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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana samake Hawa Konate Karim Dembele Bertin Coulibaly moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao samake Hawa Konate Karim Dembele Bertin Coulibaly moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： Advanced Maternal Age Childbirth Risk Mali

Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana samake Hawa Konate Karim Dembele Bertin Coulibaly moussa Mariko Seydou Colette Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecologic

关键词： Myomas Surgery Myomectomy

Bilharzia Appendicitis: Incidence in a Commune in Mali, about 3CAS

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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Surgical Science（外科学） 2024年第5期 321页

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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第5期 855页

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Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 years at the Fana Reference Health Centre, Mali

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第5期 674页

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Health 2022年第12期14卷 1307-1320页

作者： Solomane Traore Abdourahamane Haidara youssouf samake Tegué Guindo moussa Keita National Institute of Public Health (INSP) Bamako Mali Reference Health Centre (CSRéf) of Fana Koulikoro Mali

Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.

关键词： Severe Malaria Direct Average Cost Fana District Health Center Mali

Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 609-624页

作者： Amaguiré Saye Dessé Diarra Sirima Diarra Brahima Dembele Abdou Guire Souleymane Dembele yéli Dianessi moussa samake Seydou Mariko Seydou Fomba Diakaridia Kone Abdoul Razakou Dicko Pierre Coulibaly Daouda Camara Hamidou Toure Mama Sy Konake Obstetrics and Gynecology Service Commune IV Reference Health Center Bamako Mali Obstetrics and Gynecology Department of Bamako Mali Hospital Bamako Mali Department of Study and Research in Public Health Faculty of Medicine and Odontostomatology USTTB Bamako Mali Reference Health Center of Commune I Bamako Mali Obstetrics and Gynecology Department of the Somine DOLO Hospital Mopti Mali Reference Health Center of Kati Kati Mali

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

关键词： Quality Prenatal Consultation Bamako Mali

Epidemiological, Diagnostic and Therapeutic Aspects of Breast Cancer in the Gynecology and Obstetrics Department of the CHU Gabriel Touré from 2020 to 2022

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Advances in Breast Cancer Research 2023年第3期12卷 97-113页

作者： Sirama Diarra moussa samake Amaguiré Saye Brehima Dembélé Birama Traoré Souleymane B. Dembélé Déssé Diarra yely Dianéssy Abdou Guiré Bakarou Kamate Gynecology and Obstetrics Department of the District Hospital of Commune IV Bamako Mali General Surgery Department of the Commune IV District Hospital Bamako Mali Obstetrics Gynecology Service of the CSREF of San Bamako Mali Anatomo-Pathology and Cytology Department of the Point G University Hospital Bamako Mali

In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed to study the epidemiological, diagnostic, and therapeutic aspects of breast cancer to write the clinical aspects of breast cancer in the gynecology-obstetrics department of the CHU Gabriel Touré from 2020 to 2022. Methodology: This was a retrospective and descriptive study of 219 cases of breast cancer that were diagnosed in the gynecology and obstetrics department of the CHU Gabriel Touré in Bamako, from 2020 to 2022. Results: The annual frequency was 77.2 cases per year, the average age 45.55 years with extremes of 16 to 85 years;housewives represented 92.7%;multiparas were reported at 57%. Considering the history, the personal history of benign breast pathology was 55.6%. Regarding the localization, the left breast was the most affected with 53.9%, and the tumor was found in the supero-external quadrant in 53.9%. The cancer was metastatic in 81.28%. The diagnosis biopsy + histology contributed to 98.6%. The histological type was invasive carcinoma of non-specific type in 95%. As for the histoprognostic grade of SBR studied, grade II was predominant at 46%, grade III at 34.95%. The therapeutic strategy was chemotherapy in 83.1%. Neoadjuvant chemotherapy followed by surgery in 10%, primary surgery in 6.4%, radiotherapy in 0.5%. Conclusion: The major challenges in the fight against breast cancer in Mali remain a better organization of the system for early diagnosis, the establishment of a screening program, early diagnosis in women from the age of 40 and also adequate care.

关键词： Epidemiology Diagnosis Therapeutics Breast Cancer Bamako (Mali)