, and improved reproductive health services. Addressing these pressing issues should remain a primary focus in both societal and public health spheres.

Surgical characteristics of appendectomy in the eastern region of the democratic republic of congo: a cross-sectional study.

Appendectomy is a surgical procedure performed on a patient with acute appendicitis and is often performed by surgery and performed in an emergency. The authors have carried out this study, which aims to describe the surgical characteristics of appendectomies. Methods: This retrospective, descriptive, and documentary cross-sectional study was conducted from October 2021 to October 2022. Within this time ~591 acute abdominal surgical procedures were performed, including 196 appendectomies performed in the general surgery department. Results: This study focused on 196 appendectomies performed out of a total of 591 surgeries performed, with an incidence of 34.2%. 51 cases (26%) for the age group between 15 and 20 years, 129 cases (65.8%) of women participated in the appendectomy. 133 (67.8%) acute appendicitis, 48 (24.5%) appendicular abscess and 15 (7.7%) appendicular peritonitis were indications for appendectomies. For the American Society of Anesthesiologists (ASA) score: for the ASA I, 112 (57.1%) of the patients had no conditions other than those requiring surgery (appendectomy). For the Altemeier classification, the authors recorded 133 (67.9%) own surgeries. 56 (28.6%) surgical site infections followed by 39 (19.8%) inflammation (swelling and redness), 37 (18.8%) pain, 24 (12.4%) purulent peritonitis, 21 (10, 7%) postoperative hemorrhage and 19 (9.7%) paralytic ileus and 157 (80.1%) patients benefited from medical treatment. Conclusion: The low incidence of complications related to laparotomy appendectomy has been reduced to a minimum thanks to the respect of sanitary measures and the quality of the technique.

Experience on trial of labor and vaginal delivery after two previous cesarean sections: A cohort study from a limited-resource setting.

OBJECTIVE: To determine the success rate of trial of labor after two cesarean sections (TOLA2C) in the low-resource setting of the Democratic Republic of Congo (DRC) and to describe factors associated with success and related complications. METHODS: A prospective cohort study was conducted from 2015 to 2020 in a teaching hospital. Patients who underwent TOLA2C were followed across prenatal visits, onset of spontaneous labor, and delivery. Demographics and clinical characteristics were documented. Pearson and Fisher χ2 tests were used. Predictors of successful vaginal delivery were determined by logistic regression (P Ë‚ 0.05). RESULTS: Among 532 patients, the success rate of TOLA2C was 405 (76.1%). Factors associated with success included birth spacing ≥24 months (adjOR: 2.02 ; 95% CI 1.14-3.56; P = 0.015), previous vaginal delivery (adjOR: 5.02; 95% CI 2.71-9.31; P Ë‚ 0.001), intercalated vaginal delivery (adjOR: 5.15; 95% CI 2.28-11.65; P Ë‚ 0.001), cervical dilation >6 cm (adjOR: 2.37; 95% CI 1.92-6.05; P = 0.031) and/or complete dilation on arrival in the delivery room (adjOR: 1.96; 95% CI 1.33-11.45; P = 0.047) and oxytocin stimulation (adjOR: 4.24; 95% CI 1.82-9.91; P Ë‚ 0.001). No association with hemorrhage, uterine rupture, transfer to neonatology, or maternal-neonatal deaths was observed. CONCLUSIONS: TOLA2C is possible in a low-resource setting with a high success rate and low rates of complications. Patient selection and obstetrical team competency are required.

A case study of the first pregnant woman with COVID-19 in Bukavu, eastern Democratic Republic of the Congo.

INTRODUCTION: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus. CASE PRESENTATION: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-CoV-2 during the last term of her pregnancy. She gave birth by caesarean at 34 weeks of gestation to a newborn baby also infected with SARS-CoV-2. The peri-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels. CONCLUSION: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.

[Spontaneous open book uterine rupture at 15 weeks' gestation in a pauciparous woman with scarred uterus: a case study]. / Rupture utérine spontanée en livre ouvert sur grossesse de 15 semaines chez une paucipare avec utérus cicatriciel: à propos d'un cas.

Despite all the health policies implemented in our developing countries, uterine rupture (RU) remains common. They are severe and involve maternal and fetal prognosis. Among the multiple risk factors, the most common cited in the literature is C-section scar. Most occurs during labor or at the end of pregnancy. Uterine rupture during the first or second trimester is exceptional and its clinical manifestation is variable. We here report a case of spontaneous uterine rupture at 15 weeks' gestation in a pauciparous woman with scarred uterus. Exacerbation of clinical symptoms was manifested by peritoneal irritation. Surgical exploration revealed complete vertical rupture from the bottom to the lower segment of the uterus with open book opening of the uterus. This study highlights that uterine rupture should be considered in patients with scarred uterus presenting with abdominal pain associated with signs of hemoperitoneum, regardless of whether their pregnancies are at term or in the first two trimesters, and regardless of age (young patients) and parity.