Introduction: Severe preeclampsia is a frequent
cause of maternal death, and also a frequent indication for caesarean
deliveries when faced with the need to expedite delivery. We sought
complications specific to caesarean deliveries in patients with severe
preeclampsia. Methods: It was a case-control study carried out over 6 months,
from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the
Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women
undergoing a caesarean delivery to assess the risk of maternal and foetal
postoperative complications in patients with severe preeclampsia. Significance
level was set at 0.05. Results: The incidence of postoperative complications
stood at 26.4%. Maternal and foetal complications were more frequent in
preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9%
(p < 0.05) respectively. The incidence of adverse events was greater in
women with preeclampsia: pruritus and limb pain (RR = 2.96; p < 0.001), the
persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death
(RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001)
headaches resistant to first-line analgesics (RR = 3, p < 0.001),
Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute
pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p <
0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane
disease (RR = 2.93, p < 0.001). Conclusion: Severe preeclampsia is
associated with an increased risk of postoperative complications.
References
[1]
WHO Statement on Caesarean Section Rates.
http://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf
[2]
Marc, H. (2007) Operative Delivery. In: Alan, H.D. and Lauren, N., Eds., Current Obstetrics and Gynecological Diagnosis and Treatment, 10th Edition, MC Graw Hill Publishers, New York, 469-476.
[3]
Kemfang Ngowa, J.D., Ngassam, A., Tsuala Fouogue, J., Metogo, J., Medou, A. and Kasia, J.M. (2015) Early Maternal Complications of Caesarean Section about 460 Cases in Two University Hospitals in Yaoundé. Pan African Medical Journal, 21, 6967. (In French)
[4]
Nkwabong, E., Kouam, L., Wamba, T., Ngassa, P., Doh, S.A., Mve, K.V., et al (2006) Indications of Caesarean Section at the Maternity of Yaounde University Hospital Centre. Clinics in mother and Child Health, 3, 453-455. (In French)
[5]
Langer, M. (2012) The Rate of Caesareans: A Problem of Modern Obstetrics? Speculum-Zeitschrift für Gynakologie und Geburtshilfe, 30, 7-9. (In French)
https://www.kup.at/kup/pdf/10678.pdf
[6]
Mboudou, E.T., Foumane, P., Belley Priso, E., Dohbit, J., ZeMinkande, J., Nkengafac, W.M., et al (2009) Hypertension during Pregnancy: Clinical and Epidemiological Aspects at the Gyneco-Obstetrics and Pediatric Hospital of Yaounde. Clinics in mother and Child Health, 6, 1087-1093. (In French)
[7]
WHO (2013) WHO Recommendations for Prevention and Treatment Preeclampsia and Eclampsia: Implications et actions. (In French) http://whqlibdoc.who.int
[8]
Chaoui, A., Tyane, M. and Belouali, R. (2002) Management of Pre-Eclampsia and Eclampsia. 2nd National Consensus Conference Morocco. (In French)
http://www.scolarite.fmp-usmba.ac.ma
[9]
Some Der, A., Ouattara, S., Barro, D., Traoré, A., Bamabara, M. and Dao, B. (2010) Audit of Caesarean Section in Africa. Revue Médicale Rwandaise, 10, 32. (In French)
[10]
Elongui, J.P., Tandu, B., Spitz, B. and Verdonck, F. (2011) Influence of Seasonal Variation on the Prevalence of Preeclampsia in Kinshasa. Gynécologie Obstétrique & Fertilité, 39, 132-135. (In French) https://doi.org/10.1016/j.gyobfe.2010.12.010
[11]
Mbu, R.E., Dempouo, Nana, P.N., Tonye, R.N., Ako, S., Eteki, N. and TandLeke, R.I. (2006) Maternal-Fetal Outcome in Eclampic Women Delivered by Caesarean or by Vaginal Route of the Three Tertiary Hospitals in Yaounde. Clinics in mother and Child Health, 3, 555-562. (In French)
[12]
Essiben, F., Itembe, O., Foumane, P., Tsafack de Nguefack, M. and EkoEko, F. (2016) Blood Uric Acid Level as a Marker of Increased Risk of Eclampsia in Severe Pre-Eclamptic Patients: A Cross-Sectional Study in Two Tertiary Hospitals of Yaoundé, Cameroon. Health Sciences and Diseases, 17, 7-11.
