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Dead Fœtale in Utéro: Hospitable Frequency, Etiologies and Maternal Prognosis to the Service of Obstetric Gynecology of the Hospital National Donka, CHU of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 539-546页

作者： boubacar siddi diallo Abdourahmane diallo Ibrahima Sory Balde Mamadou Hady diallo Ibrahima Conte Ousmane Balde Ibrahima Sylla Diakaria Daou Sidibe Telly Sy Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of MFIU, to describe the epidemiological profile, to identify the étiologies and to establish the maternal prognosis. Methodology: It was about a prospective survey of analytic type spreading on one period of twelve (12) month achieved to the service of Obstetric Gynecology of the hospital National Donka, FALLEN from Conakry. Results: On 5226 childbirths, we recorded 208 cases of MFIU, either a frequency of 3.98%. The epidemiological profile was the one of a teenager or aged woman (more of 35 ans) with respectively (8.17%) and (7.20%), sans follow-up prénatal (10.41%), nullipare (6.02%), célibataire (7.80%), ménagère (5.02%) and non scolarisée (5.16%). The MFIU occurred in the age group of 32 - 36 SA. L’absence of the MAF was the main motive of consultation 94.23%. All cases of MFIU benefitted from a confirmation scan. The vasculo-renal syndromes and their complications were the main étiologie 43.75%;follow-up of the malaria is 13.94%. The majority of the gestantes were delivered by low way 98.08%. The induction of work has been made mainly to the misoprostol (Cytotec 200 μg) either 81.86% against 10.78% of Syntocinon in drip. The maternal morbidity has especially been dominated especially by the hemorrhages in the case of long length retention and the infections when the membranes are broken either 1.44% against 98.56% of case of good maternal prognosis. No maternal death has been recorded. Conclusion: The prenatal consultation offer recentered and the one of medical correct cares of the vasculo-renal syndromes and the malaria could reduce the cases of death fœtale efficiently in utero.

关键词： MFIU Frequency Etiologie

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The Problematics of Transferred Parturient Women in Guinean Urban Areas: The Case of the Donka Maternity Ward at the University Hospital Centre (Chu) Conakry

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Open Journal of Obstetrics and Gynecology 2019年第3期9卷 343-352页

作者： Mamadou Hady diallo Ibrahima Sory Baldé Abdourahmane diallo Ousmane Baldé boubacar siddi diallo Amadou Diouldé diallo Ibrahima Koussy Bah Oumou Hawa Bah Telly Sy Namory Keita Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea Department of Visceral Surgery Donka National Hospital Conakry Guinea

Objectives: To describe the socio-demographic aspects of transferred parturient women;To identify the means of transport used by the evacuated parturient women to the Donka maternity ward at the University Hospital of Conakry;To describe the difficulties met;And to assess maternal and fetal prognosis. Methodology: It consisted of a prospective study over a period of 6 months from 01/02 to 31/07/2018. All patients transferred to the maternity ward of the Donka National Hospital of Conakry University Hospital. Results: The frequency of obstetric transfers was 13.79%. The epidemiological profile was that of a parturient woman of an average age of 25.7 years, married, and housewife, unschooled, who was on her first pregnancy and from the city of Conakry. The average distance covered was 16 km with extremes of 3 and 50 km. The transfer to the referral maternity clinic was not medicalized in 94% of cases. The venous route was not taken in 96% of cases. The parturient was not escorted by a health worker in 98% of cases. Bleeding was the most frequent reason for evacuation, followed by acute fetal sufferings. The average number of prenatal consultation was 2 with extremes of 0 and 9. The average length of stay was 3.6 days with extremes of 1 and 28 days. The majority of transferred women had a full-term pregnancy. The Cesarean section was 79.4%. The Retro placental hematoma was the most common complication found and was 29.4%. The counter-reference was not made in 97.79%. We recorded 8 maternal deaths, for a lethality rate of 1.77%. Possible interventions to reduce the dramatic situation of obstetric evacuations require first of all the decentralization of health care structures capable of performing a cesarean section. This approach should aim to create medical centers with a surgical antenna in all municipalities. These decentralized units would reduce the delay in case management and thus, limit the number of complications.

