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Open Journal of Pediatrics 2019年第4期9卷 287-295页

作者： diallo ibrahima sory diallo sory Conté N’fanly Diawara ibrahima Bah Elhadj Mamoudou Cissé Moussa Matthias Roth Kleiner Sy Telly Pediatrics Chair Gamal Abdel Nasser University Conakry Guinea Institute of Nutrition and Child Health Conakry Guinea Gyneco-Obstetrics Chair Gamal Abdel Nasser University Conakry Guinea Department of Women Mother and Child Lausanne Switzerland

The objective of this study was to identify risk factors and study the causes of neonatal mortality of LBW newborns referred to the Institute of Nutrition and Child Health. Material and Methods: This is a prospective descriptive and analytical study from March 1 to August 31, 2015, involving 250 newborns referred to the Neonatology Department of the Institute of Child Nutrition and Health (INSE). Results: During our study period, we recorded 1169 newborns, 250 of whom were referred, representing a referral frequency of 21.38%. The overall mortality rate for transferring newborns was 46.8%. Risk factors associated with neonatal mortality were gravidity (p = 0.0019), parity (p = 0.0323), occupational activities requiring physical effort (p = 0.0257), birth weight (p = 0.0008) and prematurity (p = 0.0039). Conclusion: Neonatal mortality associated with referrals is a major health problem in developing countries. There is currently no doubt that it is possible to significantly reduce perinatal mortality and morbidity rates by organizing the identification of “mother-child” couples at risk, to refer them intently to centres better equipped with technical and human resources to care for them.

关键词： Neonatal Mortality Reference Low Birth Weight INSE

Obstetrical Surgery in the Context of Ebola Virus Disease (Ebola) in Guinea: Lessons Learned from 2 Cases

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Open Journal of Obstetrics and Gynecology 2019年第10期9卷 1305-1314页

作者： Bah Elhadj Mamoudou diallo ibrahima sory dialloThierno Saidou Leno W. Daniel Soumah Aboubacar Fode Momo Conte ibrahima Touré Abdoulaye Sow Mamadou Saliou Dao Blami Hyjazi Yolande Sy Telly Keita Namory Gyneco-Obstetrics Chair Gamal Abdel Nasser University Conakry Guinea Pediatrics Chair Gamal Abdel Nasser University Conakry Guinea Institute of Nutrition and Child Health Conakry Guinea Public Health Chair Gamal Abdel Nasser University Conakry Guinea Executive Secretariat/National AIDS Control Committee (ES/NACC) Conakry Guinea Chair of Infectious and Tropical Disease Gamal Abdel Nasser University Conakry Guinea Jhpiego USAID Conakry Guinea.

In this manuscript, the authors have studied obstetrical surgery in the context of Ebola virus disease in Guinea. No protocol recommends childbirth outside of Ebola treatment center, although it has no technical platform and no qualified providers in this area. These were unknown MVE cases in pregnant women/parturient women aged 25 and 40 years, with no education, who were confirmed in the RT-PCR test after surgical management. To fight Ebola virus transmission, traditional protection protocols must be strengthened. Training, supervision and monitoring of providers are key elements for the protection of staff in the event of an EVD outbreak. Improving working conditions and strengthening hand washing, usage of PPE/EPP, decontamination of equipment with 0.5% chlorine solution, hygiene of premises, immunization of personnel involved, are effective measures to combat EVD.

关键词： Ebola Virus Disease Childbirth Prevention and Control of Infection Guinea

Factors of Low Birth Weight Risk in the Department of Gynecology-Obstetrics of the Ignace Deen National University Teaching Hospital in Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 251-259页

作者： Abdourahamane diallo ibrahima sory Baldé ibrahima sory diallo Mamadou Hady diallo Mamadou Cellou diallo Elhadj Mamoudou Bah ibrahima Koussy Bah Telly Sy Mathias Roth-Kleiner Mamadou Pathé diallo Obstetrics and Gynecology Department of the Ignace Deen National University Teaching Hospital Conakry Guinea Institute of Nutrition and Child Health (INCH) Donka Guinea Obstetrics and Gynecology Department of Donka National University Teaching Hospital Conakry Guinea Department Women-Mother-Child University Hospital and University of Lausanne Lausanne Switzerland

Introduction: The underweight at birth is recognized as a major cause of morbidity and mortality in childhood. Objective: To identify maternal and obstetric sociodemographic factors associated with low birth weight. Patients and Methods: This is a retrospective study of analytical type that examined the records of women who gave birth in the Obstetrics and Gynecology department of Ignace Deen National University Teaching Hospital from 1st December 2016 to 30th April 2017. The analysis was made with the R version 3.3.1 software. We did a univariate and multivariate analysis. Outcomes: Out of the 1633 live births of single pregnancies that occurred during the study period, 109 children were born with a low weight (<2500 g) corresponding to a rate of 6.7%. In univariate analysis, we found a significant association between low birth weight and maternal single status (p = 0.019), maternal weight less than 60 kg (p = 0.038), primary parity (p = 0.018), maternal history of abortion (p = 0.001), history of preterm birth (p < 0.001), arterial hypertension (p < 0.001), anemia (p < 0.001) and malaria (p < 0.001). In multivariate analysis, the variables associated with low birth weight were: history of preterm delivery with OR of 8.5 [1.8 - 40.1], history of abortion (OR = 4.4 [1.4 - 13.9]), malaria (OR = 23.8 [6.1 - 92.5]), anemia (OR = 11.8 [3.7 - 38.2]) and high blood pressure (OR = 5.4 [1.6 - 17.9]). Conclusion: The decrease in frequency of low birth weight in Guinea will be done by improving the quality of prenatal care with an emphasis on screening, prevention and treatment of malaria, anemia and high blood pressure during pregnancy, prevention of abortion and premature birth.

