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Biomedical subjects

I De Schampheleire

Publications and source records attributed to I De Schampheleire.

10 recordsLinked to original sources
PubMed1995

Oxytocics in developing countries.

OBJECTIVES: A prospective multicenter study of obstetric practices was conducted in three developing countries (Benin, Congo and Senegal) to analyze oxytocic use during labor. One of the objectives was to assess the possible negative effects of the treatment regimens instituted during the labor monitoring phase. METHODS: Four health districts participated in the study. All women who gave birth in one of the participating health facilities over a 6-month period in Benin and Congo, and over a 3-month period in Senegal, were recruited. The number of deliveries studied in each district varied from 457 to 1048. For each case a partogram was used to assess the progress of labor and the onset of dysfunctional labor. Information was collected on the risk factors for dysfunctional labor, stillbirths and resuscitation of the neonate. RESULTS: Each of the four collaborating centers used oxytocics preferentially to treat dysfunctional labor, but even in normal labor (i.e. with a normal partogram) oxytocics were used in 4.4-21.5% of cases. In normal labor the incidence of neonatal resuscitation was higher in cases with than in those without oxytocic use: the relative risks (R.R.) varied from 1.9 to 5.6; the odds ratios varied from 2.4 to 7.0, and both were statistically significant in the four settings. In addition the stillbirth rate was always higher, though not significantly, when oxytocics were used in normal labor (R.R. 1.2-2.2). When the data of the four centers were pooled, the global relative risk for stillbirths was 1.9, and the 95% confidence interval was 1.1-3.4. Logistic regression analysis was carried out for five confounding factors (primiparity, a previous complicated delivery, presence of meconium, ruptured membranes and educational level) to adjust the odds ratio for the risk of neonatal resuscitation when oxytocics were used in normal labor. Except in the case of Abomey in Benin, where the variable 'presence of meconium' decreased the odds ratio from 6.4 to 3.4, the adjusted odds ratios remained similar to their non-adjusted values. In cases of non-dysfunctional labor, nurses and midwives used oxytocics more often than lesser trained health personnel (R.R. 4.0 [3.2-5.1]). CONCLUSION: Our results show that an obstetric treatment which is safe when used in certain well-defined indications, may have significant negative effects when used in situations where the same technical quality of care cannot be guaranteed.

Developing Countries↗
PubMed1993

How accurate is maternal height measurement in Africa?

Maternal height is one of the risk parameters for dystocia that is often used in antenatal clinics which are organized by health centers and dispensaries in developing countries. In this paper, the results of an analysis on the reliability of height measurements in four African countries: Benin, the Congo, Senegal and Zaire are presented. Different causes appear to reduce this reliability: attraction to round numbers, assignment of some standard size, and in one situation an overrecording (probably intentional) of an at-risk woman. Different solutions are being suggested, and the importance of assessing the quality of risk factor measurement in improving the efficacy of the risk approach strategy is stressed.

Africa↗
PubMed1992

Value of the alert and action lines on the partogram.

A partogram based on a World Health Organisation model has been used for many years in the peripheral maternity clinics of Pikine, Senegal, to monitor labour. We have assessed the value of the partogram and efficacy of the alert and action lines. 1022 pregnant women were monitored by partogram during 4 months. The alert line was crossed in 100 (9.8%) of these cases and the frequency of neonatal resuscitation was higher for this group (relative risk 4.0, 95% confidence interval 2.3-7.1; p less than 0.0001), as was the number of "fresh" stillbirths (5.3, 1.8-15.6; p less than 0.01) (recent death may have occurred during labour). Among the women who crossed the alert but not the action line, neonatal resuscitation was also four times more likely than for the normal labour group (4.0, 2.1-7.6; p less than 0.001), and the fresh stillbirth rate was higher but not significantly so. For women who crossed both lines, the fresh stillbirth rate was ten times higher than for women in the normal labour group (9.9, 2.8-34.7; p less than 0.001). Crossing the alert line had a sensitivity of 27%, a specificity of 93%, and a positive predictive value of 17% for neonatal resuscitation. If the action line was chosen as the decision level, the positive predictive value remained the same but the sensitivity was only 8%. Health workers intervened (eg, artificial rupture of the membranes, administration of oxytocics) in half the dystocic cases. Of the women who did not receive any such treatment 44% crossed the action line compared with only 26% of those who did receive treatment (p = 0.06). The results show the usefulness and efficacy of the partogram and underscore the value of medical intervention as soon as the alert line is crossed.

Bias↗
PubMed1990

[Neisseria gonorrhoea in Pikine (Senegal): survey of antibiotic sensitivity].

The antimicrobial sensitivity of 96 strains of Neisseria gonorrhoeae, isolated in 1987-88 in Pikine, Senegal was determined. Twenty four percent of isolates produced beta-lactamase (PPNG). Among the beta-lactamase negative strains, 27% showed a decreased sensitivity to penicillin (MIC 0.125-0.25 mg/l) and 3% were resistant (MIC greater than or equal to 0.5 mg/l). Seventeen percent of isolates showed a decreased sensitivity to thiamphenicol (MIC 1-4 mg/l) and 7% were moderately resistant to tetracycline (MIC 2-4 mg/l). All isolates were sensitive to spectinomycin and sensitive to moderately sensitive to kanamycin. During an earlier survey performed in 1981, chromosomal resistance to tetracycline was not seen and only 4% of strains were beta-lactamase positive. These results suggest a decreasing antimicrobial sensitivity of N. gonorrhoeae in Pikine. Spectinomycin can be used as a first choice antimicrobial and thiamphenicol may be recommended as a valuable alternative treatment of gonorrhoea in Pikine, Senegal.

Drug Resistance, Microbial↗
PubMed1990

[Sexually transmitted diseases in the female population of Pikine, Senegal].

The prevalence of some sexually transmitted disease is determined in 250 gynaecology patients and in 200 pregnant women seen in primary health centers in Pikine, Senegal. The main reason for consultation at gynaecology is infertility. Gonorrhoea and Chlamydia trachomatis infection are present respectively in 1.5% and 7% of pregnant women and in 4.4% and 7.6% of gynaecology patients. Human papillomavirus infection, determined by DNA extraction and hybridization technique, is seen in 4% of obstetric and in 1.2% of gynecology patients. Cytological anomalies is found in 5.5% of pregnant women and in 4.8% of gynecology patients.

Adult↗