关键词： Transfer Complication Conakry University Hospital

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Maternal Complications of Caesarean Section in a Resource-Limited Country: The Case of the Maternity Unit of Kankan Regional Hospital, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 981-990页

作者： Mamadou Hady diallo Ibrahima Sory Baldé Amadou Diouldé diallo Ousmane Baldé boubacar siddi diallo Ibrahima Sylla Oumou Hawa Bah Lanciné Doumbouya Aisssatou Taran diallo Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea University Department of Visceral Surgery Donka National Hospital Conakry Guinea Maternity Unit Kankan Regional Hospital Kankan Guinea University Department of Visceral Surgery Ignace Deen National Hospital Conakry Guinea

Introduction: Innovations in surgical and anaesthetic techniques to provide a good maternal and child safety have made the cesarean section a routine intervention in obstetrics. However, its complications, especially the short or long term per and postoperative maternal ones, are not exceptional and can affect mothers’ vital prognosis. The objectives of this study were to describe the maternal per and postoperative complications encountered during the cesarean section. Patients and method: This is a prospective, descriptive and analytical study carried out at the maternity ward of Kankan Regional Hospital over a 6 month period from January 1, 2018 to June 30, 2018. Results: During this period, out of a total of 2229 deliveries, 319 caesarean sections were performed i.e. a rate of 12.51%. Complications concerned 111 patients (34.79%). The average age was 28 with extremes of 15 and 45. Non-medical transportation concerned 71.17% of our patients. The cesarean section was performed in emergency situations in 82.8% of cases. Indications were dominated by the fetopelvic disproportion. There was a statistically significant relationship between labour duration and the occurrence of complications. Intraoperative complications were dominated by bleeding (25.22% of all complications and 8.77% of total cesarean sections). Post-operative complications were dominated by parietal suppurations (94.49% of all complications and 34.79% of the total number of cesarean sections). In most cases, patients simultaneously developed several complications. Conclusion: The maternal complications of cesarean sections remain considerable. If the increase in the rate of caesarean sections has contributed to the improvement of the mother-fetal prognosis, the surgical procedure itself is not without complications, which encourages us to review its indications for a better management. Hemorrhagic and infectious complications were the most frequent. These results call for increased asepsis measures i

关键词： Complications Cesarean Maternity Kankan-Guinea

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Uterine Rupture: Epidemiological Aspects, Etiologies and Maternal-Fetal Prognosis in the Obstetric Gynecology Department of the Donka CHU Conakry National Hospital, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 521-528页

作者： boubacar siddi diallo Ibrahima Sory Balde Ibrahima Conte Mamadou Hady diallo Ousmane Balde Ibrahima Sylla Abdourahmane diallo Oumou Hawa Bah Loua Avit Telly Sy Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the

关键词： Uterine Rupture Etiologie Prognosis

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Delivery Complications of the Single Fat Large Foetus (Macrosomia) with Teenagers at the Obstetrics and Gynaecology Department of the Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 624-630页

作者： boubacar siddi diallo Mamadou Hady diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane diallo Oumou Hawa Bah Mouctar Sylla Ibrahima Sory Balde Telly Sy Namory Keita University Department of Gynecology-Obstetrics Donka National HospitalConakryGuinea University Department of Gynecology-Obstetrics Ignace Deen National HospitalConakryGuinea

Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.

关键词： Teenager Large Foetus Complications

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Prognostic Materno-Fetal Types of Arterille Hypertension during Pregnancy at the Maternity of Donka, National Hospital Donka, Chu of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 722-729页

作者： boubacar siddi diallo Mamadou Sambakeita Ibrahima Sory Balde Oumar Diawara Telly Sy Mohamed Lamine Kaba Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and establish the maternal and fetal prognosis. Methodology: This was a six-month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital, CHU, Conakry. The study took place from July 1st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of a teenager (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), no schooling (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form at admission was pre-eclampsia (47.2%) followed by eclampsia (23%). Eclampsia was the major complication (48%), with 6 deaths, or 2.4%. At the first minute, 35.68% of newborns had an APGAR score of less than 7 and 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%) followed by prematurity (23.92%). We recorded 30 cases of MFIU and 7 cases of neonatal death out of 255 births, i.e. 14.50%. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for an adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the maternal and fetal prognosis.