[13]
Bourré, P. (2012) Pre-Eclampsia Risk Factors. Médecine et santé Tropicales, 22, 263-264. (In French)
[14]
Cisse, C.T., Faye Dieme, M., Ngabo, D., Mbaye, M. and Moreau, J.C. (2003) Therapeutic Indication and Prognosis of Eclampsia at the University Hospital of Dakar. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 32, 239-245. (In French)
[15]
Nejad, S.B., Allegranzi, B., Syed, S.B., Ellis, B. and Pitte, D. (2011) Healthcare-Related Infections in Africa: A Systematic Study. Bull OMS, 89, 701-776. (In French)
[16]
Lilford, R.J., Van Coeverden De Groot, H.A., Moore, P.J. and Bingham, P. (1990) The Relative Risks of Cesarean Section (Intrapartum and Elective) and Vaginal Delivery: A Detailed Analysis to Exclude the Effects of Medical Disorders and Other Acute Preexisting Physiological Disturbances. British Journal of Obstetrics and Gynaecology, 97, 883-892. https://doi.org/10.1111/j.1471-0528.1990.tb02442.x
[17]
Cissé, C.T., Andryamady, C., Faye, O., Diouf, A., Boulin, D. and Diadhiou, F. (1995) Indication and Prognosis of the Cesarean Section at the CHU of Dakar. Journal of Gynecology Obstetrics and Human Reproduction, 24, 194-197. (In French)
[18]
Fomulu, J.N., Tchana, T.M., Nana, N.P., Mbu, R. and Kasia, J.M. (2009) Maternal Mortality at the Yaoundé General Hospital: Retrospective Study over 5 Years (2002-2006). Health Sciences and Diseases, 10. (In French)
http://www.hsd-fmsb.org/index.php/hsd/article/view/48
[19]
Beye, M.D., Ndiaye, J., Diouf, E., Leye, P.A. and Sall, K.B. (2008) Caesarean Section Anaesthesia: Evaluation of the Quality of Care through a Multicentre Study Carried out in Three Hospitals in Dakar. Journal maghrébin d’anesthésie-réanimation et de médecine d’urgence, 15, 176-180. (In French)
[20]
SimaZue, A., Bang Ntamack, J. and Biyogo, P. (2009) Management of Headache after Spinal Anaesthesia in an African Hospital. Journal Canadien D’anesthésie, 56, 549-550.
[21]
Lee, K., Sohn, Y., Kim, S. and Sunwoo, N. (2002) Basilar Artery Vasospasm in Post-Partum Cerebral Angiopathy. Neurology, 54, 2003-2005.
https://doi.org/10.1212/WNL.54.10.2003
[22]
Sabiri, B., Moussalit, A., Salmi, S., El Youssoufi, S. and Meguel, M. (2007) Postpartum Eclampsia: Epidemiology and Prognosis. Gynecoobstbiologie Reproduction, 36, 276-280. (In French)
[23]
Pambou, O., Ekoundzola, J.R., Malanda, J.P. and Bouambo, S. (1999) Management and Prognosis of Eclampsia at the University Hospital Centre of Brazaville: About a Retrospective Study of 100 Cases. Médecine d’Afrique Noire, 46, 508. (In French)
[24]
Chérif, A., Ben Jemaa, W., Kacem, G.N., Jebnoun, S. and Khrouf, N. (2008) Preeclampsia Increases the Risk of Hyaline Membrane Disease in Premature Infants: Controlled Retrospective Study. Journal of Gynecology Obstetrics and Human Reproduction, 37, 597-601. (In French)
