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Clandestine Abortions and Its Complications at the University Hospital Center of the Sino-Central African Friendship

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1604-1609页

作者： roch m’betid-degana Gilles-Davy Kossa-Ko-Ouakoua Geniva Gracelia Vanciane m’betid-degana Sabrina Ouapou Sandrine Sana-Ozako Durant Boris Poutou-Piri Sifa marcelline Balungwe Apollinaire Hepatraud Eugene Serdouma Antoine Doui-Doumgba Gynecology and Obstetrics Department University Hospital Center of the Sino-Central African Friendship Bangui Central African Republic

Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.

关键词： Clandestine Abortion Complications University Hospital Center of the Sino-Central African Friendship

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management of Immediate Postpartum Hemorrhage at the University Hospital Center of the Sino-Central African Friendship

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Open Journal of Obstetrics and Gynecology 2023年第11期13卷 1783-1790页

作者： roch m’betid-degana Gilles-Davy Kossa-Ko-Ouakoua Geniva Gracelia Vanciane m’betid-degana Gamaliel Kerebi Sandrine Sana-Ozako Durant Poutou-Piri Samuel Gondje Appolinaire Hepatraud Eugène Serdouma Antoine Doui-Doumgba Department of Gynecology and Obstetrics University Hospital Center of the Sino-Central African Friendship Bangui Central African Republic Department of Gynecology and Obstetrics Camp Henri IZAMO Hospital (National Gendarmerie) Bangui Central African Republic General Surgery Department University Hospital Center of the Sino-Central African Friendship Bangui Central African Republic

Introduction: Immediate postpartum hemorrhages constitute a frequent maternal complication and remain at the forefront of maternal death in our countries. Objective: Contribute to improving the management of immediate postpartum hemorrhage in our context with a view to reducing maternal mortality. Patients and methods: We conducted a retrospective descriptive and analytical study over a period of 12 months from January 1st to December 31st 2020. Results: We collected a total of 109 files on a total of 4360 deliveries. The frequency of postpartum haemorrhages was of the order of 2.5%. The most represented age group was between 20 and 24 years old. Pauciparas represented the majority of our study population. 64.5% of patients were uneducated. These hemorrhages occurred in patients who often gave birth outside the department with 63.8%. The main causes of postpartum hemorrhage were cervical tears (51.2%) and partial placental retention (30.7%). The majority of these deliveries (48.8%) were carried out by midwives followed by assistant midwives (33.2%). Active management of the third period of delivery was systematic and immediate followed by the valve examination completed by the infusion of oxytocin in case of uterine atony, tranexamic acid ans misoprostol intrarectally. In the event of persistent hemorrhage, suture of the cervical lesions, ligation of the cervical vessels or even laparotomy either for the selective ligation of the blood vessels or for the hysterectomy for hemostasis were practiced. We do not have a Nalador, nor a Bakry balloon, nor an Interventional Radiology service for embolization of the uterine arteries. We deplore 1.3% of deaths from afibrinogenemia. Conclusion: The frequency of immediate postpartum hemorrhages is lower in our health facility. This is due to the rapid handling of cases. Improving the quality of services offered to women during childbirth can further help reduce the frequency of these hemorrhages.

关键词： Haemorrhage Postpartum Immediate University Hospital Center of the Sino-Central African Friendship

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