关键词： Risk Factors Low Birth Weight Ignace Deen Newborn to Term

Ovarian Cancer: Clinical, Therapeutic and Prognostic Aspects at the University Hospital Center of Conakry in Guinea

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1985-1993页

作者： Abdourahamane diallo Mamadou Hady diallo Fatoumata Bamba diallo ibrahima Koussy Bah Boubacar Siddy diallo ibrahima sory Balde Telly Sy Namory Keita Gynecology-Obstetrics Department Ignace Deen National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Gynecology-Obstetrics Department Donka National Hospital Conakry Guinea

Background: Ovarian cancer is the seventh most common cancer in women in the world and is the leading cause of death among gynecological cancers. Objective: The objective of this study was to describe the clinical, therapeutic and prognostic aspects of ovarian cancer in the both Gynecology-Obstetrics departments Donka and Ignace Deen of the Conakry University Hospital. Methods: This was a retrospective, descriptive study lasting 12 years from January 1, 2011 to December 31, 2022, covering the files of patients treated for ovarian cancer in the both Gynecology-Obstetrics departments Donka and Ignace Deen. The study focused on the epidemiological, clinical, histological and therapeutic aspects of the disease. Results: In total, 135 files of patients with ovarian cancer were collected out of the 3821 files of gynecological pathologies recorded in the two departments during the study period, either a frequency of 3.5%. Among gynecological and breast cancers, ovarian cancer represented 9.1%. The average age of the patients was 46.3± 17.8 years and the average parity was 4 ± 3. The revealing clinical signs were dominated by pelvic pain (92.6%) and increased abdominal volume (53.3%). The diagnosis of the disease was made mainly at stages III and IV (71.9%). The most common histological type was serous papillary adenocarcinoma (57.0%). Exclusive surgical treatment was performed in 8.1% of patients, surgery combined with chemotherapy in 63.0% of patients and exclusive chemotherapy in 11.1% of patients. After an average follow-up of 42 months, 29 patients out of the 96 operated on were alive (30.2%), 51 had died (53.1%) and 16 patients were lost to follow-up (16.7%). Conclusion: Ovarian cancer is the third most common cancer in both departments. Diagnosis is often late and the prognosis is poor.

关键词： Cancer Ovary Ignace Deen Donka

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

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

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

Risk Factors Associated with Obstetric Perineal Tear in a Maternity Ward of the Communal Medical Center of Ratoma-Conakry-Guinea

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Open Journal of Obstetrics and Gynecology 2024年第10期14卷 1628-1639页

作者： Mamadou Hady diallo Fatoumata Bamba diallo Alhassane II Sow ibrahima Tangaly diallo Fatoumata Kora Balde Alpha Boubacar Barry Abdourahamane diallo ibrahima sory Balde Telly Sy Namory Keita Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea Maternity of Ratoma Communal Medical Centre Conakry Guinea

Introduction: Obstetric perineal tears are a common complication during childbirth. The objectives of this study were to describe the sociodemographic characteristics, the different types of perineal tears and to identify the associated risk factors. Patients and Method: The maternity of the CMC of Ratoma served as a setting for carrying out this study. This was a prospective study of a descriptive and analytical type, which took place over a period of 6 months from July 1, 2021 to January 1, 2022. Results: The frequency of perineal tear was 9%. The average age of the patients concerned was 23.99 years ± 5.18 years, with extremes of 15 and 38 years. Housewives were the most numerous (30.88%). Most of our parturient had undergone excision (99.6%) and they were more frequently primiparous (40.44%) and pauciparous (47.79%). The multiplicity of risk factors was a remarkable fact (scarred perineum, edematous, short, and infected). The presentation was cephalic in 96.33%, posterior variety in 3.81% and the variety of positions could not be specified by the health worker who provided care to the parturient in 46.56%. The expulsion took place in OP (92.37%) and in OS (2.30%). In most cases, midwives carried out deliveries (93%). Perineal tears were 1st degree (54.41%), 2nd degree (39.70%), 3rd degree (5.15%) and 4th degree (0.74%). Conclusion: Prevention of perineal obstetric injuries is based on better knowledge of risk factors and delivery by qualified personnel. The main limitation of this study is the impossibility of highlighting occult perineal lesions due to the weakness of the technical platform.

关键词： Perineal Tear Risk Factors Conakry

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

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