Abdominal pregnancy with a live newborn in a low-resource setting: A case report.

Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in low-resource settings because of poor antenatal healthcare provision, low socioeconomic patient status as well as lack of adequate medical resources. Clinical diagnosis can be difficult and ultrasound scan is helpful during the early stages of gestation but can be disappointing thereafter. A case of abdominal pregnancy in a 25-year-old woman, who presented at 26 weeks of gestation with severe abdominal pain not relieved by any medication, is reported. An emergency laparotomy was undertaken as her vital signs deteriorated. An abdominal pregnancy was found and a live neonate delivered. Ministries of health in developing countries should ensure routine access to ultrasound in early pregnancy. Obstetricians should bear in mind that abdominal pregnancy can present late in gestation.

Hysterosalpingographic, ultrasonographic and clinical profile of infertile women in Butembo, Eastern Democratic Republic of Congo.

Introduction: infertility is a reproductive health issue in modern society. In developing countries, ultrasonography and hysterosalpingography (HSG) are first-line exams investigating infertility in women. It is a highly reported issue in Africa and is linked to abnormalities diagnosed by medical imagery investigations. Our research aimed to evaluate ultrasonography and HSG usage in female infertility investigation in eastern DR Congo, and to point out the most frequent lesions in infertile women in this area. Methods: it was a cross-sectional research. It included 1024 patients in four equipped hospitals with HSG and ultrasonography, who consulted from January 1st, 2019 up to December 31st, 2021. Data were collected from consultation dossiers and imagery protocols. Results: of 1024 patients, the mean age was 30.85±5.05 years, 41.79 % (n=428) had primary infertility and 57.71% (n=591) had secondary infertility with parity ranges 1.28±1.25, abortion 1.17±1.33. HSG usage rate was 26.85% (n=275) whereas ultrasonography was 66.01%(n=749). The prevalent diagnosed lesions were uterine myomas 10.51 % (n=71), polycystic ovary syndrome (PCOS) 8.28%(n=56), endometrial dysplasia 7.99% (n=54), ovarian cysts 5.03% (n=34) at ultrasonography and tubal obstructions 53.45 %(n=147), hydrosalpinx 4.73% (n=13), cervical impotence 3.27% (n=9), uterine synechias 2.55%(n=7), müllerian abnomalies 2.55%(n=7), uterine retroversion 2.18% (n=6) at HSG. History of upper genital infection was a risk factor aOR= 3.71, 95%CI 1,55-8,88; p <0.001 for tubal obstruction to HSG. Conclusion: regarding the high prevalence of tubal and uterine abnormalities in infertile women of eastern DR Congo, ultrasonography, and HSG should be more performed exams in clinical practice in low-income countries.

[Abnormal semen analyses in men undergoing premarital screening and in infertile couples in Butembo-Democratic Republic of Congo]. / Anomalies du spermogramme en consultations prénuptiales et dans les couples infertiles à Butembo, République Démocratique du Congo.

The purpose of this study was to determine the prevalence of spermogram abnormalities in men consulting for premarital screening and in infertile couples in Butembo. We conducted a retrospective descriptive study at the Graben University Diagnostic Center. The study population consisted of 890 male subjects aged 21-57 years, of whom 779 underwent prenuptial screening and 111 subjects fertility tests. The overall prevalence of spermogram anomalies in this population was 25.8%, corresponding to a total incidence of 22.9% of premarital consultants and 46,0% of males in infertile couples. Mean pH was: 7.22+/- 0.22. The average volume of semen collected was: 2.56 +/- 1.41 ml. Abnormalities were detected in all spermogram parameters, with a predominance of abnormalities in the same subject (86.5%), mainly in oligoasthenoteratozoospermia (44.8% of cases). Asthenozoospermia was the most common abnormality (90.9% of cases), followed by oligozoospermia (87.4% of cases), teratozoospermia (66.9% of cases), necrozoospermia (55.6% of cases), and azoospermia (10.4% of cases). This study highlights that the cytological profile of the spermogram of this population in Butembo is dominated by associations of anomalies. Other tests such as bacteriological examinations and biochemical marker assays are necessary, in order to identify the causes of abnormalities and to provide appropriate therapies.