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

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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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 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 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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Artificial Induction of Labor with Misoprostol: Maternal and Fetal Prognosis at the Referral Health Center of Commune I of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 70-79页

作者： mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara mamadou sima Bourama Kané Kalba Tembiné Ibrahima Tégueté Youssouf Traoré Department of Gynecology of Hô pital du Mali Bamako Mali Service of Anesthesia and Resuscitation of Hô pital du Mali Bamako Mali Service of Gynecology-Obstetrics CHU Point G Bamako Mali Service of Pediatric of Hô pital du Mali Bamako Mali Service of Medical Imaging of Hô pital du Mali Bamako Mali Service of Gynecology-Obstetrics CHU Gabriel Toure Bamako Mali

Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.

关键词： Induction Misoprostol Maternal and Fetal Prognosis Commune I

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Routine Screening for Cervical Cancer

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 922-928页

作者： Alassane Traoré Aphou Sallé Koné sima mamadou Amadou Bocoum mamadou Bakary Coulibaly Koninba Diabaté Adama Diakité Kanté Ibrahim Seydou Mariko Idrissa Mama Diarra Service de gynécologie H&ocirc pital du Mali Bamako Mali Service de radiothérapie H&ocirc pital du Mali Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire du Point G Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire Gabriel Touré Bamako Mali

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases;

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Endoscopic Management of Migrated Intra Uterine Device in Sub-Saharan Health Setting Area. Our Experience about Seventeen Cases

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Surgical Science 2018年第1期9卷 17-23页

作者： Traoré Youssouf Kanté Ibrahim sima mamadou Ongoiba Ibrahima Coulibaly Ahmadou Dicko Birama Bocoum Amadou Kodio Souma Théra Tiounkani Téguété Ibrahima Traoré mamadou Department of Gynecology and Obstetrics of Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics of Point “G” Teaching Hospital Bamako Mali Department of Forensic Medicine of Bamako University Bamako Mali

Intra uterine device migration is a relatively rare event. The migration of the IUD in the surrounded viscera can be managed by endoscopy approach. Objectives: We reported our experience to determine the epidemiologic characteristics of patients that presented migrated IUD, to report clinical aspects and describe the laparoscopic management. Method: We conducted a descriptive and prospective survey from January 1st, 2014 to October 31, 2016. That survey took place in the department of gynecology and obstetrics of Point G Teaching hospital, Bamako, Mali. Population study concerned patients with intra uterine device complications. Statistic tests used have been X2 or Fisher test according their application conditions. P Results: Seventeen patients were included. Mean age of patients is 29 years with extremes of 13 years and 44 years. The main reference incitement of patients were perforation of the uterus and pelvis pain (27.8% for each), misplaced IUD (22.3%). Complications observed were intra uterine device migrated in to the bladder (1 case), in the abdomen (10 cases), in the ovary (2 cases) and in the uterine tuba (1 case). Three perforations were done without migration in to surrounded viscera. We used endoscopic surgery among all of them. But in one case we switched endoscopy method in to laparotomy because of important intra peritoneal bleeding to end the management of the patient. No death occurred and mean duration of the stay of hospitalization was 2 days. Conclusion: IUD migration is a scarce event. All the surrounded viscera can be the site of its migration. The management of that complication is usually done by endoscopy method.

关键词： IUD Migration Bladder Pain Endoscopy Surgery Mali

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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 organization’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 popularized to help reduce the unmet need for family planning.

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

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Evaluation of the Quality of Prenatal Consultation in Rural Area of Mali, Case of Kadiolo Health District

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Open Journal of Clinical Diagnostics 2020年第1期10卷 49-64页

作者： Fane Seydou Sissoko Abdoulaye Kanté Ibrahima Bocoum Amadou sima mamadou Sanogo Abdoulaye Traore Soumana Oumar Sanogo Siaka Amara Traore mamadou Salia Traore Alassane Saleck Doumbia mamadou Keita Salem Yargueit Traore Youssouf Tegueté Ibrahima Mounkoro Niani Gynecology-Obstetrics Service University Teaching Hospital Gabriel Touré Bamako Mali Hospital Mother-Child the Luxembourg Bamako Mali University Teaching Hospital of Point G Bamako Mali Referral Health Center of Kadiolo Bamako Mali Referral Health Center of Commune V Bamako Mali Hospital of Mali Bamako Mali Referral Health Center of Commune VI Bamako Mali

