TITLE:
Emergency C-Section on Multi-Scar Uterus: Maternal and Fetal Prognosis at the Nianankoro Fomba Hospital in Segou, Mali
AUTHORS:
Tidiani Traoré, Seydou Traoré, Seydou Z. Dao, Abdoul K. Ballo, Kassoum Sidibé, Brahima Donigolo, Babou Traoré, Famakan Kané, Adama Coulibaly, Abdrahamane Diarisso, Alima Sidibé, Adama Camara, Yacouba Dembélé, Thierno Boubacar Bagayoko, Alpha Sanogo, Adama Bah, Abdoulaye Kassogue, Hamidou Toungara, Seydina Alioun Beye, Agoustin Thera, Youssou Traoré, Ibrahima Teguété, Niani Mounkoro, Amadou Dolo
KEYWORDS:
C-Section, Prognosis, Segou, Multi-Scar Uterus, Emergency
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.5,
May
31,
2023
ABSTRACT: Background: Multi-scar uterus is a uterus with two or more scars
due to surgery or trauma. Objective: The aim was to compare the maternal
and fetal prognosis of emergency C-sections of bi-scar uteruses to those of
uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials
and Methods: It was a descriptive and analytical cross-sectional study with
prospective data collection over a 24-month period from March 20, 2018, to
March 20, 2020. Results: In 2 years, we collected 103 emergency
C-sections for multi-scar uterus out of 1198 C-sections with a frequency of
8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The
bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the
C-section was performed during the latent phase of labor. The C-section was
performed under loco-regional anesthesia in 89.3% of cases. Difficulties in
hemostasis and bladder injury were the most frequent intraoperative accidents.
Surgical site infection was the main postoperative complication. No maternal
deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths
in bi-scar uterus against 3.7% in three or more scar uteruses and including 2
fresh stillbirths and 1 macerated. We did not record any early neonatal deaths
after C-section. Conclusion: The frequency of emergency C-sections in
patients with a multi-scar uterus remains very high in our hospital. A better
awareness of the patients, their spouses and all the actors involved in the
management of pregnancies and childbirth, can contribute to curb this trend.