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Hemorrhages in the First Trimester of Pregnancy: Etiological Aspect and Management at the Maternity Ward of the Ignace Deen National Hospital of the University Hospital of Conakry

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 719-730页

作者： Fatoumata Bamba Diallo Elhadj Mamoudou Bah Massa Keita Mamadou Sanoussy Barry abdoul aziz Balde Mamadou Dian Balde Ibrahima Sory Balde Telly Sy University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any ca

关键词： Pregnancy First Trimester Hemorrhage Etiologies Management Ignace Deen Guinea

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Modern Postpartum Contraception: The Experience of Nabil Choucair Health Center, Dakar (Senegal)

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Open Journal of Obstetrics and Gynecology 2020年第7期10卷 930-945页

作者： Babacar Biaye Khadidiatou Ndour Omar Gassama Youssoupha Toure Mor Cissé Abdou Ndiaye abdoul aziz Diouf Mamour Gueye Alassane Diouf Jean Charles Moreau Gynecological and Obstetric Clinic of Aristide Hospital Le Dantec of Dakar Dakar Senegal

Introduction: In Senegal, according to the 2017 Demographic Health Survey, about 22% of married women have an unmet need for family planning. Globally, 61% of women do not have access to postpartum family planning. Material and Method: This is a prospective, descriptive and analytical study from March 05, 2017 to January 31, 2018. The interrogation was done in the hospital ward with filling in the data collection form. The data collected was first coded and then entered, using the sphinx software. The data analysis was done with Epi info version 7 software and included a descriptive and analytical component. Results: The average age of the patients was 26 years with extremes of 15 and 48 years. Average gestation was 2.3 with extremes of 1 and 8 pregnancies. More than half of the women (64.7%) had delivered by caesarean in an emergency setting. More than half of the women (66.7%) had chosen the hormonal contraceptive method within 48 hours of delivery and the implant was the type of contraceptive prescribed in almost half of the cases (49.3%). Conclusion: Integrating postpartum family planning into programs will ultimately help to dramatically decrease high-risk pregnancies, decrease the unmet need for family plannin

关键词： Contraception Postpartum Mother and Child Health

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Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

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Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： Fatoumata Dicko-Traoré abdoul Karim Doumbia Mariam Sylla Mariatou Traoré Djènèba Konaté Fatoumata Léonie Diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni Traoré abdoul aziz Diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

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Ovarian Pregnancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1446-1451页

作者： Hadja Maïmouna Barro Daff Brahima Donigolo Aïssatou Mbodji Khalifa Babacar Mansour Fall Youssoupha Touré Moussa Diallo abdoul aziz Diouf Alassane Diouf Cheikh Anta Diop University of Dakar Gynecological and Obstetrical Clinic Public Institution Aristide-Le Dantec Hospital Da-kar Senegal Department of Obstetrics and Gynecology University Hospital of Pikine Thiaroye Pikine Senegal

Background: Ovarian pregnancy is a rare entity of ectopic pregnancy, with a prevalence in the literature estimated between 1/2500 to 1/5000 births. The majority of ovarian pregnancies are diagnosed in the 1st trimester due to the noisy symptomatology. However, in small proportions, they may continue into the 2nd or 3rd trimester, making their diagnosis more difficult. Aim: We report a case of ovarian pregnancy in a 26-year-old patient, discovered intraoperatively as a large unruptured ovarian mass. Case report: A 26-year-old woman referred to the maternity ward for management of fetal death in utero at 31 weeks of amenorrhea associated with overlying placenta previa. Ultrasound performed in the department, was in favor of an abdominal pregnancy stopped at 31 SA with a placenta that seemed to adhere to the posterior wall of the uterus, which was empty. A Laparotomy was performed, on exploration, a large right ovarian mass was found, the site of the pregnancy. A right adnexectomy, after adhesiolysis, was performed. The incision of the operative part revealed a macerated female fetus. The clinical evolution was favorable. Conclusion: We report on a case of unruptured ovarian pregnancy, discovered in the 3rd trimester of pregnancy. The ultrasound diagnosis of an ovarian pregnancy beyond the 2nd trimester remains a challenge, the management remains surgical.

