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Delay for Performing Laparotomy for Extra Uterine Pregnancy in N’Djamena Mother and Child University Hospital

Open Journal of Obstetrics and Gynecology 2024年第4期14卷 520-527页

作者： gabkika bray madoué Saleh Abdelsalam Khadidja Mahayadine Salah Serfeurbe Pefah Foumsou Lhagadang Faculty of Human Health Sciences of N’ Djamena N&#8217Djamena Chad N’ Djamena Mother and Child University Hospital N&#8217Djamena Chad

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in N’Djamena Mother and child University hospital (NMCUH). We included in this series all patients admitted for EP managed by laparotomy. Data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within 1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.

关键词： Delay Laparotomy NMCUH Chad

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Caesarean Section in the Mother and Child University Hospital of N’Djamena: Indications and Prognosis

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1463-1470页

作者： gabkika bray madoué Mahamat Alhadi Chene Saleh Abdesalam Neramadji Doumbé Félicité Foumsou Lhagadang NDjamena Faculty of Human Health Sciences NDjamena Chad. NDjamena Mother and Child University Hospital NDjamena Chad.

Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.

关键词： Caesarean Section Indications Prognosis NMCUH Tchad

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Spontaneous Bilateral Tubal Ectopic Pregnancy:A Case Report

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Open Journal of Obstetrics and Gynecology 2017年第8期7卷 866-870页

作者： Lhagadang Foumsou bray madoué gabkika Damthéou Sadjoli bray madoué Kaimba Department of Gynaecology and Obstetrics Faculty of Human Health SciencesUniversity of N’DjamenaN’DjamenaChad N’Djamena Mother and Child Hospital N’DjamenaChad Department of Surgery Faculty of Human Health SciencesUniversity of N’DjamenaN’DjamenaChad

Bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. We report a case of spontaneous bilateral tubal ectopic pregnancy diagnosed intra operatively. A 30-year-old patient was admitted to the emergency room of N’Djamena mother and child hospital complaining of vaginal bleeding and abdominal pain. Salpingectomy left tube and salpingotomy right tube were performed without complication and that histopathological report confirmed the diagnosis.

关键词： Bilateral Ectopic Pregnancy Salpingectomy Salpingotomy

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Maternal and Fetal Prognosis of Evacuated Parturients in N’Djamena Mother and Child Hospital (Chad)

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 263-271页

作者： Lhagadang Foumsou bray madoué gabkika Foba Kheba Sadjoli Damthéou Salathiel Djongali Department of Gynecology and Obstetrics Faculty of Human Health Sciences University of N’Djamena N’Djamena Chad N’Djamena Mother and Child Hospital N’Djamena Chad

Introduction: All pregnant women are at risk of obstetric complications leading to high fetal-maternal mortality and morbidity. The aim of this work was to evaluate the maternal and fetal prognosis of evacuated parturients. Patient and Method: we conducted a prospective analytical survey for four months, from April 1st to July 31st, 2018 in the Maternity of N’Djamena Mother and Child Hospital about the maternal and fetal prognosis of evacuated parturients. Any parturient evacuated or referred for obstetric complications was included. Study parameters were epidemiological, clinical, para-clinical, therapeutic and prognosis order. These parameters were analyzed in the SPSS 18 French version software. Results: Evacuated parturients represented 20% of maternity admissions. The average age was 23.9 years, with extremes ranging from 15 and 43 years. They were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were dominated by the 1

关键词： Maternal and Fetal Prognosis Evacuated Parturients Obstetric Complications Mother and Child Hospital N’Djamena Chad

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Problematic of Clandestine Induced Abortions in Three Maternity Hospitals of Chad

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Open Journal of Obstetrics and Gynecology 2017年第9期7卷 937-943页

作者： Lhagadang Foumsou Guira Daniel Dangar Ouchémi Choua Sadjoli Damthéou bray madoué gabkika Olivier Moalloum Tarda Rostand Dounou Njiki Department of Gynecology and Obstetrics University of N’Djamena N’Djamena Chad N’Djamena Mother and Child Hospital N’Djamena Chad Department of Surgery University of N’Djamena N’Djamena Chad UNFPA City Chad

Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complicati

关键词： Clandestine Induced Abortion Motivations Complications Maternity Chad

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Obstetric Complications Due to Female Genital Mutilation (FGM) at N’Djamena Mother and Child Hospital (Chad)

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Open Journal of Obstetrics and Gynecology 2015年第14期5卷 784-788页

作者： Lhagadang Foumsou Richard Norbert Nglalé Jeanne Fouedjio Gédéon Ndakmissou bray madoué gabkika Sadjoli Damthéou Philip Njotang Nana Abdoulaye Sépou Department of Gynecolgy and Obstetric Faculty of Human Health Sciences University of N’Djamena N’Djamena Chad Department of Gynecolgy and Obstetric Faculty of Health Sciences University of Bangui Bangui Central African Republic Department of Gynecolgy and Obsteric Faculty of Biomedical Sciences and Medicine University of Yaounde I Yaounde Cameroon

Background: Female genital mutilation (FGM) or female circumcision is all procedures involving partial or total removal of the external female genital organ or other injuries to the female genital organ whether for cultural or any other non-therapeutic reasons. Female genital mutilation causes numerous complications. Four in such cases multiplies obstetric complications. The aim of this study was to identify obstetric complications due to FGM. Patients and Material: We conducted a comparative prospective case-control study for three months, from January 1st to March 31st, 2014 in the maternity of N’Djamena Mother and Child. It focused on identifying neonatal and/or maternal complications during childbirth due to FGM. The study population consisted of pregnant women at term admitted for delivery labor. All parturients had to present the same sociodemographic and clinical profiles. A history of FGM was the main distinguishing criterion. Results: During the study period, we recorded 312 births to women with genital mutilation, among 1905 deliveries, representing a prevalence of 16.4%. One hundred ninety-one cases of circumcised women responding to the inclusion criteria were selected. Most of these women were between the ages of 20 and 29. The extreme age group was 15 and 39 (with a mean of 24.5 years). FGM was significant in age group over 20 years (Khi2 = 10.8;OR = 2.6 [1.4 - 4.9];P = 0.001). The type II of FGM which removed a part of the clitoris and the adjacent labia minora represented 64.40% patients in the group of women with FGM. Perinea laceration was the frequent maternal complication among parturient with FGM (Khi2 = 9.8;OR = 2.2 [1.4 to 3.6];P = 0.0007). FGM type III was associated with a high proportion of maternal complication (Khi2 = 11.2;OR = 7.3 [1.97 - 31.6];P = 0.0001). Still births were significantly higher in the group of parturient with FGM (11.5%, P = 0.015). Conclusion: Female genital mutilation is a common cultural practice in our country;it co

关键词： Female Genital Mutilation Childbirth Maternal-Fetal Complication N’Djamena (Chad)

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