Every woman has the right to receive satisfactory quality prenatal care in reproductive health. Giving a life while remaining alive and without sequelae must be the slogan of any gynecologist - obstetrician and midwife, as well as any health worker. It was a descriptive cross-sectional study dealing with the evaluation of the quality of prenatal consultations at the Kadiolo referral health center (or RHC). Adevis Donabedian’s model for assessing the quality of care and services served as a benchmark. According to Donabedian quality means good technical care, with good interpersonal relationships, and adequate and comfortable premises. This study took place from April 24 to December 04, 2017 and aimed to assess the current level of the quality of prenatal consultations at the Kadiolo referral health center, to study the structures in place including infrastructure and personnel, to specify the procedures and to determine their results. This work has permitted us to classify the RHC of Kadiolo at level III with 85%, which means that the references evaluated were satisfactory, with the level of 75% to 94%. In terms of structure, a pricing system was deemed affordable by the opinion of pregnant women. The analysis of the level of the human dimension revealed that the health center was level III. The pregnant women were satisfied with the reception which was good in 76% of the cases, as well as with the quality of the respect of the privacy in 96% and confidentiality in 95%. Despite the satisfaction of pregnant women, gaps remain to be filled in concerning the quality of the services received at the Kadiolo referral health center so as to reach level IV.

关键词： Pregnancy Prenatal Consultation Quality of Care and Services Risk Factors Kadiolo Referral Health Center Mali

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Perinatal Deaths in Rural a Health Area, Case of the Health District of Kadiolo, Mali

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Surgical Science 2019年第11期10卷 385-397页

作者： Seydou Fané Amadou Bocoum Youssouf Traoré Abdoulaye Sissoko Ibrahima Tegueté mamadou sima mamadou Salia Traoré Tiounkani Augustin Thera Yaya Sylla Alassane Traoré Soumana Oumar Traoré Aminata Kouma Niani Mounkoro Gabriel Toure Teaching Hospital Center-Gynecology-Obstetrical Service Bamako Mali Hospital mère enfant le Luxembourg Bamako Mali Point G Teaching Hospital Center of Bamako Bamako Mali Referral Health Center of Kadiolo Sikasso Mali Mali Hospital Bamako Mali Reference Health Center of Commune 6 of Bamako District Bamako Mali Kati Hospital Kati Mali

The perinatal mortality is a public health issue in developing countries. In fact, the perinatal death rate seems the highest in a Malian rural area. The objective of this work was to study the perinatal mortality in a rural area of Mali (Kadiolo). Methodology: It was a cross-sectional descriptive study conducted in Kadiolo over 12 months. The study took place from April 1, 2016 to March 31, 2017. We have included in our study all dead fetuses in gestational age ≥ 28 weeks of amenorrhea (WA) or weight ≥ 500 grams (g) and infants died during the first week of life. Mothers who have experienced a perinatal death were included. Results: During the 12 months of study period, we have recorded a total of 2212 births out of which we have collected 205 perinatal deaths, a perinatal mortality rate of 205/2212 with 93 per 1000. The stillbirth rate was 152/2212 with 69‰ and the early neonatal mortality rate was 53/2212 with 24‰. The sociodemographic characteristic of the patients was: patient who has been evacuated 71.70%, unschooled 77.1%, coming out of the city Kadiolo 76%, young women 65% and patient who did not receive antenatal care 35%. Conclusion: Our study confirms the high rates of perinatal deaths in rural areas. The implementation of a coherent and efficient care strategy should help in reducing the still high rates.