关键词： Ectopic Pregnancy Ovarian Pregnancy Adnexal Mass

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Study of Antenatal Care Completion Determinant Factors in Kedougou Health District (Senegal)

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1449-1470页

作者： Babacar Biaye David Ngom Moussa Ndiaye Fode Danfakha Omar Gassama abdoul aziz Diouf Adama Faye Dembo Guirassi Alassane Diouf Jean Charles Moreau Aristide Le Dantec Teaching Hospital Dakar Senegal kedougou Health District Kedougou Senegal Public Health Department Cheikh Anta Diop University Dakar Senegal Reproductive Health Department/Health Ministry Dakar Senegal

Introduction: Maternal mortality is a public health problem of more concern to developing countries. As part of improving the maternofoetal prognosis during pregnancy and childbirth, it is essential to carry out regular follow-ups of pregnant women (FE) through antenatal consultations (ANC). In fact, the World Health Organization (WHO) recommends at least four ANC at regular intervals during pregnancy. In Senegal the completion rate varies greatly depending on the region. In the District of Kédougou it was 41% in 2017 (DHIS2). The national target was not achieved despite the interventions. Thus we studied the determinants of CPN completion in the health district of Kedougou in 2017. Method: The study is of a descriptive and analytical cross-sectional type and concerned a sample of 884 women who gave birth between October 2017 and September 2018. They were chosen by a sample whose distribution in the district was made according to the quota method while respecting the demographic weight of each area of responsibility of the District. Results: The results of our study showed that the average age of women was 24 years with an average number of pregnancies equal to 3. The ANC completion rate at 37% was lower than the administrative data rate which was 41%. The determinants with a statistically most significant link with the completion of ANC are respectively satisfaction with the care and quality of service, the level of information of women regarding PNC, marital status, affordability and distance from the location of t

关键词： Prenatal Consultation Completion Kédougou

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Effect of the Covid-19 Pandemic on Prenatal Consultations for Pathological Pregnancies at the Maternity Unit of Abass Ndao Hospital, Dakar, Senegal

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Open Journal of Epidemiology 2022年第4期12卷 421-430页

作者： abdoul aziz Ndiaye Djiby Sow Nogaye Dieye El Hadji Gueye Boubacar Gueye Alioune Badara Tall Papa Gallo Sow Oumar Sidibe Ousseynou Ka Université Alioune Diop de Bambey Bambey Sénégal Université Cheikh Anta Diop de Dakar Dakar Sénégal Centre Hospitalier Abass NDAO Dakar Sénégal Centre Africain d’Etudes Supérieures en Gestion Dakar Sénégal

Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass NDAO Hospital Centre. Materials and Methods: This was primarily a retrospective study conducted at the Abass NDAO Hospital maternity ward. The target was the medical records of women followed for a pathological pregnancy at maternity from July 2019 to November 2020. Second, the department’s qualified staffs were asked about their experiences with the Covid-19 pandemic. Data collection was carried out between October 2021 and February 2022. Results: A total of 690 prenatal charts for pathological pregnancy were collected: 375 (54%) before the pandemic compared to 315 during Covid-19 (46%). The average age of women was 28.15 years. The age group 25 and 35 was the most represented (36.81%). Reasons for consultation were dominated by threats of premature delivery (51%), followed by severe pre-eclampsia (14%) and premature membrane rupture (11%), respectively. The frequency of prenatal consultations (PNCs) was inversely related to pandemic dynamics and significant monthly variations were observed. Qualified health personnel were midwives (71.40%) and gynecologists (28.60%). During the pandemic, more than the majority of staff (67%) worked 3 days a week, and 24% of health workers 5 days. The majority of staff (60%) reported experiencing overwork during the pandemic. Non-compliance with consultation days was noted in 38% of health providers. Protective equipment was not provided to 14% of the staff. Staff difficulties during prenatal consultations were fear of occupational exposure (12%) and patient reluctance (88%). Conclusion: The Covid-19 pandemic is having a major impact on prenatal consultations for pathological pregnancies at Abass NDAO Hospital. Effective measures must be taken to avoid the consequences of maternal mortality and the functioning of the s

关键词： Pandemic Covid-19 Pathological Pregnancy

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Assessment of Obstetric Evacuations: Received during the Year 2020 at the Touba Ndamatou Public Health Hospital Establishment

