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Obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 69-76页

作者： Logbo-Akey Kossi Edem bassowa akila Ketevi Tina Kambote Yendoubé Patchidi Kibandou Amewouho Kofi Ajavon Dédé Régina Aboubakari Abdoul-Samadou Service de Gynécologie-Obstétrique CHU Kara Université de Kara Kara Togo Service de Gynécologie-Obstétrique CHU Campus Université de Lomé Lomé Togo Service de Gynécologie-Obstétrique CHU Sylvanus Olympio Université de Lomé Togo Faculté des sciences de la santé Université de Lomé Lomé Togo Service de Gynécologie-Obstétrique CHR Tomdé Université de Kara Togo

Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the Obstetrics and Gynecology Department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3rd trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: Obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.

关键词： Obstetric Emergency Kara University Hospital

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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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Obstetric Emergencies at the Kara University Hospital Maternity Ward:Sociodemographic, Etiological and Prognostic Aspects

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第1期

作者： Logbo-Akey Kossi Edem bassowa akila Ketevi Tina Kambote Yendoubé Patchidi Kibandou Amewouho Kofi Ajavon Dédé Régina Aboubakari Abdoul-Samadou

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Ultrasound-Guided Core Needle Biopsy of Breast Lesions: Results and Usefulness in a Low Income Country

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Open Journal of Radiology 2017年第4期7卷 209-218页

作者： Mazamaesso Tchaou Tchin Darré Pihou Gbandé Massaga Dagbé akila bassowa Lantam Sonhaye Lama-Kegdigoma Agoda-Koussema Department of Radiology The University Teaching Hospital of Lomé Lomé Togo Department of Pathology The University Teaching Hospital of Lomé Lomé Togo Department of Obstetrics and Gynecology The University Teaching Hospital of Lomé Lomé Togo

Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lomé, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women;from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1% had a family history of breast cancer. Lesions were most often palpable (90.7%). They were located in the left breast in 54.7%. Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4% and probably benign (Birads 3) in 29.6%. Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9%) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1%) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%. Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%. Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predict

关键词： Ultrasound Core Needle Biopsy Breast Cancer Histology

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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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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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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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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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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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Determinants of Home Birth in the Community of Dagbati in Togo

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Open Journal of Obstetrics and Gynecology 2022年第6期12卷 520-527页

作者： Améyo Ayoko Ketevi akila bassowa Bidilukinu Katende Dédé Régine Diane Ajavon Adjo Sylvie Biwuh Alessi Andele Abdoul-Samadou Aboubakari Koffi Akpadza Department of Gynecology-Obstetrics Sylvanus Olympio Teaching Hospital Lome Togo Department of Gynecology-Obstetrics Campus Teaching Hospital Lome Togo Department of Gynecology-Obstetrics Regional Hospital Center Kara Togo Department of Gynecology-Obstetrics Kara Teaching Hospital Lome Togo

Introduction: Home birth or unassisted birth means for a woman to make the decision to give birth at home, not alone in absolute terms, but without professional assistance, be it that of a midwife, a doctor or any other person with midwifery qualifications. Methods: This was a descriptive cross-sectional study conducted from November 04th to December 21st, 2019 and from August 17th to August 21st, 2020, in the community of Dagbati, in 33 women who gave birth at home, received at the USP of Dagbati and during advanced strategies;who were registered or not in the delivery register of USP Dagbati and who agreed to participate in the survey freely and in an informed manner. Results: Of the 48 deliveries that took place in the locality during our study period, 33 took place at home, with a rate of 68.7%. The average age of the women giving birth was 26.33 years with extremes of 15 and 47 years. In 42.4% of cases, they were farmers. Twenty-seven women who gave birth had farmer spouses (81.9%). The distance between their house and the health center was greater than 2 km in 78.8% of cases. Among the reasons for giving birth at home, the lack of financial means was mentioned in 60.6%. In 63.6%, the family had assisted the women in giving birth. Conclusion: Home birth is still a reality in our communities, despite the increased number of health facilities. The sensitization of the population, the improvement of the conditions of accessibility to the health center, the quality of obstetric care, and also, the improvement of the living conditions of women will surely allow a total abandonment of home births.

关键词： Home Births Dagbati Determinants Parturient Togo

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