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Artificial Induction of Labor with Misoprostol: Maternal and Fetal Prognosis at the Referral Health Center of Commune I of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 70-79页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Mamadou Sima Bourama Kané Kalba Tembiné Ibrahima Tégueté Youssouf Traoré Department of Gynecology of Hô pital du Mali Bamako Mali Service of Anesthesia and Resuscitation of Hô pital du Mali Bamako Mali Service of Gynecology-Obstetrics CHU Point G Bamako Mali Service of Pediatric of Hô pital du Mali Bamako Mali Service of Medical Imaging of Hô pital du Mali Bamako Mali Service of Gynecology-Obstetrics CHU Gabriel Toure Bamako Mali

Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.

关键词： Induction Misoprostol Maternal and Fetal Prognosis Commune I

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Role of Laparoscopic Surgery in the Management of Female Infertility at the Department of Gynecology of Hôpital du Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1430-1440页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Bourama Kané Adama Sangaré Kalba Tembiné Ibrahima Tégueté Youssouf Traoré Service of Gynecology of Hopital du Mali Bamako Mali Service of Medical Imaging of Hopital du Mali Bamako Mali Service of Pediatric of Hopital du Mali Bamako Mali Service of Anesthesia and Resuscitation of Hopital du Mali Bamako Mali Service of Gynecology-Obstetrics CHU Gabriel TOURE Bamako Mali

Infertility is a socio-cultural drama in Africa, especially in Mali and remains difficult for couples to overcome. Laparoscopy, also called minimally invasive surgery or keyhole surgery, is an operative technique that permits to explore the pelvis and perform an appropriate therapeutic procedure. The objective of our work was to assess the role of laparoscopic surgery in the treatment of female infertility at Hopital du Mali. It was a retrospective descriptive study that was conducted over a period of 5 years (January 2013 to December 2018). Any patients followed for infertility and who underwent laparoscopic surgery in the gynecology department over a period of two (2) years were included. The outcome of laparoscopic surgery was evaluated in terms of conception of pregnancy. We had collected 103 infertile patients out of 2984, with a frequency of 3.45%. The mean age of our patients was 30.2 years. Housewives and out-of-school women accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%. Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with an average duration of 6.2 years. Systematic chlamydial serology was positive in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of cases. Adhesiolysis was the main procedure performed with 84.47% bilateral tubal patency achieved in the methylene blue test. Among our patients who had contracted a pregnancy (22.99%), 85% had carried their pregnancies to term. Tubal damage was the main cause of infertility. Adhesiolysis remains the main laparoscopic procedure for treatment.

关键词： Laparoscopic Surgery Infertility Hopital du Mali

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Clinical and Therapeutic Aspects of Genital Prolapse at Hôpital du Mali about 100 Cases

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 121-132页

作者： Mamadou Bakary Coulibaly Mody Abdoulaye Camara Alassane Traoré Mamadou Keïta Bourama Kané Abdramane Togo Issa Ongoiba Kalba Tembiné Amadou Sidibé Baba Fané Ibrahima Tégueté Youssouf Traoré Gynecology Department of Hô pital du Mali Bamako Mali Medical Imaging Department of Hô pital du Mali Bamako Mali Referral Health Center of Commune VI of the District of Bamako Bamako Mali Pediatrics Department of Hô pital du Mali Bamako Mali Anesthesia and Intensive Care Unit Hô pital du Mali Bamako Mali Biomedical Department of Hô pital du Mali Bamako Mali Department of Gynecology Obstetrics UTH Gabriel Touré Bamako Mali

To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.

关键词： Genital Prolapse Therapeutic Attitudes Hôpital du Mali

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Angiographic Features of Intracranial Aneurisms in Mali: A Preliminary Study of 105 Patients

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World Journal of Neuroscience 2023年第1期13卷 1-11页

作者： Mahamadou Dama Oumar Coulibaly Oumar Diallo Daouda Sissoko Hawa Diarra kalba tembine Mamadou Salia Diarra Madani Ouologem Drissa Kanikomo Neurosurgery Department University Hospital of Mali Bamako Mali Radiology Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Neurosurgery Department Hospital of Luxembourg Bamako Mali Unite of Neurology Infirmery of the Armies Bamako Mali Department of Neurosurgery Gabriel Touré Hospital Bamako Mali

Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform. Conclusion: The angiographic feature of an intracranial aneurism in the Malian population may differ from other populations of the sub-region. The anterior communicating complex aneurysm is more common and the aneurism of the posterior part of the Willis circle is less common. We found the aneurism size ≥ 6 mm, ACA, MCA and Pcom more frequent.

关键词： Subarachnoid Hemorrhage Aneurism CT Angiography RMA

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Uterine Leiomyomas Surgery: Assessment of Five Years in the Gynecology Department of Hôpital du Mali

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Open Journal of Obstetrics and Gynecology 2021年第9期11卷 1161-1171页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Adama Sangaré Issa Ongoiba Mamadou Keïta kalba tembine Amadou Sidibé Ibrahim Teguete Youssouf Traore Service of Gynecology of Hô pital du Mali Bamako Mali Service of Medical Imaging of Hô pital du Mali Bamako Mali Gynecology-Obstetrics Unit of Referral Health Center of Commune VI Bamako Mali Service of Anesthesia and Resuscitation of Hô pital du Mali Bamako Mali Service of Gynecology-Obstetrics Chu Gabriel Toure Bamako Mali

Uterine leiomyomas (myomas) are the most common benign tumors of the female genital tract. They affect 20% to 25% of women of childbearing age and are 3 to 9 times more common in black women. We initiated this study in order to report the socio-demographic aspects and the indications for leiomyomas surgery at Hôpital du Mali. This was a retro-prospective descriptive study, conducted in the gynecology department of Hôpital du Mali from January 1, 2015 to December 31, 2019. Any patients, regardless of their age, in whom a leiomyomas had been detected and surgically treated were included. We had collected 180 cases of surgery for leiomyomas out of 950 surgical procedures, with a frequency of 18.94%. The 36 - 45 age group represented 45% of our patients with an average age of 35 years. Nulligravida

关键词： Uterine Leiomyomas Surgery Hôpital du Mali

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Clinical and Therapeutic Aspects of Giant Fibroids at the Hôpital du Mali about 30 Cases

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Open Journal of Obstetrics and Gynecology 2020年第6期10卷 778-789页

作者： Mamadou B. Coulibaly Alassane Traore Mody A. Camara Abdrahamane Togo Adama Sangaré Issa Ongoiba kalba Timbine Amadou Sidibé Apérou Guindo Niani Mounkoro Ibrahim Teguete Youssouf Traore Moustaphe Toure Service of Gynecology of the Hopital du Mali Bamako Mali Service of Medical Imaging of the Hopital du Mali Bamako Mali Service of Anesthesia and Resuscitation of the Hopital du Mali Bamako Mali Service of Gynecology-Obstetrics of Gabriel TOURE Teaching Hospital Bamako Mali

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.

关键词： Giant Fibroma Care Surgery Hôpital du Mali

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