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Open Journal of Obstetrics and Gynecology 2022年第6期12卷 528-540页

作者： Babacar Biaye Mouhamadou Wade Daba Diop Abdou Karim Diallo Mor Ndiaye Alioune Diop Awa Ndiaye Mamadou Sene abdoul aziz Diouf Mamour Gueye Université Cheikh Anta Diop Dakar Senegal

The counter-referral system is particularly important for care during pregnancy, childbirth and the post-partum period as it facilitates access to emergency obstetric and neonatal care. It allows people to access care that is not likely to be provided at the base and to manage certain complications arising in emergency settings. We therefore looked at the evaluation of obstetric evacuations from the Touba Ndamatou public health. Methodology: This was a retrospective study of descriptive and analytical type extending over a period of 12 months from January 1, 2020 to December 31, 2020 at the public hospital health establishment (PHHE) of Touba Ndamatou. Results: One thousand five hundred and sixty (1560) patients evacuated for obstetrical reasons were collected out of a total admission of 5560, i.e., a frequency of 28%. The average age of the patients was 25.54 years. The mean gestation was 3.24 pregnancies. The average parity was 3.04 deliveries. Almost all of our patients (99%) were married. Slightly more than one in two women (53.6%) had performed at least 2 or 3 Prenatal consultations. 80% of parturients had traveled a distance of less than 20 km. 623 patients came by their own means (54.6%). Evacuation was provided by an ambulance in 509 patients, i.e., 44.6%. Arterial hypertension and its complications were the frequent reason for evacuations with approximately one in four patients (26.2%). Only 3.6% of patients had qualified personnel on board being evacuated. In our series, 13 deaths were recorded, i.e., 1.1% of cases. The distance traveled seemed not to influence the future of the mother (p = 0.51). The non-accompaniment of the patient during the evacuation by a medical staff seemed to influence the prognosis of the mother (p = 0.031). Fetal morbidity was higher among evacuees not accompanied by medical personnel. The state of apparent death was observed in the majority of cases in patients received over a distance of more than 20 km. Conclusion: Evacuation

关键词： Evacuation Pregnancy Senegal

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Epidemiological and Clinical Aspects of Abnormal Movements in Children from 2 Months to 15 Years in the Pediatric Department of Gabriel Toure University Hospital Centre of Bamako

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Open Journal of Pediatrics 2022年第1期12卷 170-178页

作者： Karamoko Sacko Djeneba Konaté Amadou Touré Belco Maiga Fousseyni Traoré Adama Dembelé Pierre Togo abdoul Karim Doumbia Andoule Guindo Rokia Togola Oumar Coulibaly Diakite Fatoumata Léonie Francois Ibrahima Ahamadou Kalirou Traoré abdoul aziz Diakité Boubacar Togo Gabriel Toure University Hospital Centre Bamako Mali University Hospital Centre Point G Bamako Mali

Introduction: Abnormal or involuntary movements correspond to a disorder in the programming and/or execution of movement. They have two characteristics;they are hardly or not at all controlled by the will and occur in the absence of any paralysis. Objective: To determine the epidemiological, clinical and etiological characteristics of abnormal (involuntary) movements in children aged 2 months to 15 years. Patients and Methods: This was a prospective, descriptive study from January 2016 to December 2018 of children aged 2 months to 15 years seen in neuropediatric consultations for abnormal movements. Results: During the study period 1920 children were seen in neuropediatric consultations and 57 presented with abnormal movements, i.e. a frequency of 2.96%. Children aged between 6 and 60 months were the most affected (54.4%). The sex ratio was 1.53. Movement abnormality was the most common reason for consultation (45.7%), followed by apyretic convulsions (28%), and laxity (5.3%). The onset was progressive in 68.4% of children. The main types of abnormal movements were chorea (31.6%), dystonia (26.3%), myoclonus (17.5%), tremor in 10.5%. The causes were infectious (73.68%). Conclusion: Abnormal movements are rare in paediatric practice. They have multiple causes and their management is urgent in certain situations that can jeopardise the future of children.

