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Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health

Open Journal of Obstetrics and Gynecology 2018年第1期8卷 1-9页

作者： Youssouf Traoré Ibrahima Téguété amadou bocoum Mamadou Traoré Seydou Dao Marion Koko Bomini Niani Mounkoro amadou Dolo Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X2 or Fisher test, its 95% confidence interval (CI95%), p value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009;RR = 3.04;CI95% [2.80 - 5.11]), prolonged labor (p = 0004;RR = 4.00;CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;RR = 1.47;CI95% [1.17 - 3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

关键词： Early Postpartum Hemorrhage Risk Factors Surgery Maternal Death

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The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 158-169页

作者： Traoré Youssouf Téguété Ibrahima Dicko Fatoumata Traoré bocoum amadou Fané Seydou Traoré Tidiani Traoré Mamadou Salia Dao Seydou Touré Moustapha Varol Nesrin Dolo amadou Department of Gynaecology and Obstétrics Gabriel TOURE Teaching Hospital Bamako Mali Department of Pediatics Gabriel TOURE Teaching Hospital Bamako Mali Department of Gynaecology and Obstétrics Regional Hospital of Segou Bamako Mali Department of Gynaecology and Obstétrics Point G Teaching Hospital Bamako Mali Motherhood Unit of “Csref Commune II” Bamako Mali Department of Gynaecology and Obstétrics “Hopital du Mali” Teaching Hospital Bamako Mali Sydney Gynaecology & Endometriosis Centre Sydney Medical School The University of Sydney Sydney Australia

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0

关键词： Low Birth Weight Human Immunodeficiency Virus Infection Mother to Child Transmission Newborn Death Mali

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Epidemiology, the Main Reasons and Maternal-Fetal Complications of Unassisted Childbirth in the Health District of V Bamako Commune, Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1381-1395页

作者： Soumana Oumar Traoré Cheickna Sylla Saleck Doumbia Alou Samaké amadou bocoum Seydou Fané Rokiatou Torian Sangaré Fatoumata Keita Ibrahima Tegueté Youssouf Traoré Niani Mounkoro Mamadou Traoré amadou Ingré Dolo Obstetric Gynecology Department The Reference Health Centre of Commune V Bamako Mali Obstetric Gynecology Department The Koutiala Reference Health Centre Koutiala Mali Obstetric Gynecology Department The Commune VI Reference Health Centre Bamako Mali Obstetric Gynecology Department The Gabriel Touré University Hospital Centre Bamako Mali

Objective: To describe the epidemiological aspects, to determine the reasons leading women to give birth outside of health facilities and to determine the maternal prognosis. Patients and Methods: This was a cross-sectional, analytical, quantitative and qualitative descriptive study over a period from 1 June to 31 December 2016 (7 months) on unassisted childbirth in the health district of commune V of Bamako. Results: We recorded 70 unsured deliveries, a frequency of 1.04% out of a total of 6719 deliveries. The extreme ages were 15 years and 41 years with an average age of 28 years. 90% of the birth attendants were married and 10% were single. The women's profession: 48% were housewives, 11% saleswomen, 13% hairdressers, 4% female teachers. Education level: 71% were uneducated and 29% educated. Among those who are educated, their level was primary in 50%, secondary in 32% and higher in 18%. 42% had done antenatal consultation. The main reasons: ignorance of work 44.3%;religious beliefs and societal burdens 10.0%;fear of caesarean section 4.3%;late-night birth labour 5.7%;lack of financial and/or transport means 17.1%; distance from the locality 2.9%;insecurity 2.9%. Maternal and perinatal prognosis: complications were mostly hemorrhagic and concerned 27 (39%) patients. These included uterine atony (13 cases), placental retention (8 cases), soft pa

关键词： Childbirth Unsured Reasons

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Prognosis of Pregnancy and Childbirth in Heart Operated Patients: Experience in a 3 Referral Hospital in Mali, Case of the Gabriel University Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2021年第12期11卷 1875-1887页

作者： Fané Seydou Sanogo Siaka Amara bocoum amadou Sylla Checkna Kante Ibrahima Traore Youssouf Tegueté Ibrahima M. Traoré Mounkoro Niani A. Dolo UTH Gabriel Toure Bamako Mali Point G Hospital Teaching Bamako Mali

