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Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou Hospital in Malti

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1414-1421页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué seydou Traoré seydou z. dao Balilé Harber Sabré Koné Kassoum Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrhamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health Department of Segou District Hospital Bla Mali Regional Health Department of Koutiala Reference Health Center Koutiala Mali Regional Health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method : This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi² (p < 0.05), Odds ratio (OR) and its 95% confidence interval (CI). Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00; CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score < 7) (2.95%) than that of fetuses with apex presentations (0.41%) at both the 1st and 5th minute P: 0.00; CI: (0.00 - 0.004). The risk of stillbirth was 5 times higher for breech deliveries (2.07%) than for vertex deliveries (0%) (P: 0.00; CI: (0.00 - 0.004). Maternal complications were more frequent in breech deliveries (2.48% post-partum haemorrhage, 1.24% perineal tear and 0.83% uterine rupture) compared with 1.65% post-partum haemorrhage, 1.03% perineal tear and 0.62% uterine rupture respectively in vertex deliveries. There were no deaths in either group. Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.

关键词： Delivery Breech Vertex Prognosis Mali

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Hysterectomies for Gynaecological Pathology: 56 Cases at the Segou Regional Hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1363-1373页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué seydou Traoré seydou z. dao Balilé Harber Sory Diallo Kassoun Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrahamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health Department of Segou District Hospital Bla Mali Regional Health Department of Koutiala Reference Health Center Koutiala Mali Regional Health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.

关键词： Hysterectomy Gynaecological Pathology Mali

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Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the Reference Health Center of Commune III of the District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1431-1436页

作者： Hamady Sissoko Souma Kodio Hamidou Albachar Cheickna Sylla Salif Diarra Sidy Moctar Diakité Mohamed Traoré Souleymane Traoré Ibrahim Fomba Ouncoumba Diarra Nana Bah Drissa Diarra Mahamoudou Coulibaly Bocary Sidi Koné Hawa Samaké Ahmadou Coulibaly Mamadou Traoré seydou z. dao Sitapha Dembélé Samou Diarra Konimba Koné Alou Samaké Sanogo Siaka Amara Reference Health Centre of Commune III of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Mohamed VI Perinatal Clinic Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Point-G Obstetrics and Gynecology Department of University Hospital Center Bamako Mali Reference Health Centre of Commune II of the District of Bamako Bamako Mali H Department of Gynecology and Obstetrics of the Fousseyni daou Hospital in Kayes Kayes Mali Reference Health Centre of Commune VI of the District of Bamako Bamako Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

关键词： Migration Implant Pulmonary Artery Bamako

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Maternal and Fetal Prognosis of Uterine Rupture in the Health District of Koutiala

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1187-1196页

作者： Cheickna Sylla Soumana Oumar Traoré Sitapha Dembele seydou z. dao Mamadou Traoré Amadou Boucoum seydou Fané Ibrahima Tegueté Youssouf Traoré Niani Mounkoro Department of Obstetrics and Gynecology Koutiala Reference Health Centre Sikasso Mali Faculty of Medicine and Odontostomatology University of Science Technology and Technology of Bamako Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune V Bamako Mali Department of Obstetrics and Gynecology Kayes Hospital Kayes Mali Department of Gynecology and Obstetrics Commune II Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Gabriel Touré University Hospital Bamako Mali

Introduction: Uterine rupture is a complete or incomplete non-surgical continuity solution of the wall of the gravid uterus. Indeed, it is a Affection obstetrical condition whose maternal-fetal prognosis is poor in terms of morbidity and mortality. Objectives: To assess the risk factors for uterine rupture in the Koutiala Health District. Methods: This was a descriptive and analytical cross-sectional prospective collection study from January 1, 2019 to December 31, 2019, a 12-month period. In our study, all patients admitted to the maternity ward were included during the study period for which the diagnosis of uterine rupture was made. Results: Out of a total of deliveries, we recorded 27 cases of uterine rupture, a frequency of 1.04%. The average age of our patients was 32 years with extremes of 19 and 45 years. We notice 92.6% of uterine ruptures during the transfer. Almost 3/4 of our parturients were out of school 70.4% versus 11.1% in primary school and 18.5% in secondary school. The majority of patients affected by uterine rupture came from rural areas 85.2%. Only 14.8% were from Koutiala city. The admission time to the Koutiala Reference Health Centre was 2 hours 30 minutes in 50.85% of our patients with extremes of 15 minutes and 4 hours 30 min. The average parity was 6.30 - 3036;large multiparous accounted for 63% in our sample followed by multiparous

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The Free Cesarian in the Health District of Bougouni

