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Obstetric References in Disadvantaged Environments: Case of References to the University Hospital Center of Kara, in Northern Togo

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 267-277页

作者： Kossi Edem Logbo-Akey Bassowa Akila Kofi Mawoulé Améwouho Ketevi Tina Yendoubé Pierre Kambote Dédé Régine Diane Ajavon Baguilane Djoauguibe abdoul-samadou aboubakari Koffi Akpadza Service de Gynécologie-Obstétrique CHU Kara Togo Service de Gynécologie-Obstétrique CHU Campus Lomé Togo Service de Gynécologie-Obstétrique CHU Sylvanus Olympio Lomé Togo Service de Gynécologie-Obstétrique CHR Tomdé Kara Togo

Introduction: References are frequent and most often carried out in emergency situations. The objective of this study was to describe the epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Methodology: This was a retrospective cross-sectional descriptive study conducted from September 1, 2022, to February 28, 2023, at CHU-Kara, focusing on obstetric referrals to the Gynecology-Obstetrics department. Result: 828 patients were referred for obstetric reasons out of 1295 admissions, representing a frequency of 63.9%. The average age was 25.04 years. They were primigravida (38.3%), unemployed (62.7%). Motorcycles were the main means of transportation, accounting for 53.1% of cases. The average distance to reach the referral center was 31.6 km, covered in an average of 71 minutes. In 40.7% of cases, patients had less than 4 prenatal consultations and were referred in peripartum (56.6%) for pre-eclampsia (14%), post-term pregnancy (11.8%), dystocia (10.5%). Eighty-six point nine percent (86.9%) of the referred patients were able to deliver during their stay in the department, of which 61.7% had vaginal deliveries. The maternal and perinatal mortality rates were 0.7% and 14.9%, respectively. Conclusion: Obstetric referrals to Kara University Hospital are frequent during the perpartum period and are often carried out by motorbike.

关键词： Obstetric Referral Epidemiology Prognosis CHU-Kara

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Women’s Preferential Contraceptive Methods in Publics’ Family Planning Centers in Lomé(Togo, West Africa): A Prospective Study of 734 Cases

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Open Journal of Obstetrics and Gynecology 2015年第10期5卷 564-571页

作者： Amah Biova Adama-Hondégla abdoul-samadou aboubakari Kodjo Fiagnon Akila Bassowa Essohana Joseph Badabadi Koffi Akpadza Department of Gynecology and Obstetrics Sylvanus Olympio Teaching Hospital University of Lomé Lomé Togo Department of Gynecology and Obstetrics University Hospital Center of Kara Kara Togo

Justification and Objectives: The reasons for the choice of contraceptive methods in Lomé were insufficiently documented. The current study aimed to identify preferential contraceptive methods in women in Lomé and the reasons for the choices. Materials and Methods: Prospective study conducted on 734 clients recruited in five family planning centers in the municipality of Lomé over a period of 3 months (30th September to 30th December 2005). Data were collected by direct interview and processed by Excel and Epi info 7 software. Results: Contraceptive methods preferred in descending order were: Medroxyprogesterone acetate injection (51.6%), Norethisterone enantate injection (17.3%), inert Intra Uterine Device (12.0%), Progestogen implants (11.0%), combined oral pills (8.03%) and spermicide jelly (0.1%). The main reasons for choices were the method’s reversibility (32.56%) and its long acting property;especially in illiterate women (p 10-10). Friends and medical staff counted for the choice in 9.26%. In 76.87% of cases, the husbands were reported to agree with the chosen methods. Conclusion: The choice of contraceptive methods in Lomé was mainly guided by the notion of reversibility and its long acting property. The focus should be put more on the quality of counselling towards women with low education level.

关键词： Contraception Women Preferences Reasons of Choice Lomé Togo (Africa)

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Cervical Cancer Screening by Midwives in the Kara Region of Northern Togo: Knowledge, Attitudes and Practices

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 140-146页

作者： Kossi Edem Logbo-Akey Dede Regina Ajavon Kignomon Bingo M’bortche Pierre Yendoubé Kambote Kbando Noé Patidi abdoul samadou aboubakari Department of Gynecology and Obstetrics CHU Kara University of Kara Kara Togo Gynecology and Obstetrics Department of CHR Tomdé University of Kara Kara Togo Clinic of the Togolese Association for Family Welfare (ATBEF) University of Lome Lome Togo University of Lome Lome Togo

Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.