关键词： Prognostic Arterille Hypertension Pregnancy

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Fetal Prognostics in Relation to Uricemia and Maternal Proteinuria of Arterial High Blood Pressure Types during Pregnancy at the Maternity of Donka, National Hospital Donka, CHU of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 960-967页

Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and to establish fetal prognosis based on uricemia and maternal proteinuria. Methodology: This was a six (6) month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital-CHU Conakry. The study took place from july 1 st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of teenagers (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), not schooled (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form during the admission was pre-eclampsia (47.2%) followed by eclampsia (23%). At the first minute, 35.68% of newborns had an APGAR score of less than 7 and the fifth 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%), followed by prematurity (23.92%). In 90.90% of hypotrophy, there are ?85.24% of premature babies, 95.55% of SFA, and 80% of MIU;the serum uric acid was greater than 350 mmol. We recorded 204 children born with mothgers with proteinuria greater than or equal to 30 mg/dl, or 80% of children. 30 cases of MFIU and 7 cases of neonatal death out of 255 births, that is 14.50% were noted. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the ma

关键词： Uricemia Maternal Proteinuria Arterial High Blood Pressure

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The Maternal Deaths at the Obstetrics and Gynaecology Department of the Ignace Deen National Hospital, University Teaching Hospital (CHU) Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 597-603页

作者： boubacar siddi diallo Mamadou Hady diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane diallo Oumou Hawa Bah Saran Camara Ibrahima Sory Balde Telly Sy Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the Gynaecology Obstetrics Department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.

关键词： Review Maternal Deaths

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Care Taking of Obstetric Emergencies in the Department of Gynaecology and Obstetrics at Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 604-611页

作者： boubacar siddi diallo Ibrahima Sory Balde Ibrahima Conte Mamadou Hady diallo Ousmane Balde Ibrahima Sylla Abdourahmane diallo Oumou Hawa Bah Fatoumata Binta Sow Telly Sy Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the Department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refu

关键词： Obstetric Emergency Care Taking

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The Eradication of the Immunodeficiency Virus Human (HIV/AIDS) Transmission from Mother-to-Child (ETMC) in the Maternity Ward at the Ratoma Medical Centre, Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 715-721页

作者： boubacar siddi diallo Mamadou Samba Keita Ibrahima Sory Balde Mamadou Hady diallo Ibrahima Conte Ousmane Balde Ibrahima Sylla Oumou Hawa Bah Moussa Kante Telly Sy Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this article are to: 1) Determine the prevalence of parturient that escapes from the ETME, 2) Determine the rate of acceptability or non-acceptability of the HIV tests, 3) Describe the epidemiological profile and 4) Describe the factors explaining the lack of screening during pregnancy. Methodology: This report is based on an eventual descriptive study carried out in the Maternity Ward at the Ratoma Medical Centre for the past six months. The study took place over six (6) months from June 15 to December 15, 2016. The data were collected by individual interviews using a data collection sheet and prenatal consultation booklet that were administered to parturients in their language of comprehension. Each unscreened parturient received in the delivery room or in immediate postpartum received pre- and post-test HIV/AIDS counseling with immediate announcement of the outcome for all those who accepted the principle. For parturients who were in the active phase of work, counseling/testing was done in the immediate postpartum period. The data were manually collected from the pre-established fact sheets, captured using the Word, Excel and PowerPoint software packages of the 2007 Office and analyzed by the Epi-Info software (version 3.5.4). The limitations of the study were the lack of adequate room for the HIV testing council, the refusal of HIV testing by some parturients and the lack of achievement of CD4 levels in the hospital laboratory. Outcomes: The survey indicated that out of the 41.80% (177/423) of pregnant women that have recently given birth, ignore their HIV status. About 36.90% (66/177) rejected the screening and the 6.4% (7/111) that accepted were HIV/AIDS positive. The epidemiological study revolved around the following categories of women aged between 24 and 33 (42.85%), 1) Married (100%), 2) Housewives (57.14%), 3) Out-of-school (57.14), 4) Lack prenatal follow-up (42.85%), 5) Ignorance of the existence of HIV (71.42%). Reason In

关键词： Catch-Up HIV Work Room

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