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Vesico-Vaginal and Recto-Vaginal Fistula and Death Caused by a Vaginal Foreign Body in a Body-Packer

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1056-1061页

作者： Hamidou Soumana Diaouga Maimouna Chaibou Yacouba Madeleine Garba Rahamatou Nafiou Idi madi nayama Obstetrics and Gynecology Service Maternity Issaka Gazobi in Niamey Abdou Moumouni University Niamey Niger Obstetrics and Gynecology Service Niger-Turkey Friendship Hospital Abdou Moumouni University Niamey Niger Obstetrics and Gynecology Service Maternity of the Regional Hospital of Niamey Abdou Moumouni University Niamey Niger

Foreign body retained for long duration sometimes causes vesico-vaginal and recto-vaginal fistula. We report a 60-year-old woman with vaginal foreign body causing vesico-vaginal and recto-vaginal fistula;she died after foreign body removal due to septic shock. The patient had vaginal purulent discharge, abdominal pain, and a septic shock. A fragment of stone (limestone) was present in the vagina, which was removed. The patient developed urinary incontinence and fecal incontinence after removal of the foreign body. The examination demonstrated the presence of vesico-vaginal and recto-vaginal fistula. The patient died four days after removal of the foreign body due to septic shock and multi-visceral failure. During the extraction foreign body, bacteria could be disseminated into the systemic circulation and might cause septic shock. Thus, wide-spectrum antibiotic therapy must be used before the procedure, which may decrease the chance of septic shock.

关键词： Vaginal Foreign Body Vaginal Discharge Vesicovaginal Fistula Rectovaginal Fistula

Sexual Violence in the Zinder Region, about 441 Cases in Reference Motherhoods

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Surgical Science 2023年第2期14卷 90-96页

作者： Souleymane Oumarou Garba Zélika Salifou Lankoande Maina Oumara Nabara Ibrahim Issa Abdou Amadou Oumarou Habou madi nayama Mother and Child Health Centre of Zinder André Salifou University of Zinder Zinder Niger General Referral Hospital of Niamey Abdou Moumouni University of Niamey Niamey Niger Mother and Child Health Centre of Zinder Zinder Niger Mother and Child Health Centre of Maradi Dan Diko University of Maradi Maradi Niger National Hospital of Zinder André Salifou University of Zinder Zinder Niger Issaka Gazobi Maternity of Niamey Abdou Moumouni University of Niamey Niamey Niger

Background: Niger is one of the countries that have the highest fertility rate in the world, with 7, 6 children per woman. Zinder is the most populated region of Niger with 5 million inhabitants that is 1/5 of Niger population. The demographic impact that has affected Niger the last 10 years: unemployment poverty and drug use, spawned violence of all kinds in Zinder region (physical and sexual violence). Sexual abuse is a major risk for poor psychiatric and physical outcomes. As sexual violence has serious consequences on the life and future of women and the community and it concerns our field of intervention, we initiated this study whose objective was to determine the socio-epidemiological and lesional aspects, the consequences and appropriate solutions of sexual violence in the Zinder. Methodology: This was a retrospective collection study of all cases of alleged sexual violence received over a 12-year period from 1 January 2009 to 30 June 2021 in Zinder’s referral maternity wards. Results: During the study period, 441 cases of sexual violence were collected;an annual average of 36 cases (441/12). The frequency is 1.29% on the 34,186 consultations. The mean age was 12.31 years with age extremes of 3 to 43 years. Students accounted for 25.39%. Street vendors were found in 224 cases or 50.79%. The predominant reason for admission is rape in 64.63%. The defloration was 52.15%. Pregnancy was found in 118 cases or 26.75%. HIV serology was positive in 1 victim. School dropout was 26.75%. Conclusion: The victims of sexual violence were minors, mostly street vendors and school children. The lack of means of repression at the time allowed the expansion of this violence. The consequences of sexual violence were severe. Advocacy has improved the phenomen on of sexual violence in Zinder.

关键词： Sexual Violence Zinder Reference Motherhoods Niger

Experience of Menopause for Women in the Niamey Region, Republic of Niger

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1147-1154页

作者： Rahamatou Madeleine Garba Daddy Gaoh Nassira Salamatou Guédé Hamidou Soumana Diaouga Nafiou Idi Maina Oumara madi nayama Niger-Turkey Friendship Hospital Niamey Niger Abdou Moumouni University Niamey Niger Issaka Gazobi Maternity Hospital in Niamey Niger General Reference Hospital of Niamey Niamey Niger

Introduction: Menopause is poorly documented in Africa. For most of the women living there, the experience of this period does not seem to be very problematic. For women living in rural areas, other concerns are more prominent. Methods: The study was prospective, quantitative and qualitative about 500 cases collected over a period of 6 months. The study involved postmenopausal women in the Niamey region of public services, in certain residential areas, or accompanying people in health structures. Parameters taken into account were sociocultural, antecedents, experience, knowledge, and management of menopause. The data was entered and analyzed using Microsoft Office Word 2010 and Microsoft Office Excel 2010 software. Results: The average age was 56.4 years with extremes of 40 and 80 years;57% were still living with their husbands and 39% widows;60.2% housewives;53% uneducated, 17% have higher education;60.2% had had at least 6 children and 39.6% had used contraception. The comorbidities observed were arterial hypertension (24.4%) and diabetes (7%). As for the representation that women made of menopause, for all of them, this stage is the beginning of old age. The most frequent signs were asthenia (86.2%) and mood disorders (70.6%). Almost all of the patients (99.8%) had not used hormonal treatment for the menopause and among them 27% the management of the menopause was with traditional means. Conclusion: Menopausal disorders are certainly a reality in our socio-cultural context. They are not a primary concern either through ignorance or resignation of the women concerned.

