Practice of Obstetric Analgesia in Maternity of Kinshasa City

Abstract

Objective: The study was carried out to make an inventory of the practice of obstetrical analgesia in Kinshasa’s maternities. Methods: This is a transversal and multicenter study carried out from January 2017 to December 2018 in three maternity hospitals in Kinshasa where obstetric analgesia is regularly practiced. The collected data (women's characteristics, techniques used, complications and maternal satisfaction) were analyzed with SPSS 22.0 for p <0.05. Results: One hundred and twenty women were retained out of 4148 deliveries, i.e. 2.8%. The mean age was 31 ± 5.3 years. The majority of women (84.2%) had a university education. The primiparous represented 50.8% and at the beginning the average visual analogic scale was 9.1. Women were ASA I in 85.8% and all pregnancies were full term. Mean cervical dilation before analgesia was 4.5 ± 1.2 cm. Epidural analgesia (89.2%) was the most used technique using bupivacaine (93%) and fentanyl (60.3%). Spinal analgesia was used in 10%. The maintenance was done with the electric syringe pump in 80% and the analgesia was comfort in 86.7%. The mean dilation of the cervix before spinal analgesia was 7cm and 4cm for the epidural. Delivery was vaginal in 88.3% and cesarean section in 11.7% with failure to engage (50%) as the main indication. Arterial hypotension (8.3%) was the most frequent complication and 88.3% of the women declared themselves satisfied. Conclusion: Obstetric analgesia is practiced in Kinshasa, but still with a very low rate of achievement.