TITLE:
Maternal-Fetal Prognosis of Delivery in the Presentation of the Seat at the Kayes Hospital (Mali)
AUTHORS:
Mahamadou Diassana, Ballan Macalou, Sitapha Dembele, A. Sidibe, A. Hamido, D. Konate, Soumana Oumar Traore, Mamadou Sima, Cheickna Sylla, Amadou Bocoum, Seydou Fane, Soumaila Traore
KEYWORDS:
Siege Delivery, Obstetric Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.5,
May
20,
2021
ABSTRACT: Objective: The purpose of this study was to assess the risk factors associated with
seat presentation and to determine the maternal-fetal prognosis of delivery in
the presentation of the seat. Materials and methods: This was a
descriptive, cross-sectional and analytical case-control study with prospective
data collection, from January 1, 2018 to December 31, 2019, a 12-month period
at Kayes Hospital, Mali. Results: During our study period we recorded
3820 deliveries, including 120 breos; a frequency of 3.14% of all deliveries.
The 20 - 35 age group was the most represented in cases 61.7%. Of the cases 66.7%
(n-80) were out of school, we note 75.8% (n-182) of out-of-school controls. Primiparaes were
the majority among cases 39.2% (n-47), as were 39.1% of the controls (n-118).
The cases had a history of caesarean section at 15% (n-18); 13, 3% (n-32). The
most common mode of presentation was the 70% decomplete seat. It was mainly the
anterior left sacro iliac variety (85.8%). The low pathway was preferred during
these deliveries to 70% against 30% of caesarean section of which 28.3% of
cases were carried out in an emergency. Several factors such as delivery
pathway, mode of presentation, length of expulsion and obstetric manoeuvres
used influenced fetal prognosis. Fetal complications were dominated by acute
fetal suffering (15.8%), followed by dislocation of the shoulder (0.8%). The
most common morbid maternal complications were soft part tears (15 cases or
12.5%) and parietal suppuration (1 case or 0.8%). We did not record any
maternal deaths. Conclusion: Our results confirm that childbirth is a
risky delivery, and must require careful selection of eligible cases and
rigorous management of labour with trained teams. In these circumstances, it
seems totally abusive to advocate as a single mode of delivery caesarean
section in all presentations of the chair in the primigestes.