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Cervico-Isthmic Pregnancy on Cesarean Scar Successful Treated with Methotrexate, Mifepristone and Misoprostol: A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第9期11卷 1229-1235页

作者： k. E. Logbo-Ak.y D. R. Ajavon k. B. M’bortche P. Y. k.mbote A. S. Aboubak.ri k. akpadza Gynecology and Obstetrics Department of k.ra University Hospital University of Kara Kara Togo Gynecology and Obstetrics Department of CHR Tomdé University of Kara Kara Togo Togolese Association of Family Well-Being Planning Center (ATBEF) University of Lomé Lomé Togo Gynecology and Obstetrics Department of Sylvanius Olympio University Hospital University of Lomé Lomé Togo

Introduction: Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year-old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. k.0358912">The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. Conclusion: Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful.

关键词： Cervico-Isthmic Pregnancy Medical Treatment Methotrexate

Fœtal Death in Utero: Maternal Epidemiological and Prognostic Aspects at Sylvanus Olympio Teaching Hospital in Lomé

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 511-520页

作者： Baguilane Douaguibe A. S. Aboubak.ri A. Bassowa D. Ajavon T. k.tevi k. E. Logbo-Ak.y B. Baramna k. Fiagnon k. akpadza Gynecology and Obstetrical Service CHU Campus Lomé Togo Gynecology and Obstetrical Service CHU Kara Togo Gynecology and Obstetrical Service CHU-SO Lomé Togo

The fetal death In Uterus is relatively a common problem in developing countries. In Africa, the rate of deaths varies from one hospital to another. We wanted to evaluate the prevalence, to describe the epidemiological aspects, etiologies and maternal prognosis associated with fetal deaths in Uterus in 2017 at Sylvanus Olympio Teaching Hospital in Lomé. Patients and methods: This was a retrospective descriptive study conducted from January 1st to December 31st, 2017. We have included all pregnant cases received and treated on the spot for in uterus deaths as defined by the World Health Organization. Medical termination of pregnancy records, intrapartum deaths, less than 22 amenorrhea week.’ pregnancies and complications of abortion were not included. Results: The fetal death rate in uterus was 3.64%. The multigravida and multiparous were respectively 49% and 41%;the referees were 51%, 28% evacuated;21% came on their own. The gestational age of 28 - 37 week. was 39% and 17% had no prenatal consultation. The analysis has revealed that high blood pressure, preeclampsia, and retroplacental hematomas were the main etiologies associated with fetal deaths in uterus. Conclusion: In uterus fetal deaths remain common in our country. The main causes were hypertension disorders of pregnancy. There were also some unk.own causes which could be related to economic or cultural reasons. For instance, autopsies of in uterus deaths and placental anatomopathology examination are not performed because of culture.

关键词： Fetal Death in Uterus Etiology Maternal Prognosis

Ovarian Dysgerminoma Associated with Pregnancy: A Case Report from the Sylvanus Olympio University Hospital Center

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 830-835页

作者： Baguilane Douaguibe Bingo k. M’Bortche Tina Ayok. k.tevi Ak.la Bassowa Dede Ajavon T. Dare Francis Baramna-Bagou k.mi A. Migbegna Abdoul Samadou Aboubak.ri k.ffi akpadza Department of Gynecology and Obstetrics Sylvanus Olympio University Hospital Center Lomé Togo Togolese Association of Family Well-Being Planning Center (ATBEF) Lome Togo Department of Gynecology and Obstetrics Campus University Hospital Center Lomé Togo Department of Gynecology and Obstetrics University Hospital Center Kara Togo Department of Pathology University Teaching Hospital of Lomé Lomé Togo

Back.round: Dysgerminoma is a germ cell tumor of the ovary usually found in young women. It represents 1% to 2% of all ovarian cancers. The preoperative diagnosis is generally difficult. The surgery and the pathology study are therefore essential for the diagnosis, and optimal management. The incidence of pregnancy with dysgerminoma is extremely low. The treatment and management during pregnancy often jeopardize the materno-fetal prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant woman. Observation: Patient was an 18-year-old, female with no known past medical history, who presented to the emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous uterus (height 42 cm). An ultrasound showed an active pregnancy, and a large vascularized, finely echogenic, multi-partitioned, thick-walled liquid ovarian tumor. Ca125 was 231.5 IU/ml. Ovarian dysgerminoma was suspected. The surgery and the pathology study of the surgical specimen confirmed the suspected diagnosis. Patient died on postoperative day 8. Conclusion:

关键词： Dysgerminoma Young Pregnancy Adnexectomy

Effect of daily supplementation of soy isoflavones on hot flashes and night sweats in African menopausal women

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Open Journal of Obstetrics and Gynecology 2014年第1期4卷 42-46页