关键词： Cancer of the Cervix Knowledge Screening Midwives Kara

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Delivery Outcome in Women with Major Sickle Cell Syndrome: A Comparative Study of the Homozygous Forms “SS” versus the Heterozygous “SC”

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 713-722页

作者： Amah Biova Adama-Hondégla abdoul-samadou aboubakari Kossi Edem Logbo-Akey Kodjo Fiagnon Akila Bassowa Koffi Akpadza Department of Gynecology and Obstetrics of the Sylvanus Olympio University Hospital of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital of Kara Kara Togo

Objectives: To determine the prevalence of women who delivered in the two major sickle cell syndromes, “SS” and “SC”, and to identify maternal and early neonatal prognosis inherent to each form. Material and Methods: This is a comparative, descriptive and retrospective cross-sectional study of 226 files of women carrying major sickle cell syndrome (66 cases of “SS” form versus 160 cases of “SC” form), collected from May 2008 to May 2013 at the Gynecology and Obstetrics Clinic of the Sylvanus Olympio’s University Hospital of Lomé. Data were processed by Epi Info 6 software. For comparison of variables, the Chi-2 test of Fisher with significance as p < 0.05 has been used, so is the calculation of Odds Ratio with its confidence interval at 95%. Results: Carriers of the two major sickle cell syndromes represent 0.8% of all the deliveries during the study period. Caesarean section, especially prophylactic one, was the dominant mode of delivery. The SS forms have been exposed to have more vaso-occlusive crises (22.7% vs. 13.1%;p = 0.04, OR = 0.31), more blood transfusion (57.6% vs. 29.4%;p = 7 × 10-5, OR = 3.2) and more puerperal infections (p < 0.05). Acute chest syndrome was not related to any of the two forms of sickle cell disease (13.6% vs. 8.1%;p = 0.15). The maternal mortality rate and the perinatal mortality among SS form against SC form were not significant (respectively 15.1% vs. 8.7%;20.9% vs. 17.1%). Conclusion: Maternal and fetal complications were present in both forms of major sickle cell syndrome but the "SS" form gave exposure to greater maternal morbidity. Resuscitative measures in adults and newborns should be reinforced at the delivery time of these “at-risk-pregnancies”.

关键词： Sickle Cell Disease Childbirth Prognosis Homozygous SS Heterozygous SC Togo Africa

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Cancers in the Elderly Seen in Anatomical Pathology Laboratory in Lomé, Togo

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Open Journal of Pathology 2016年第1期6卷 26-31页

作者： Tchin Darré Atchi Walla Tchilabalo Matchonna Kpatcha abdoul-samadou aboubakari Nidain Maneh Mikotakatola Koulinga Koffi Amégbor Gado Napo Koura Department of Pathology The University Teaching Hospital of Lomé Lomé Togo Department of Trauma and Orthopedic The University Teaching Hospital of Lomé Lomé Togo Department of Urology The University Teaching Hospital of Lomé Lomé Togo Department Obstetrics and Gynecology The University Teaching Hospital of Kara Kara Togo Department of Ophthalmology The University Teaching Hospital of Lomé Lomé Togo

Background: The elderly cancers are worldwide a major public health issue. Their exact incidence is unknown in Togo. The purpose of this study was to describe epidemiological and histological data of cancers in the elderly in Togo. Materials and Methods: This was a cross-sectional and descriptive study of cases of elderly cancers diagnosed at the laboratory of pathology of the university teaching hospital of Lomé from 1995 to 2014 (20 years). Cases of examination on samples of the elderly (biopsy, excision, surgical specimens) were collected from the data records of that laboratory. Results: Overall, 792/5200 cases of elderly cancer were collected representing 15.2% of all cancers diagnosed in the laboratory. The annual incidence was 39.6 cases. Patient age ranged from 65 to 103 years old, with a mean of 68.5 ± 4 years old. The sex ratio (M/F) was 1.3. At pathological level, the study material included pieces (n=290 cases;36.6%) and biopsies (n=502 cases;63.4%). Cancers located preferably in prostate in men (38%), and in women the most frequent locations were cervix (16.2%) and breast (15.8%). We noticed four histological groups: carcinomas (n = 706 cases;89.1%), sarcomas (n = 43 cases;5.5%), lymphoma (n = 34 cases;4.3%) and melanoma (n = 9 cases;1.1%). Carcinomas were dominated by adenocarcinomas (50.1%) and squamous cell carcinomas (33.8%);Kaposi’s sarcoma (32.6%) was the most common histological type in sarcomas. Conclusion: Our results showed that the elderly cancers were frequent in Togo, locating mostly in uterus cervix and breast in female, and prostate in men. This study could help to advocate the establishment of a cancer registry in Togo.

关键词： Cancer Elderly Togo

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Outcome of Pregnancies under Cupper Intrauterine Device: Experience of 10 Cases Collected at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 616-623页

作者： Bingo Kignomon M’bortche Kossi Edem Logbo-Akey Tina Ayoko Ketevi Baguilane Douaguibe Francis Baramna-Bagou abdoul-samadou aboubakari Koffi Akpadza Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynaecology-Obstetrics The University Hospital Kara Kara Togo Department of Gynaecology-Obstetrics The University Hospital Sylvanus Olympio Lomé Togo

Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.