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1233-1245页

作者： Cheickna Sylla Soumana Oumar Traoré Sitapha Dembele seydou z. dao Lassana Togola Amadou Boucoum seydou Fané Ibrahima Tegueté Youssouf Traoré Niani Mounkoro Department of Obstetrics and Gynecology Koutiala Reference Health Centre Sikasso Mali Faculty of Medicine and Odontostomatology University of Science Technology and Technology of Bamako Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune V Bamako Mali Department of Obstetrics and Gynecology Kayes Hospital Kayes Mali Department of Gynecology and Obstetrics Commune II Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Gabriel Touré University Hospital Bamako Mali

Purpose: The purpose of this study was to assess the impact of free caesarean section on maternal-fetal prognosis. Materials and Methods: This was a descriptive, cross-sectional, comparative analytical study of one year of non-free caesarean section and three years of free with retrospective data collection. Our study took place from January 1, 2004 to December 31, 2004 and from January 1, 2007 to December 31, 2009. Results: Caesarean section completion rates are 1.28%, 1.30%, 1.53%, 1.32% respectively in 2004, 2007, 2008, 2009. The average age was 27 years with extremes of 15 to 40 years. The peak of evacuations was recorded in 2007 with a rate of 89.4% and the peak of direct admissions in 2009 with a rate of 14.9%. An adequate means of transport was used in 77.20%. In 22.80% of cases an inadequate means was used. The indications of caesarean sections were dominated by preeclampsia 211/1045 caesarean section followed by acute fetal suffering 179/1045;86/1045;placenta previa 64/1045;presentations of the shoulder i.e. 53/1045;pre-rupture syndrome 44/1045;retro-placental hematoma 27/1045. In terms of maternal prognosis: we noted maternal deaths with a rate of 2.4%, 2.4%, 4.

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Epidemiological Clinical Aspects and Medical Management of Sexual Assault in the Region of Ségou in Mali

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 209-221页

作者： Tidiani Traoré Thierno Boubacar Bagayoko Alpha Sanogo Sory Ibrahime Koné seydou Traoré Kassoum Sidibe Bréhima Donigolo Bréhima Doumbia seydou z. dao Famakan Kane Adama Bah Seydina Alioun Beye Amadou Bocou seydou Fané Yossuf Traoré Ibrahim Téguété Nianankoro Fomba Hospital Ségou Mali Koutiala Reference Health Center Koutiala Mali Common Reference Health Center II Bamako Mali Bla Reference Health Center Bla Mali Anesthesia and Resuscitation Service Center Hospitalier Universitaire Point G Bamako Mali Gabriel Touré University Hospital Bamako Mali

Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.

关键词： Aspects Sexual Assaults Epidemio-Clinics Management Segou

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Mothers’ Level of Schooling, Monitoring of Their Pregnancy and Perinatal Prognosis at the Reference Health Centre of Commune V of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 383-394页

作者： Albachar Hamidou Sitapha Dembélé Cheickna Sylla Sissoko Hamady seydou z. dao Alou Samaké Saleck Doumbia Cissao Chiaka Sanogo Siaka Amara Sema Keita Reference Health Center of Kayes Kayes Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali National Centre for Scientific and Technological Research in Bamako Bamako Mali Department of Gynecology and Obstetrics of the Fousseyni daou Hospital in Kayes Kayes Mali Department of Gynecology and Obstetrics of the Gabriel Touré University Hospital Bamako Mali Reference Health Centre of Commune III of the District of Bamako Bamako Mali Reference Health Centre of Commune II of the District of Bamako Bamako Mali Reference Health Centre of Commune VI of the District of Bamako Bamako Mali Reference Health Center of Fana Koulikoro Mali

Introduction: The level of schooling of mothers is a determining factor in the follow-up of pregnancy and consequently the prognosis of childbirth and the quality of the newborn. Objective: The aim was to assess the impact of the level of education on the follow-up of their pregnancy and perinatal prognosis at the Reference Health Centre of Commune V of the District of Bamako. Materials and Methods: This was a prospective, cross-sectional and analytical study aimed descriptive from August 15 to December 15, 2021. We included in this study all pregnant women who had a gestational age of at least 22 weeks of amenorrhea and who gave birth or were received in the immediate postpartum period at the maternity ward of the Reference Health Center of Commune V. Results: Out-of-school parturients accounted for 60% of cases. Among the parturients in school, 18% had a higher level. In our study, 14.3% of women in labour knew the date of the last menstrual period. In our series, 100% of mothers in higher and secondary school had completed an antenatal consultation (CPN) compared to 90.7% in the out-of-school mothers. CPN1 was performed in the first trimester of pregnancy in 21.1% among out-of-school parturients compared to 83.5% among higher-level parturients. The number of NPCs was greater than or equal to 4 in 47.9% of parturients. Conclusion: Women’s schooling has an impact on their socio-economic conditions on the one hand and on the monitoring and prognosis of pregnancies on the other.