作者： Ronbinson Enow Mbu Yao Raphael Abauleth akpadza k.ffi Namory k.ita Amadou Dolo Jean Lank.ande Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundeCameroun Department of Obstetrics and Gynecology Cocody University and HospitalBoulevard de l’Universitéde CocodyAbidjanCôte d’Ivoire Department of Obstetrics and Gynecology Tokoin University Hospital198 rue de l’hôpitalLomeTogo Department of Obstetrics and Gynecology University of Conakry and DONKA HospitalConakryRepublique de Guinée Department of Obstetrics and Gynecology Gabriel TouréUniversity HospitalBamakoMali Department of Obstetrics and Gynecology Yalgado Ouédraogo University HospitalAvenue du capitaine Thomas SankaraOuaga-dougouBurkina Faso

The aim of this study was to evaluate the effectiveness of a pharmaceutical grade isoflavone supplement (Inoclim?) 40 mg per capsule of soy extract rich in daidzin and genistin) on the number of hot flashes and night sweats in menopausal African women. This open, prospective, multicenter study involved 140 menopausal women with climacteric symptoms (i.e., a minimum of five hot flashes and/or moderate to severe night sweats per day). These patients received a daily 40-mg supplement of soy isoflavone contained in an Inoclim? capsule (Laboratoire Innotech International, France). The dose was increased to two capsules per day when there were more than five hot flashes or when the women could not sleep because of night sweats. The patients were followed up over a 4-month period and data were analyzed using EPI-InfoTM version 3.5.1. The outcome measure was fewer hot flashes and night sweats. The mean daily number of episodes of hot flashes was 5.7 at baseline and 1.8 at week.16, corresponding to a decrease of 68.4% (n = 93 patients at baseline and n = 66 at 16 week.). The mean number of daily episodes of night sweats was 3.7 at baseline and 0.8 at week.16, corresponding to a decrease of 78.4% (n = 127 patients in the first week.and n = 73 at 16 week.). Over 80% of patients took.a single one 40 mg capsule per day. The percentage of patients who adhered to the prescription was more than 95% during the 4-month follow-up period. These results confirm the effectiveness of a pharmaceutical grade isoflavone supplement (40 mg, rich in genistin and daidzin) on vasomotor symptoms in menopausal women.

关键词： Menopause Climacteric Disorders Hot Flashes Night Sweats Soy Isoflavones Genistin Daidzin Genistein Daidzein Inoclim

Delivery Outcome in Women with Major Sick.e 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 Aboubak.ri k.ssi Edem Logbo-Ak.y k.djo Fiagnon Ak.la Bassowa k.ffi 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 k.ra Kara Togo

Objectives: To determine the prevalence of women who delivered in the two major sick.e 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 sick.e 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 k.e 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 k.e 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 sick.e 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： Sick.e Cell Disease Childbirth Prognosis Homozygous SS Heterozygous SC Togo Africa

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 Aboubak.ri k.djo Fiagnon Ak.la Bassowa Essohana Joseph Badabadi k.ffi 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)

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 k.gnomon M’bortche k.ssi Edem Logbo-Ak.y Tina Ayok. k.tevi Baguilane Douaguibe Francis Baramna-Bagou Abdoul-Samadou Aboubak.ri k.ffi 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

In Utero Fetal Death: Epidemiological and Management Aspects at the Sylvanus Olympio University Hospital (CHU SO) in Lomé

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1695-1701页

作者： k.mlan Alessi Andele Ameyo Ayok. k.tevi Baguilane Douaguibe Aquila Bassowa Dédé Régine Diane Ajavon Abdoul Samadou Aboubak.ri k.ffi akpadza Department of Gynecology and Obstetrics Sylvanus Olympio University Hospital Center Lom Togo Department of Gynecology and Obstetrics Campus University Hospital Center Lom Togo Department of Gynecology and Obstetrics Regional Hospital Center Kara Togo Department of Gynecology and Obstetrics Kara University Hospital Center Kara Togo

Introduction: The occurrence of intrauterine fetal death (IUFD) is a traumatic event not only for the mother and her family but also for the obstetric team. IUFD is a common event. Objective: the aim of our study is to describe the epidemiological, diagnostic and management aspects of IUFD at the Sylvanus Olympio University Teaching Hospital (CHU SO), Lomé. Methodology: It was a descriptive cross-sectional study with retrospective data collection process that concerned cases of IUFD from January 1st 2023 to December 31, 2023 at CHU SO. Results: The hospital prevalence of IUFD was 2.43%. The mean age of the mothers was 30.6 ± 6 years. The Multigestures represented 32.52% and primiparous women represented 29.72%. Pregnant women were referred in 88.11% of cases;47.55% had done at least 4 antenatal care visits and 4.20% had a history of IUFD. The etiological factors of IUFD were preeclampsia in 28.67% of cases, retroplacental hematoma in 28.67% and premature rupture of membranes in 4.55% of cases. Misoprostol was used for artificial induction of labor in 57.14% of cases and the delivery route was vaginal in 75.87% of cases. Conclusion: The frequency of IUFD is high and its reduction remains a challenge in low-income countries.

关键词： In Utero Fetal Death Fetal Death Togo

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 Ak.la Bassowa Dede Ajavon Bingo k.gnomon M’Bortche Tina Ayok. k.tevi Francis Baramna-Bagou k.mi Migbegna Abdoul Samadou Aboubak.ri k.ffi 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