Guèye S M, Moreau J C, Moreira P, Faye E O, Cissé C T, De Bernis L, Diadhiou F
Clinique Gynécologique et Obstétricale, CHU Le Dantec, 3, avenue Pasteur, BP 6758, Dakar, Sénégal.
J Gynecol Obstet Biol Reprod (Paris). 2001 Nov;30(7 Pt 1):700-5.
National prospective descriptive study on dystocia were conducted in Senegal in 1992 and 1996. We examined more closely the data on uterine rupture to determine trends between these two surveys.
Data were collected for all patients undergoing an obstetrical intervention between January 1st and December 31st in 1992 and in 1996 in one of the referral maternity-obstetrical surgery units in each of the 10 regions in Senegal.
The rate of uterine rupture was 1 per 51 interventions in 1992 (1.87%) versus 1 per 53 interventions in 1996 (1.94%). This dramatic event was recurrent in 7 of the 10 regions. The patients involved were aged 25-35 years (68% in 1992 versus 70% in 1996), multiparous or grand multiparous (52% in 1992 versus 70% in 1996), illiterate (90%), with poor follow-up (less than 3 prenatal consultations in 56% of the cases), and were generally evacuated to the unit (80% in 1992 versus 97% in 1996) without medical care (55%). Maternal mortality was high (28% in 1992 versus 12% in 1996). Infant mortality was also very high (98% in 1992 versus 86.6% in 1996). Conservative treatment of uterine rupture was used increasingly: the rate of conservative suture rose from 3.3% in 1992 to 22% in 1996.
Prevention is a challenge for healthcare workers, public authorities and the population in general. Health policy should be directed towards forming general practitioners in obstetrical surgery. Emergency surgery kits should be made available to improve the quality of care in all maternity units throughout the country.
1992年和1996年在塞内加尔开展了关于难产的全国前瞻性描述性研究。我们更仔细地研究了子宫破裂的数据，以确定这两次调查之间的趋势。
收集了1992年和1996年1月1日至12月31日期间在塞内加尔10个地区的每个地区的一家转诊产科-妇产科手术单位接受产科干预的所有患者的数据。
1992年子宫破裂发生率为每51次干预1例（1.87%），1996年为每53次干预1例（1.94%）。这一严重事件在10个地区中的7个地区反复出现。涉及的患者年龄在25 - 35岁之间（1992年为68%，1996年为70%），多产或经产妇（1992年为52%，1996年为70%），文盲（90%），随访不佳（56%的病例产前检查少于3次），并且通常在没有医疗护理的情况下被送往该单位（1992年为80%，1996年为97%）（55%）。孕产妇死亡率很高（1992年为28%，1996年为12%）。婴儿死亡率也非常高（1992年为98%，1996年为86.6%）。子宫破裂的保守治疗使用得越来越多：保守缝合率从1992年的3.3%上升到1996年的22%。
预防对医护人员、公共当局和普通民众来说都是一项挑战。卫生政策应致力于培养产科手术方面的全科医生。应提供急诊手术套件，以提高全国所有产科单位的护理质量。
