TITLE:
The Fate of Newborns Delivered through Cesarian Section at Brazzaville University Hospital
AUTHORS:
Jean Alfred Mbongo, Gickelle Bitsene Mpika, Peggy Mawandza, Delvie Ardèche Bitsangou, Gaston Ekouya Bowassa, Clotaire Itoua, Leon Herve Iloki
KEYWORDS:
Newborns, Emergency Caesarean Sections, Congo
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.7,
July
30,
2019
ABSTRACT: Objectives: To assess the fate of newborns born by emergency Cesarean section during
the early neonatal period at the University Hospital Centre (UHC) in
Brazzaville, with a view to improving neonatal prognosis. Patients
and methods: This
was a descriptive and cross-sectional analytical study of exposed and unexposed
type, which took place from 24 March 2018 to 24 May 2018. All cases of newborns
born by Cesarean section were included. Children born by extreme emergency and
urgent Cesarean section were considered as exposed, and the others not exposed. The variables studied were
the epidemiological characteristics of the mothers, the history of pregnancy
and its management, anthropometric data on the newborn, the state of the child
at birth and monitoring up to the seventh day. The test for comparing the proportions of target
groups related to the child’s
condition was used. Results: The mothers were aged 20 to 29 years (extreme 16 to 44 years); 32 of them
(22.5%) had a scarred uterus; 29 pregnant women (20.4%) had a pathology
associated with pregnancy. The distance travelled to consult was between 5 and
10 Km (63 cases or 44.3%). Emergency Caesarean sections were performed in 110
patients (77.5%) and scheduled Caesarean sections in 32 pregnant women (22.5%).
Localoregional anaesthesia
by spinal anaesthesia predominated (78.9%), by the association Bipivancaine +
Fentanyl (69 cases or 48.6%) whose practitioner was often the nurse
anaesthetist (131 cases or 92.3%). No accidents have occurred intraoperatively.
At birth we noticed: 4.2%
stillbirth, 19.7% bad, requiring resuscitation of at least 5 minutes for 16
newborns (57.1%). 26 newborns (18.3%) required care in the Neonatology
Department. Early neonatal morbidity was dominated by respiratory distress (10
cases or 38.5%), early neonatal infection (5 cases or 19.1%) and a lethality
rate of 19.2%. Conclusion: The future of the newborn, born by emergency Cesarean
section is mixed; emergency control can improve the situation.