关键词： Menopausal Experience Climacteric Syndrome HTM Niamey

Torsion of a Large Ovariancyst during the Postpartum Period: A Case Report from the Niger-Turkey Friendship Hospital in Niamey

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1134-1139页

作者： Rahamatou Madeleine Garba Hamidou Soumana Diaouga Nafiou Idi Bibata Boukari Bako Salamatou Guédé Maina Oumara madi nayama Niger-Turkey Friendship Hospital Niamey Niger Abdou Moumouni University Niamey Niger Issaka Gazobi Maternity Hospital Niamey Niger General Reference Hospital of Niamey Niamey Niger

Adnexal torsion is defined by the existence of a partial or complete torsion of the ovary and a tubal portion around its vascular pedicle. It is a rare gynecological emergency. We report the case of adnexal torsion on a large postpartum ovarian cyst in a 40-year-old patient. The diagnosis was suspected based on clinical and ultrasound signs and confirmed by exploratory laparotomy. The appearance of the cyst was suggestive of a mucinous cystadenoma of the ovary. The treatment was radical by performing an adnexectomy. The surgical piece weighed 5.2 kg. The postoperative course was simple. Anatomopathological examination had not been carried out;the parents had buried the operating piece.

关键词： Pelvic Pain Adnexal Torsion Postpartum Period Mucinous Cystadenoma

Prevalence and Socio-Demographic Aspect of Gender-Based Violence at the Zinder Holistic Care Centre (Niger) in 2024

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1726-1734页

作者： Zelika Lankoande Salifou Hamidou Soumana Diaouga Souleymane Oumarou Garba Zakari Salissou Hassane Yacouba Souley Aboua Nassirou Rahamatou Madeleine Garba madi nayama Department of Obstetrics and Gynaecology Faculty of Health Sciences Andre Salifou University of Zinder Zinder Niger Mother and Child Health Centre Zinder Niger Department of Obstetrics and Gynaecology Faculty of Health Sciences Abdou Moumouni University of Niamey Niamey Niger Issaka Gazobi Maternity Hospital Niamey Niger

Introduction: Gender-based violence is an important public health problem worldwide. The aim of this study was to describe the prevalence, the socio-demographic profile of patients (survivors and perpetrators) and the different types of gender-based violence treated at the Zinder holistic care centre in the Republic of Niger. Method: This was a descriptive cross-sectional study of cases of gender-based violence recorded and managed at the holistic gender-based violence management centre in Zinder (Niger) over the period from 1 January 2022 to 31 December 2023. The data collected were analysed using EPI infos version 7.1 software. Result: During the study period, 515 cases of gender-based violence were recorded. Most of the victims were women and girls (95.15%). Minors accounted for 42.28% of cases. The victims were aged 18 and over in 57.67% (297 cases). Single people accounted for 39.22% of cases. Students accounted for 41.36% of cases. As regards the perpetrators of gender-based violence;men accounted for almost all the cases (95.53%). In 45.44% of cases it was the sexual partner, and in 36.12% of cases, the assault took place in the victim’s home. Five types of gender-based violence were observed: physical violence (121 cases, 23.5%), denial of resources, opportunities or services (148 cases, 28%), rape (117 cases, 22.7%), sexual abuse (64 cases, 12.4%), forced marriage (42 cases, 8%) and psychological/emotional abuse (28 cases, 5.4%). Conclusion: Gender-based violence is common in Niger. The victims were young women, pupils or students, single and unemployed. Efforts still need to be made to increase the reporting of cases of GBV, involve community leaders and provide optimal medical, legal and socio-professional care.

关键词： Gender-Based Violence Domestic Violence Sexual Abuse Child Abuse Niger

Abdominal Pregnancy with Hemorrhagic Placenta: About a Case at the Mother and Child Health Center of Zinder

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Surgical Science 2023年第2期14卷 84-89页

作者： Souleymane Oumarou Garba Maina Oumara Zélika Salifou Lankoande Issa Abdou Amadou Hassane Laoul Nabara Ibrahim H. Adamou madi nayama Mother and Child Health Center ANDRE Salifou University of Zinder Zinder Niger Reference General Hospital of Niamey ABDOU Moumouni University of Niamey Niamey Niger Mother and Child Health Center Dan Diko University of Maradi Maradi Niger National Hospital of Zinder ANDRE Salifou University of Zinder Zinder Niger Issaka Gazobi Maternity ABDOU Moumouni University of Niamey Niamey Niger

Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.

