RESUMEN
OBJECTIVE: to determine the beneficial role of Fetal Hemoglobin (FHb) and alpha-thal on fetal and maternal morbidity during pregnancy in sickle cell patients. STUDY SITE: the study was conducted at the sickle cell center of Kinshasa between 2008 and 2018. SETTING AND STUDY POPULATION: this is a documentary and analytical study that included 980 deliveries of homozygous sickle cell patients. METHODS: the diagnosis of SCD and the quantification of FHb were performed with the capillary electrophoresis technique. The molecular test confirmed the diagnosis of SCD. The diagnosis of alpha-thal was made with the multiplex ligation-dependent probe amplification (MLPA) technique. Sickle cell pregnancies were followed according to the protocol of care in force in the University of Kinshasa Hospital service. The variables of interest were: hematological variables, sickle cell crises during pregnancy, maternal and fetal complications. STATISTICS: statistical analyses were performed with SPSS 20.0 software. Means and standard deviations were compared with the Student's t and ANOVA tests. The value of p <0.05 was considered the significance level. RESULTS: the Hb-SS / alpha-thal and HbSS / HPFH genotypes were observed in 101 and 121 women, respectively. Otherwise, 758 women had HbSS genotype. The morbidity related to sickle cell complications in the mother and fetus were less frequent in the Hb-SS / alpha-thal and HbSS / HPFH groups than in HB-SS group. The differences were statistically significant. CONCLUSION: this study showed a significant protective effect of alpha-thal and HPFH during pregnancy in sickle-cell pregnant women.
RESUMEN
This prospective and multi-centric study assessed the lacking of pattern in fractured patients and features of vertebral fractures in postmenopausal black women living in central Africa. INTRODUCTION: Patients with osteoporosis commonly collapsed their vertebral body. This has been widely studied in Caucasians, Asians, and Americans and studies in black African are lacking. Our study was designed to establish a pattern of patients with fractures and determine the features of vertebral fractures in postmenopausal black women living in Central Africa. METHODS: A prospective and multi-centric study was conducted from June 2011 to June 2016, to assess the thoraco-lumbar-computed tomographic images of women. The menopausal statuses and anthropometric parameters (age, height, and weight) were collected. The body mass index and the Asset Poverty Index were evaluated. The reviews included a morphometric analysis of each vertebra that was rated according to the visual semi-quantitative system proposed by Genant et al. RESULTS: Four hundred thirty women aged 47-87 years old were included in this study. The mean age was 57 years old, and the mean menopause duration was 11.45 ± 6.6 years with extremes ranging from 2 to 37 years. The body mass indices were rated as overweight and obese in 80.8% of subjects and 54, 3% had high-API indices. Among the 4730 vertebrae analyzed, 529 (11.12%) were fractured, with 68.7% exhibited a cup-shaped deformation (biconcave), 19.8% had a wedge-shaped deformation, and 11.4% exhibited a cake (crush) deformation. Of the vertebras, 88.8% were grade 0, 5.5% grade 1, 5% grade 2, and 0.57% were grade 3. Of the women, 68.8% had one vertebra fractured and 31.2% had more than one fractured vertebrae. CONCLUSION: This study seemed to determine the pattern and features of vertebral fractures in black African women which may be useful for comparisons with the pattern of worldwide populations.