关键词： Perinatal Deaths Dystocia Rural Environment Mali

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Maternal and Perinatal Prognosis of the Cesarean at Chu Point G, Bamako, Mali

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1461-1469页

作者： Coulibaly Ahmadou Seydou Z. Dao Cissouma Assétou sima mamadou Kanté Ibrahim Ousmane mamadou S. Traoré Koné Konimba Diarra Drissa Sissoko Hamadi Théra Thiounkani Traore Youssouf Obstetric Gynecology Department of the University Hospital Center (CHU) Point G Bamako Mali Obstetric Gynecology Department of the Reference Health Center of Commune II Bamako Mali Pediatric Department of Sikasso Hospital Sikasso Mali Obstetric Gynecology Service of the Reference Health Center of Commune III Bamako Mali Obstetric Gynecology Department of the University Hospital (CHU) Gabriel Touré Bamako Mali

Objective: In light of numerous obstetric evacuations to the Point G University Hospital and taking into account the practice of cesarean section for many years in the service, it seemed necessary to us to make our contribution to the study of cesarean section by putting emphasis on maternal and perinatal prognosis in the Obstetric Gynecology Department of the Point G university hospital. Method and materials: We conducted a retrospective cross-sectional study in the Gynecology and Obstetrics Department of the Point G University Hospital, from January 01, 2018 to December 31, 2018. The Point G University Hospital is a 3rd level center of reference in the field of obstetrics in Mali. There is no neonatal ward. The study included all women who gave birth in the gynecology and obstetrics department during the study period. All prophylactic and emergency Caesarean section records during the period in which management took place in the ward were included. The records of patients who had a prophylactic or emergency cesarean section in other health facilities and non-usable records were not included. Data were collected using a pre-established survey form. The variables analyzed were socio-epidemiological, clinical and prognostic. Data were analyzed using IBM SPSS software version 16.00. The Chi2 test and Fischer’s exact test were used to highlight risk factors. The significance level retained was p

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Emergency Caesarean Section in Adolescent Girls at the Referral Health Center in Commune I

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Open Journal of Obstetrics and Gynecology 2020年第2期10卷 298-310页

作者： Alassane Traore mamadou B. Coulibaly Soumana O. Traore Modibo D. Soumare Seydou Fane Bourama Kane mamadou sima Saliou A. Traore Seydina A. Beye Yacouba L. Diallo Youssouf Traore Gynecology Service of Hopital du Mali Bam Bamako Mali Gynecology-Obstetrics Service Referral Health Center of Commune IV Bamako Mali Gynecology-Obstetrics Service Referral Health Center of Commune I Bamako Mali Gynecology-Obstetrics Service University Teaching Hospital (UTH) Gabriel Touré Bamako Mali Pediatric Service of Hopital du Mali Bamako Mali Gynecology Service UTH Point G Bamako Mali Anesthesia Resuscitation Service UTH Point G Bamako Mali Medicine and Endocrinology Service Hopital du Mali Bamako Mali

Teenage pregnancy is common in Mali due to the high rate of unwanted pregnancies and early marriages. The general objective of this study was to study emergency cesarean delivery in adolescent girls at the referral health center (RHC) in commune I of the district of Bamako. It was a descriptive study with prospective data collection from January 1 to December 31, 2018. Any adolescent girls in whom an emergency caesarean section was performed were included. The data were entered and analyzed on SPSS 20.3. Results: we have collected 616 adolescent parturients, 202 caesareans were performed in emergency, with a frequency of 32.8%. The average age was 17 with the extremes of 13 and 19. Early marriage was found out in 95.5% of our patients, 40 adolescent girls were primiparous (20%), 4 of whom had an inter-reproductive interval of less than a year. The main indications for cesarean section were fetal distress in 71 cases (35%), fetal-pelvic disproportion, scar uterus in the border pelvis (11% each), breech presentation in 15 cases (7%). Anemia (10.4%) was the main complication, followed by vascular pedicle attack (5.94%), infection of the operating site (1.5%) and a bladder wound (0.99%). Fetal mortality was 1.4% and neonatal 3.8%.?Conclusion:?the association between adolescence and caesarean section in emergency constitutes risk factors which increase maternal and neonatal morbidity and mortality. Fighting these factors improves the survival of the mother and the newborn.

关键词： Adolescent Cesarean Emergency Mortality

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