Introduction: In sub-Saharan Africa and Mali, young women who have had heart surgery want to become pregnant. The occurrence of pregnancy in these women who have had heart surgery is becoming more and more frequent in our country because of the persistence of acute rheumatoid arthritis (RAA) and especially the increasingly easy access to heart surgery. General Objective: To study the evolution of pregnancy and the prognosis of childbirth in women who have undergone heart surgery. Methodology: This was a retrospective and descriptive study that took place over a period of five (5) years in the gynecology-obstetrics department of University Teaching Hospital (UTH) Gabriel Touré and the cardiology department of UTH Luxembourg. Was included in the study any pregnant woman admitted to the gynecology-obstetrics department of UTH Gabriel Touré and having a history of heart surgery. The variables studied were the socio-demographic characteristics, the type of heart disease, the management, the evolution of the pregnancy and the prognosis. Data was typed on word processor, Excel and analyzed on Epi info and SPSS. The Chi square or Fisher exact test (for the number

关键词： Cardiac Surgery Pregnancy Prognosis

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HIV/AIDS Screening in the African Birthplace (Hospital in Kayes, Mali)

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 279-287页

作者： Mahamadou Diassana Ballan Macalou Sitapha Dembele A. Sidibe M. Diallo Soumana Oumar Traore Cheickna Sylla amadou bocoum Ibrahima Teguete Youssouf Traore Obstetrics and Gynecology Department at Fousseyni DAOU Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Centre in Bamako Commune V Bamako Mali Department of Obstetrics and Gynecology at Gabriel Toure University Hospital Bamako Mali

Purpose: The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. Materials and Methods: This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. Results: During our study period, we recorded 4269 deliveries. HIV-positive patients known before labour accounted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20 -

关键词： Screening HIV/AIDS Parturients Delivery Room

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Pregnancies without Prenatal Care in the Health District of Commune V in Bamako: Obstetrical Prognosis

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Open Journal of Obstetrics and Gynecology 2020年第8期10卷 1086-1092页

作者： Traoré Soumana Oumar Sylla Cheickna Samaké Alou Doumbia Saleck bocoum amadou Fané Seydou Sangaré Rokiatou Toriane Kéita Fatoumata Tégueté Ibrahima Traoré Youssour Mounkoro Niani Traoré Mamadou Dolo amadou Ingré Healthcare Centre in Commune V Bamako Mali Healthcare Centre in Koutiala Koutiala Mali Healthcare Centre in Commune VI Bamako Mali Gabriel Touré University Hospital Center Bamako Mali

Summary: We attempted to determine the obstetric prognosis of women without antenatal care in the Health District of Commune V of Bamako, Mali. Materials and Methods: We undertook this retrospective case-control study from January 1 to March 31, 2017. Of all women having given birth to during this period in this district, we compared characteristics and obstetric outcomes between women without antenatal care (study group) vs. those with antenatal care (age/parity matched control). Results: 13.8% of women were without antenatal care (23.45 ± 9.56 years of age: 13 - 42). Study group (without antenatal care), compared with control, was significantly more likely to be household helpers (OR = 2.5 [2.0 - 3.4]) and single (OR = 2.3 [1.8 - 2.8]). Study group women were more significantly likely to have the following poor obstetric outcomes: premature rupture of the membranes, post-maturity, low birth weight, hypertensive disorders of pregnancy, uterine rupture, fetal death, anemia, fetal malposition, cesarean section, postpartum hemorrhage, puerperal infection and maternal death. Study group showed a higher risk of early neonatal death, low Apgar score, and transfer to Neonatology institute. Conclusion: In accordance with the previous reports in any other countries, no prenatal checkup causes higher poor outcome of both mothers and infants/neonates also in this area.

关键词： Absence of Prenatal Follow-Up Obstetrical Prognosis

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Sacrospinous Fixation in the Gynecology Department of Hôpital du Mali

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Open Journal of Obstetrics and Gynecology 2021年第1期11卷 20-26页

作者： Traoré Alassane Sissoko Abdoulaye Coulibaly Mamadou Bakary Traoré Soumana Oumar Sima Mahamadou bocoum amadou Traoré Soumaila Touré Moustapha Tegueté Ibrahima Traoré Youssouf Obstetrics and Gynecology Department at Hopital du Mali Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Mère-Enfant Bamako Luxembourg Obstetrics and Gynecology Department at the Referral Health Center Commune V Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Point G Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Gabriel Touré Bamako Mali Obstetrics and Gynecology Department at the Regional Hospital of Sikasso Sikasso Mali

Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du Mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. During the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital st

关键词： Sacrospinous Fixation Genital Prolapse Hôpital du Mali

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Maternal Deaths in Patients Evacuated to the Fousseyni Daou Hospital in Kayes over a Decade

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1389-1398页

作者： Mahamadou Diassana Sitapha Dembele Ballan Macalou Alima Sibibe Falaye Keita Mamadou Haidara Famakan Kane Cheickna Sylla amadou bocoum Sanogo Siaka Amara Soumaila Traoré Department of Gynecology and Obstetrics Fousseyni Daou Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynaecology and Obstetrics Regional Hospital of Sikasso Sikasso Mali

