BIBLIOGRAPHIE

RECOMMANDATIONS.

 Au gouvernement de:

• Former les spécialistes en gynécologie et obstétrique pour chaque zone de santé afin d’améliorer la santé maternoinfantile dans notre système sanitaire du pays.

Au PNSR de:

• Développer une politique de suivi de grossesse sur utérus et de référence pour l’examen du neuvième mois par un obstétricien ;
• Améliorer la qualité des CPNs dans le vrai modèle recentré pour cette catégorie de femmes ;
• Etaler cette étude dans toutes les zones de santé au Sud-kivu.

Aux prestataires de:

• Disponibiliser les informations (indications, incident et technique) après chaque césarienne surtout la première pour préparer la suite ;
• Transférer les gestantes avec utérus multicicatriciel vers les HGR, capable d’offrir les SONU (obstétricien, anesthésiste-réanimateur, néonatologue et banque de sang) ;
• Réduire le taux de la première césarienne par des indications médicales pour diminuer le risque potentiel de césariennes multiples ;
• Développer le mode de counseling chez les gestantes dans le post partum ;
• Introduire l’audit obstétrical quotidien des indications de césarienne pour diminuer le taux de césariennes en cours de travail et incite à être actif en première comme en seconde partie du travail (Lasnet A, et al., 2014) ;
• Sensibiliser la communauté sur la morbidité et la mortalité maternoinfantiles liées à un utérus multicicatriciel ;
• Programmer les accouchements sur utérus cicatriciel ;
• Bien évaluer les dossiers des femmes pendant la gestion des grossesses sur utérus multicicatriciel.

Aux femmes porteuses des utérus multicicatriciel de :

• Respecter la fréquence des CPNs ainsi que les recommandations.

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