关键词： Abnormal Movements Convulsions Children Bamako

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Large Basilar Trunk Aneurysm Discovered Incidentally in a Patient with Ischaemic Stroke: Case Report

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World Journal of Cardiovascular Diseases 2023年第11期13卷 811-817页

作者： Wendlassida Martin Nacanabo Yannick Laurent Tchenadoyo Bayala abdoul Nassir Porgo Emilie Agathe Carama Bademain Jean Fabrice Ido Taryètba André Arthur Seghda Wendlassida Léa Francoise Sawadogo Sidy Mahamoud Guebre abdoul-aziz Christian Napon André K. Samadoulougou Cardiology Department Bogodogo University Hospital Ouagadougou Burkina Faso Rheumatology Department Bogodogo University Hospital Ouagadougou Burkina Faso Neurology Department Bogodogo University Hospital Ouagadougou Burkina Faso

Summary: Many anomalies can be observed in the basilar trunk, such as aneurysms. Basilar trunk aneurysms are rare with a low reported prevalence. In this study, we describe a case of ischaemic stroke revealed by a basilar trunk aneurysm associated with venous thromboembolic disease. The patient was 60 years old and had no specific pathological history. She was seen for a sudden onset of right hemiplegia associated with dysarthria that had been present for 12 hours. The physical examination revealed a pyramidal syndrome and an altered general condition. An emergency cerebral computed tomography (CT) scan showed evidence of a cerebrovascular accident associated with a saccular aneurysm. We adopted the diagnosis of a deep left sylvian stroke associated with a superficial right sylvian stroke in the setting of an incidentally discovered basilar trunk aneurysm. On the 9ème day of hospitalisation, the patient experienced sudden onset of respiratory distress in conjunction with a warm, painful swelling of the right leg. TTE revealed signs of pulmonary embolism, with thrombi in the inferior vena cava and right atrium. Pulmonary embolism was highly probable, with a modified Geneva score of 15. We adopted the diagnosis of DVA complicated by pulmonary embolism in the setting of a basilar trunk aneurysm. The patient was transferred to the cardiology department, where she received oxygen therapy and thrombolysis with streptokinase. The immediate outcome 6 hours later was the sudden death of the patient due to the onset of cardiogenic shock.

关键词： Aneurysm Ischemic Stroke Thrombolysis

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Assessment Postpartum Glucose Status among Women with Gestational Diabetes: Experience of a Sub-Saharan African Endocrinology Department

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Journal of Diabetes Mellitus 2020年第3期10卷 124-131页

作者： Ngoné Diaba Diack Aminata Mbaye Nafy Ndiaye Yakham Mohamed Leye abdoul aziz Diouf Mamadou Ba Khadidja Samb Papemomar Guisse abdoulaye Leye Alassane Diouf Endocrinology-Diabetology Department Teaching Hospital of Pikine Dakar Senegal Obstetrics and Gynécology Department Teaching Hospital of Pikine Dakar Senegal

Background: Women with gestational diabetes mellitus (GDM) have a significantly increased risk for developing type 2 diabetes after delivery. The purpose of this study was to determine the postpartum glycemic status among women with GDM in an Endocrinology-Diabetology department in Sub-Saharan Area. Methods: It was a prospective cohort study conducted between January 1, 2013, and July 31, 2018 (over period of 5 years and 7 months) at Pikine National Hospital, Dakar, Senegal. Postpartum glucose status was evaluated at least 6 weeks post-partum among women with history of GDM according to IADPSG criteria. The glycemic status after delivery was pointed referring to 2006 WHO criteria. Results: Overall 53 patients were included in this study. Fasting plasma glucose was performed as a screening test in 94% of the cases. A type 2 diabetes after GDM as diagnosed in 6 patients, accounting for a prevalence of 11.32%. An Impaired Fasting Glucose (IFG) was revealed in 5 patients (9.43%). The patients underwent a screening test in the first year after delivery in 54.70% of the cases, over a half of whom during the post-partum period range from the 6th to the 12th week. Insulin usage during pregnancy was statistically correlated with the occurrence of postpartum diabetes. Conclusion: Diabetes prevention and early diagnosis require a glycemic status monitoring among women with history of GDM.

关键词： Gestational Diabetes Mellitus Postpartum Glucose Status Type 2 Diabetes Africa IADPSG

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