关键词： Contraception Pregnancy Etiologies Outcome Lomé

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Births at Home: About 411 Cases Collected in the Township of Hiheatro in the Southern Part of Togo

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Open Journal of Obstetrics and Gynecology 2021年第10期11卷 1306-1316页

作者： Baguilane Douaguibe Akila Bassowa Dede Ajavon Bingo Kignomon M’Bortche Tina Ayoko Ketevi Francis Baramna-Bagou Komi Migbegna abdoul samadou aboubakari Koffi Akpadza Department of Gynecology and Obstetrics Sylvanus Olympio University Hospital Center Lomé Togo Department of Gynecology and Obstetrics Campus University Hospital Center Lomé Togo Department of Gynecology and Obstetrics Kara University Hospital Center Lomé Togo

This was a cross-sectional and descriptive study conducted from January 2nd to march 30th 2019 in the township of Hihéatro in Togo. We included in the study, women who had given birth at least once at home and who accepted to undergo the survey. Data were collected, using a pre-planned and pre-tested survey sheet, by a team of four trained interviewers under the responsibility of a supervisor. Interviews were carried out in the homes of the respondents after obtaining their informed consent. The parameters studied were the number of births at home, socio-demographic characteristics, and reasons for births at home and maternal and fetal prognosis. 411 women gave birth at home in the township. The average number of births at home per woman was 2 with extremes of 1 and 7 births per woman. The average age of the women was 28.4 years with the extremes of 15 and 38 years. The 25 - 34 age group represented 67.1% of cases. The average parity of the patients was 2. Multiparas represented 59.8% of cases. The main reasons for giving births at home by the interviewees were insufficient financial means in 36% of cases and the lack of means of transport in 28% of cases. Maternal morbidity was marked by 14.1% perineal tear, 1.6% hysterectomy. Four hundred and eleven newborns were registered. Of these newborns, 4.4% were stillborn and 8.8% did not cry at birth. Free obstetric care and increased awareness on the importance of assisted deliveries will improve the maternal-fetal prognosis.

关键词： Childbirth Home Complications Togo

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Maternal Deaths after Obstetrical Referral and/or Evacuation to the Obstetrics Gynecology Clinic of the Sylvanus Olympio University Hospital Center, Togo

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Advances in Reproductive Sciences 2023年第2期11卷 37-45页

作者： Ameyo Ayoko Ketevi Bidilukinu Katende Akila Bassowa Komlan Alessi Andele Baguilane Douaguibe Dédé Régine Diane Ajavon abdoul samadou aboubakari Koffi Akpadza Department of Gynecology-Obstetrics Faculty of Health Sciences University of Lome Lomé Togo Department of Gynecology-Obstetrics Faculty of Health Sciences University of Kara Kara Togo

Introduction: Maternal death or maternal mortality is “the death of a woman occurring during pregnancy or within 42 days of termination, regardless of duration or location, for any specific cause or aggravated by pregnancy or its management, but neither accidental nor fortuitous. Methods: This was a descriptive and analytical cross-sectional study carried out from January 1st, 2021 to April 30th, 2022 at the Obstetrics Gynecology Clinic of the Sylvanus Olympio University Hospital Center (SOUHC). Results: we noted 86 cases of maternal deaths after referral/evacuation i.e. a maternal mortality rate hospital of 555 maternal deaths per 100,000 LB. The average age of the patients was 31.1 ± 6.3 years with extremes of 15 and 45 years. In 33.7% of cases our patients were resellers. Multiparas represented 33.7% of the sample, they had performed less than three antenatal consultations. Postpartum hemorrhage was the reference reason in 33.7%. In 74.4% of cases, the patients referred had arrived by taxi. In 87.9% of cases, the patients had died of direct obstetric causes. Immediate postpartum hemorrhage accounted for 44.6% of cases and anemia, 36.4%. There is a statistically significant association between the availability of blood product and the avoidability of maternal death after obstetrical referral and/or evacuation (p value = 0.0188 0.05). Conclusion: Determining responsibility for maternal death is not always easy. There is an urgent need to strengthen the policy of reducing maternal mortality in Togo. This remains possible by developing communication strategies and a solid referral/counter-referral system.

关键词： Maternal Death Reference Counter Reference Togo

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Cystic Degeneration of Uterine Leiomyoma Misdiagnosed as Ovarian Malignancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 745-751页

作者： Kossi Edem Logbo-Akey Kignomon Bingo M’bortche Pierre Yendoubé Kambote Kibandou Noe Patidi Dédé Régine Diane Ajavon abdoul-samadou aboubakari 1Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Togolese Association for Family Welfare (ATBEF) Clinic University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital Sylvanus Olympio University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tomdé University of Kara Kara Togo

Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5th post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.

关键词： Leiomyoma Cystic Degeneration Ovarian Tumor

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Epidemiological and Prognostic Aspects of Obesity and Pregnancy in the Gynecology-Obstetrics Department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 88-96页

作者： Komlan Alessi Andele Ameyo Ayoko Ketevi Baguilane Douaguibe Akila Bassowa Dédé Régine Diane Ajavon Kodjo Fiagnon abdoul samadou aboubakari Koffi Akpadza Department of Gynecology and Obstetrics Sylvanus Olympio University Hospital Center Lome Togo Department of Gynecology and Obstetrics Campus University Hospital Center Lome Togo Department of Gynecology and Obstetrics Regional Hospital Center Kara Togo Department of Gynecology and Obstetrics Kara University Hospital Center Kara Togo

Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1st to the 30th of June 2022 at the CHU SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.

关键词： Obesity Pregnancy CHU SO Togo

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