Introduction: Evacuation refers to the rapid transfer of a patient in an emergency, from one health center to another more equipped and better specialized. The objective of this study was to study maternal mortality in patients evacuated to the gynecology and obstetrics department at the Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a descriptive, cross-sectional, retrospective study over nine years from January 1, 2011 to December 31, 2019 and prospective over one year from January 1, 2020 to December 31, 2020 involving all patients or parturients evacuated for obstetrical causes and died in the gynecology-obstetrics department of the Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of the statistical data was carried out using SPSS 20.0 software. Results: during our study period we identified 38,854 obstetric admissions including 6758 evacuations or 17.4%, among the 6758 cases of obstetric evacuations 284 died, a frequency of 4.2%. The maternal death audit committee of the Fousseyni Daou hospital in Kayes audited 101/284 cases (files) or 35.5% of which 64 maternal deaths (63.4%) were considered inevitable. In our study the 20 - 29 age group was more represented with 38%. 85% of the deceased patients lived in rural areas. In our series, 63.7% of the deceased patients had not had antenatal consultations (NPC). Eclampsia accounted for 26.8% of admissions diagnoses and 30.9% of causes of death. Seventy-two (72%) of deaths occurred postpartum, 15% perpartum and 13% prepartum. Direct obstetric causes were predominant at 65.1%. Conclusion: Indicators of maternal deaths among evacuated patients remain poor in our work. Maternal deaths were driven by socio-economic and cultural factors, but also by factors related to the health system.

关键词： Maternal Mortality Evacuation Kayes Hospital

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The Complications of Cesarean Section at Teaching Hospital Gabriel TOURE, Bamako Mali

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 546-557页

作者： Abdoulaye Sissoko Alassane Traore Ibrahim Kante amadou bocoum Soumana Oumar Traore Seydou Fane Daniel Dembele Aminata Kouma Mamadou Sima Fatoumata K. Tounkara amadou Fomba Ibrahima Teguete Youssouf Traore Soumaila Keita Niani Moukoro Teaching Hospital Gabriel TOURE Bamako Mali Teaching Hospital Bamako Mali Teaching Hospital Point G Bamako Mali District Hospital Commune V Bamako Mali Teaching Hospital Kati Bamako Mali Research Center CHU of Quebec University of Laval Quebec Canada

Cesarean operation permits to save the mother and fetus. However, in developing countries as ours, complications related to this cesarean are not to be neglected. It constitutes an important cause of maternal and fetal morbidity and mortality. Here we rapport the experience of our structure about the complications of cesarean. Objectives: The objectives of this study were to study the complications the complications of cesarean section at teaching hospital Gabriel TOURE, Bamako Mali. Materials and methods: We have carried out a cross sectional analytic study from January 1st?2003 to December 31st?2013. All the patients who gave birth by cesarean operation in gynecology-obstetric service of teaching hospital Gabriel TOURE were included during this period of study. Descriptive statistics were used, Chi-square test Pearson, and?Cochran Armitage test have?been used to calculate the P-value of trend. We performed multivariate analyses with a high alpha threshold of 10%, and then logistic regression multivariate. Results: We have registered 28,376 deliveries with 9509 cases of cesarean (33.5%) and a complication cesarean rate of 32% (3049/9509). The main risk factors for cesarean operation completions were adolescence primiparity, obesity, the non-realization of antenatal care, evacuations and co-morbidities. Intraoperative complications were dominated by hemorrhage 8.3% and bladder lesion 1.1%, whereas anemia (58.8%) and parietal infection (21.1%) dominated the postoperative complications table. The evacuation (Odds Ratio adjusted (ORa) = 1.96) as well pre-eclampsia/eclampsia?(ORa = 2.34) and the sicle cell disease (ORa = 9.99) were the main influencing factors of material death. Praevia placenta (ORa = 1.75) abruption placenta (ORa = 11.08) and fetal malformation (ORa = 2.21) dominated the influencing factors of perinatal death. Conclusion:?The cesarean complications rates were high in our improvement of the quality of antenatal care.?The reorganization and revitalizati

关键词： Cesarean Complication Risk Factors Morbidity Mortality

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Routine Screening for Cervical Cancer

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 922-928页

作者： Alassane Traoré Aphou Sallé Koné Sima Mamadou amadou bocoum Mamadou Bakary Coulibaly Koninba Diabaté Adama Diakité Kanté Ibrahim Seydou Mariko Idrissa Mama Diarra Service de gynécologie H&ocirc pital du Mali Bamako Mali Service de radiothérapie H&ocirc pital du Mali Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire du Point G Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire Gabriel Touré Bamako Mali

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases;

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