TITLE:
The Problem of Traditional African Pharmacopoeia in Obstetrics: Use of Plants for Utero-Tonic Purposes and Materno-Fetal Outcome in Douala (Cameroon)
AUTHORS:
Essome Henri, Mve Koh Valere, Nana Njamen Theophile, Boten Merlin, Ekono Michel Roger, Penda Ida Calixte, Tocki Toutou Grâce, Halle Ekane Gregory, Foumane Pascal, Mboudou Emile Telesphore
KEYWORDS:
Utero-Tonic Plants, Hyperkinesia, Fetal Distress, Caesarean Section
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.11,
November
11,
2019
ABSTRACT: Introduction: The use of traditional preparations for the induction or acceleration of
labor remains a common practice in our country in particular and in Africa in
general with sometimes derogatory outcomes for the mother and the fetus. Goal: The objective was to assess immediate maternal and neonatal outcomes in
women who reported having used the traditional pharmacopoeia for utero-tonic
purposes. Methodology: We conducted a multi-centric cross- sectional
study with prospective data collection in the maternities of the Laquintinie
Hospital, Bonassama District and Nylon Hospitals. It took place over a period
of seven months, from 1st October 2016 to 31st April 2017. This included all
women who reported having used the unconventional pharmacopoeia for utero-tonic purposes before or after contractions started.
The student and Chi-square tests were interpreted at the statistical threshold of 5% and the
95% confidence intervals. Results: We recruited 168 cases, 68.5% of the
245 women interviewed. The mean age was 27.1 ± 0.41 years; 55% of
our respondents had a secondary level of education; 80% of them were admitted at term and 43% were
multiparous. Nulliparity predisposed to traditional pharmacopoeia use (RR =
1.55, CI = 0.79 - 3.03) but primiparity reduced this risk (RR = 0.4, CI = 0.24 - 0.926).
Stimulation of labor was the first indication in 85% of women, the rectal
evacuation enema was the main route used (67%). The majority of plants used
were those of the families Asteraceae, Anthericaceae,
and Malvaceae. In per partum, 42% had a brilliant dilatation; there was
a statistically significant association between the occurrence of dynamic dystocia (CI = 0.28 - 1.54, p = 0.006) and the risk of perineal tear (RR = 3.13, CI = 1.68 - 5.85; p = 0.007). The APGAR score at 5 min of life was less than 7 in 64%
of cases (p = 0.027). The caesarean section rate was 69%. Conclusion: Traditional
products with uterotonic effects are frequently used and unregulated with its
corollary of materno-fetal complications.