关键词： Level Schooling Mothers Aftercare Pregnancy Prognosis

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Evaluation of Insertion with the New Inserter of the Intra-Uterine Device of the Postpartum at the Referral Health Center of Commune II of Bamako, Mali

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 41-48页

作者： seydou z. dao Mamoudou Sissoko Bakary Abou Traoré Sakoba Konaté Kassoum Sidibé Mamadou Sima Ahmadou Coulibaly Mamadou S. Traoré Youssouf Traoré Amadou Ingré Dolo Referral Health Center of Commune II Bamako Mali Point G Teaching Hospital Bamako Mali Gabriel Toure Teaching Hospital Bamako Mali

Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1st 2016 to August 31st, 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organiz.tion’s criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn’t notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn’t have any side effects in 98% of cases. Conclusion: The insertion of a postpartum intra-uterine device with the new inserter has supplanted the insertion techniques using forceps in our center because of its ease and speed. Its use is worth being populariz.d to help reduce the unmet need for family planning.

关键词： Family Planning Intra-Uterine Device New Inserter Postpartum

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Maternal-Fetal Prognosis of Eclampsia at the Second Reference Hospital in the Urban Commune of Segou in Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1414-1429页

作者： Tidiani Traoré Cheickna Sylla Kassoum Sidibé Babou Traoré Sylvain Guindo Adama Coulibaly Seydina A. Beye seydou z. dao Famakan Kané Youssouf Traoré Ibrahima Téguété Moustaphe Touré Department of Gynecology and Obstetrics NianankoroFomba Hospital Ségou Mali Department of Gynecology and Obstetrics Reference Health Centre in Koutiala Sikasso Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune II Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre in Bla Ségou Mali Department of Gynecology and Obstetrics Gabriel TOURE University Hospital Center Bamako Mali Department of Gynecology and Obstetrics University Hospital Center of the Mali Hospital Bamako Mali

Aim: To describe the epidemiological, therapeutic and prognostic aspects of eclampsia at the second reference hospital in the urban commune of Ségou in Mali. Patient and Methods: This was a descriptive, cross-sectional, analytical, retrospective and prospective study based on a comprehensive de-engineering. It covered a 3-year period from January 1, 2010 to December 31, 2012 and involved 176 cases. Results: The incidence of eclampsia during the study period was 2.9%. Classically, it occurred in 74.4% in young primigeste, in 73.9% in the 3rd trimester of pregnancy and 26.1% of cases during postpartum. We recorded maternal complications such as retro-placental hematoma, acute kidney failure and delivery hemorrhage. The case fatality rate was 2.3% or 4 cases of maternal death. At the fetal level, there was 29.5% prematurity, 31.8% neonatal suffering, 11.4% hypotrophy, 11.9% in utero fetal death and 7.4% early neonatal death. Conclusion: The maternal-fetal prognosis remains reserved despite the progress made in the management of eclampsia in our services.

关键词： Pronostic Maternal Fetal Eclampsia Unsealed Pregnancy

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Contraception: School Knowledge and Practical Attitudes in the Urban Commune of Segou, Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1370-1380页

作者： Tidiani Traoré Cheickna Sylla Kassoum Sidibé Babou Traoré Sylvain Guindo Adama Coulbaly seydouna A. Beye seydou z. dao Famakan Kané Youssouf Traoré Ibrahima Téguété Moustaph Touré Nianankoro Fomba Hospital Ségou Mali Department of Gynecology and Obstetrics Reference Health Centre in Koutiala Sikasso Mali Department of Gynecology and Obstetrics Reference Health between the Commune II Bamako Mali Mali Reference Health Centre Bla Ségou Mali Department of Gynecology and Obstetrics Gabriel TOURE University Hospital Bamako Mali Department of Gynecology and Obstetrics University Hospital of the Hospital of Mali Bamako Mali

The aim was to describe aspects of students’ knowledge of sexuality and contraception and their sexual behaviour in schools in Ségou, Mali. Materials and Methods: This was a one-pass cross-sectional survey with reasoned choice at the first level and random choice at the second level over a 3-month period from January 2013 to March 2013. Results: The majority of the students involved in our study reside in the commune of Ségou, 90.4%. The average age of our students was 18. The female sex was the most represented in our study with 59.7%. The majority of students had casual sex at 60.3% and 70.9% irregularly. The change of sexual partner affected 47.9% of schoolchildren. Of our sexually active students, 72.6% had sexual partners and 37.4% had more than 2 partners. The main sources of information are respectively the media with 72.1% followed by teachers with 12.9% and friends with 09.7%. Among the most well-known contraceptive methods, condoms rank first with 72.6%, followed by injectable with 72.0%. 70.6% of the population had not yet used a contraceptive method at first sexual intercourse and in 72.9% of cases was condoms. The most cited source of contraceptive supply is pharmacy with 49.5% followed by family planning centres and maternity wards at 16.2% and shops at 16.2%. Conclusion: The referral of young people to approved health facilities for contraception could prevent them from risky sexual behaviours.

关键词： Teenagers Youth School Environment Contraception Sexuality

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