[Results of the ruptured pregnant uterus at Kinshasa University Clinics. Apropos of 24 cases from 1973 to 1980].
Rupture of a pregnant uterus is still a dramatic occurrence in Africa and is particularly serious for the newborn. All the same, scrupulous observation in high-risk pregnancies in the labour ward, which is the best place for the uterus to rupture if it must, can lead to a lessening of the chances of this occurring and even to eliminating this serious obstetric complication. 48,685 deliveries occurred in the university clinics of Kinshasa (Zaïre) in the 8 years between 1 January 1973 and 21 December 1980. There were 24 cases of ruptured uterus diagnosed. Before delivery the clinical signs were found in 15 cases; out of which the Bandl-Frommel ring occurred 7 times, vaginal bleeding and the fetus palpable under the abdominal skin 4 times. Very heavy vaginal bleeding was the clue to the diagnosis in 9 cases discovered after delivery. There were 15 cases of complete rupture, 9 of which occurred in healthy uteruses. More frequently, however (13 out of 24 cases) a scarred uterus was the site and partial rupture occurred in 7 out of 9 cases. In these 8 years the yearly increase in the number of deliveries was 738. The prognosis for the mother and fetus improved. They dropped to 4.16%, or 1 maternal death, and 46% or 11 fetal deaths, whereas they had been previously 14.2% and 50% in the years between 1 January 1967 and 31 July 1972. Depending mainly on pre-, intra, and postoperative resuscitation, surgical treatment consisted of repairing the rupture (17 cases or 70.83%) and in carrying out hysterectomy in 7 cases (29.16%).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D015023:Democratic Republic of the Congo; D005260:Female; D006801:Humans; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012421:Rupture; D014599:Uterus / Q000293:injuries*
Evolution des ruptures de l'utérus gravide dans les cliniques universitaires de Kinshasa. A propos de 24 observations de 1973 à 1980.