[Knowledge of breastfeeding among mothers before maternity discharge]

OBJECTIVES

The aim of our study was to assess the knowledge of parturients about breastfeeding and to analyze the factors influencing this level of knowledge.

METHODS

It was a prospective, descriptive and analytical, cross-sectional study carried out over a period of six months including 500 parturients who gave birth at the maternity unit of the National Center for Maternity and Neonatalogy of Tunis during the period from July to December 2020. Sociodemographic, obstetrical and breastfeeding related data were collected through individual interviews carried out before leaving the postpartum service using a questionnaire written in Tunisian dialectal Arabic.

RESULTS

The average age of the mothers was 31.5 years. Housewives accounted for 73.3 % of cases. Forty-four percent of the women surveyed were first-time mothers. The main source of information was relatives (74.8 %). The prevalence of breastfeeding was 93.8 %. Knowledge about breasfeeding was insufficient in 76.4 % of cases. The level of knowledge was insufficient in particular regarding signs of effective breastfeeding, signs of awakening of the newborn, lactogenesis, and diet of breastfeeding women. Unemployment of the parturient age over 30 and primiparity negatively influenced the knowledge of parturients.

CONCLUSION

The level of knowledge of parturients was heterogeneous but generally insufficient. Health education programs on MA targeting subjects most at risk of insufficient knowledge should be put in place in order to improve the knowledge base and hopefully improve the breastfeeding rates.

Bishop Score vs. ultrasound cervical length in the prediction of cervical ripening success and vaginal delivery in nulliparous women

AIM

The aim of this paper was to compare the predictive value of Bishop Score and sonographic measurement of cervical length for predicting cervical ripening success and vaginal delivery in nulliparous women with low Bishop Score.

METHODS

A prospective observational study including 77 nulliparous pregnant women at exactly 41 weeks of gestation with a Bishop Score ≤ 5. Cervical measurement was performed by transvaginal ultrasonography and Bishop Score was determined by digital examination. All patients had cervical ripening with Prostaglandins prior to labor induction with oxytocin.

RESULTS

Cervical ripening was successful in 63 patients (81%) and vaginal delivery occurred in 51 women (66.2%). Multiple logistic regression analysis demonstrated cervical length assessed by transvaginal sonography as the only independent predictor of successful cervical ripening and vaginal delivery. The best cut-off point was 34.6 for predicting successful cervical ripening and 32.5 mm for predicting vaginal delivery. The chance of vaginal delivery was 90% when initial cervical length was < 32.5 mm and 50% when cervical length was >32.5 mm.

CONCLUSION

Compared with the Bishop score, ultrasound cervical length measurement is a better predictor of cervical ripening success and vaginal delivery in nulliparous women at 41 weeks of gestation with an unfavorable cervix.

[Endometrial ossification. 6 cases]

Endometrial ossification is a rare and benign pathology. The etiopathogenesis of this pathology is controversial. Findings suggestive of diagnosis are fairly well know, menstrual irregularities is the main clinical symptoms, expulsion of bony fragments is a rare but pathognomonic event. Pelvic ultrasonography suggested an intrauterine foreign body and hysteroscopy was necessary to make the correct diagnosis. Six cases of endometrial ossification diagnosis and treated at obstetrics and gynaecology department A of centre of La Rabta teaching hospital (Tunis) are reported.

[Fetal pathology study of 88 cases of letal spina bifida]

Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.