关键词： Abdominal Pregnancy Hemorrhagic Placenta CSME Zinder

Deep Vein Thrombosis Complicating SS Sickle Cell anemia in Pregnancy: About a Case Diagnosed at the Issaka Gazobi Maternity

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Open Journal of Blood Diseases 2021年第2期11卷 25-30页

作者： Chaibou-Yacouba Maimouna Hamidou Soumana-Diaouga Amadou Djibrilla-Almoustapha Moctar Abdoulaye-Maliki Mansour Sidi-Mahamane Madeleine Garba-Rah Idi Nafiou madi nayama Issaka Gazobi Maternity Niamey Niger Science of Health Faculty Abdou Moumouni University of Niamey Niamey Niger Hematology Department of the Niamey National Hospital Niamey Niger Cardiology Department of the Niamey National Hospital Niamey Niger

Pregnancy in a sickle cell patient is a source of maternal and perinatal morbidities. Thromboembolic diseases of which Deep Vein Thrombosis (DVT) is one of the complications. The frequency of the latter is poorly assessed. Very few studies have been done on this topic. We report a case of DVT in a 35-year-old patient with sickle cell SS pregnant with 27SA diagnosed and cared for at the Maternity Issaka Gazobi (MIG) in Niamey. The management was based on low molecular weight heparin combined with preventive measures against sickle cell anemia and a planned cesarean section which led to a favorable maternal and perinatal prognosis.

关键词： DVT Sickle Cell Disease Gravido-Puerperalitis MIG Niamey

Analysis of Maternal Mortality at the Maradi Maternal and Child Health Center/Niger: About 379 Cases

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1529-1539页

作者： Amadou Issa Abdou Oumara Maina Lankoandé Salifou Zélika Tamo Kailou Azize Moussa Boukari Soumana Diaouga Hamadou Oumarou Garba Souleymane Hassane Rabiatou nayama madi Mother and Child Health Center Dan Dicko Dankoulodo University of Maradi Maradi Niger Faculty of Health Sciences General Reference Hospital Abdou Moumouni University of Niamey Niamey Niger Mother and Child Health Center Andr Salifou University of Zinder Zinder Niger Issaka Gazobi Maternity of Niamey Faculty of Health Sciences Abdou Moumouni University of Niamey Niamey Niger

Introduction: Pregnancy, childbirth, and their consequences continue to be the leading cause of death, illness, and disability among women of reproductive age in developing countries. In Niger, maternal deaths account for about 39% of all deaths of women aged 15-49. Our aim was to identify the factors linked to maternal mortality in order to contribute to its reduction. Method: this is a descriptive retrospective study of 379 cases of maternal deaths collected at the Maradi CSME from January 1, 2018, to December 31, ***: Our study’s maternal mortality ratio is 2645.72 per 100,000 live births. The mean age of our patients was 27.46 years, with extremes ranging from 15 to 47 years. The 20-24 age group was the most represented, with 88 cases (23.2%). Housewives were 361 (95.3%), and 334 patients (88.1%) were uneducated. There were 261 of them from rural areas, i.e. 69%. The mean parity in our study was 3.46, with extremes ranging from 0 to 15. Multiparous patients 117 cases (30.9%) represented the most significant proportion. Only 42 patients (11.08%) had performed four or more antenatal consultations. Direct obstetric causes accounted for 56.73% of the causes of maternal death. Anemia was the leading cause of maternal death (31.66%). Nearly half of the patients had died before 24 hours after admission, i.e. 49.86%. Conclusion: Maternal mortality remains a significant challenge for developing countries, given its magnitude and timid decline. The fight to reduce maternal mortality must be the priority of our countries’ health policies.

关键词： Maternal Mortality CSME Maradi Anemia

Emergency Obstetric Hysterectomy in a Low Resources Country: An Eight-Year Retrospective Cohort Study from a Secondary Care Hospital in Niger

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Open Journal of Obstetrics and Gynecology 2024年第10期14卷 1611-1627页

作者： Amadou Issa Abdou Hamidou Soumana Diaouga Zalika Salifou Lankoandé Souley Ibrahim Lailata Maina Oumara Harouna Salifou Jamila Salamatou Guédé Younsou Ganda Moussa Boukari Oumarou Garba Souleymane Hamissou Souley M. Noury madi nayama Department of Obstetrics & Gynecology Mother and Child Health Centre Dan Dicko Dankoulodo University of Maradi Maradi Niger Department of Obstetrics & Gynecology Issaka Gazoby Maternity Hospital Abdou Moumouni University in Niamey Niamey Niger Department of Obstetrics & Gynecology Mother and Child Health Centre Andre Salifou University of Zinder Zinder Niger Department of Obstetrics & Gynecology General Referal Hospital Abdou Moumouni University in Niamey Niamey Niger Department of Anesthesia Referal Hospital in Maradi Maradi Niger

Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed

关键词： Emergency Obstetrical Hysterectomy Postpartum Hemorrhage Maternal Mortality Niger