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Implementing uterine balloon tamponade(UBT)device for immediate postpartum hemorrhage management:Leveraging resource allocation and highlighting noteworthy experiences

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Gynecology and Obstetrics Clinical Medicine 2023年第3期3卷 175-180页

作者： Mian Dehi Boston Guie Privat Apollinaire Horo Aka Edele Kouakou Konan Virginie Aholoupke Bruno KonéSeydou Rochon Sarah Boni Serge Burke Thomas F Felix Houphouet Boigny University Cote d’Ivoire Division of Global Health and Human Rights Department of Emergency MedicineCote d’Ivoire National Mother and Child Health Program Côte d'Ivoire Cote d’Ivoire Massachusetts General Hospital Division of Global Health and Human Rights BostonMAUSA Harvard T.H.Chan School of Public Health BostonMAUSA Harvard Medical School BostonMAUSA

Background The use of uterine balloon tamponade(UBT)devices for intrauterine packing and management of vaginal bleeding by uterine atony has shown promising results in improving the quality of care and reducing maternal *** This report aims to provide an overview of progress made in implementing UBT devices in northern Cote d'*** and methods A four-year retrospective study was conducted in the North-East(163,645),North-Center(351,909),and North-West(57,983).In 2017,UBT was adopted by members of the healthcare ***,5 national and 32 regional trainers have been *** training session was a theoretical and practical program with a low *** is a male condom tied to a urinary catheter,filled with *** outcomes included stopping bleeding,avoiding the need for surgery,and preventing maternal deaths(MD).In 2018,3,515 UBT devices were *** 2019,monitoring tools and transmission circuits of the data were *** 2020,the collection of data and local manufacturing was *** During the process,978 health workers,mainly midwife(52.0%)and nurses(32.2%)out of the 1,295 assigned were *** number of trained individuals decreased from 209 in 2019 to 160 in 2020.A total of 1,715 UBT devices were locally manufactured,adding to the existing gift of 5,080 devices,with total availability of 6,*** distribution of devices increased from 2017 to 2019 but decreased in *** rates increased from 87.3%in 2017(365/418)to 95.0%in 2019(556/585)and slightly decreased in 2020 to 98.0%(681/695).Adverse outcomes(144/2,193),included MD(35/2,193)and medical evacuation to the surgical center(109/2,193).Conclusion The implementation of UBT in northern Cote d'Ivoire successfully reduced maternal death rates caused by immediate post-partum hemorrhage(IPPH).However,to ensure sustainability,further improvements are needed,including increased monitoring,ongoing training,and device availability.

关键词： Implementation Uterine balloon tamponade post-partum hemorrhage Health providers Health regions

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Complications of Twin Delivery and Associated Factors: A Hospital-Based Cross-Sectional Analytical Study in Yaoundé

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1363-1376页

作者： Jeanne Hortence Fouedjio Cliford Ebong Ebontane Fouelifack Ymélé Florent Janvier Binwe Isidore Tompeen Esther Meka Owno Paul Etoundi Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Obstetrics and Gynecology Unit Central Hospital of Yaoundé Yaounde Cameroon Obstetrics and Gynaececology Unit Gyneco-Obstetric and Pediatric Hospital of Yaoundé Yaounde Cameroon

Background: Twin birth is considered a high-risk obstetrical situation. Despite the progress in obstetrical and pediatric care that has occurred in recent years, twin delivery is still associated with high maternal morbidity and perinatal mortality. Few recent studies have focused on the complications and risk factors associated with complications of twin birth in our environment. The objective of our study was to identify the complications of twin birth and the factors associated with them. Methodology: We carried out a cross-sectional analytical study. Data collection was prospective, over a period of 4 months (January 1, 2022 to April 30, 2022), at the maternity units of the Gyneco-Obstetric and Pediatric Hospital of Yaoundé and the Central Hospital of Yaoundé. The study population included all pregnant women who gave birth to twins during our study period at these hospitals. Data analysis was done using the SPSS software (Statistical Package for the Social Sciences) version 23.0. The Chi-square test was used to compare proportions and the student’s t test to compare means. A p-value of less than 0.05 was considered statistically significant. Results: In total, we recorded 37 complicated twin deliveries out of a total of 66 twin deliveries. This corresponded to a complication rate of 56%. Maternal complications occurred in 11.38% of cases, the majority being soft tissue lesions (4.54%), and postpartum hemorrhage (4.54%). Perinatal complications at the time of delivery were dominated by early neonatal infections (12.12%), non-reassuring fetal condition (10.6%) and intrauterine fetal death (6.06%). Factors associated with complications of twin births after univariate analysis were: maternal age ≤ 30 years (OR = 8.15;CI = 9.78 - 71.06;P = 0.03), being a student, (OR = 5.09;CI = 3.65 - 7.10;P = 0.00), primary level of education (OR = 1.48;CI = 3.30 - 6.63;P = 0.00), having less than four prenatal contacts (OR = 5.76;CI = 12.2 - 27, 24;P = 0.02), lack of ultrasound as

关键词： post-partum hemorrhage Prenatal Visit Ultrasound Twin Birth

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