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obstetric References in disadvantaged Environments: Case of References to the University Hospital Center of Kara, in Northern Togo

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Open Journal of obstetrics and gynecology 2024年第2期14卷 267-277页

作者： Kossi Edem Logbo-Akey Bassowa Akila Kofi Mawoulé Améwouho Ketevi Tina Yendoubé Pierre Kambote dédé Régine diane Ajavon Baguilane djoauguibe Abdoul-Samadou Aboubakari Koffi Akpadza Service de gynécologie-obstétrique CHU Kara Togo Service de gynécologie-obstétrique CHU Campus Lomé Togo Service de gynécologie-obstétrique CHU Sylvanus Olympio Lomé Togo Service de gynécologie-obstétrique CHR Tomdé Kara Togo

Introduction: References are frequent and most often carried out in emergency situations. The objective of this study was to describe the epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Methodology: This was a retrospective cross-sectional descriptive study conducted from September 1, 2022, to February 28, 2023, at CHU-Kara, focusing on obstetric referrals to the gynecology-obstetrics department. Result: 828 patients were referred for obstetric reasons out of 1295 admissions, representing a frequency of 63.9%. The average age was 25.04 years. They were primigravida (38.3%), unemployed (62.7%). Motorcycles were the main means of transportation, accounting for 53.1% of cases. The average distance to reach the referral center was 31.6 km, covered in an average of 71 minutes. In 40.7% of cases, patients had less than 4 prenatal consultations and were referred in peripartum (56.6%) for pre-eclampsia (14%), post-term pregnancy (11.8%), dystocia (10.5%). Eighty-six point nine percent (86.9%) of the referred patients were able to deliver during their stay in the department, of which 61.7% had vaginal deliveries. The maternal and perinatal mortality rates were 0.7% and 14.9%, respectively. Conclusion: obstetric referrals to Kara University Hospital are frequent during the perpartum period and are often carried out by motorbike.

关键词： obstetric Referral Epidemiology Prognosis CHU-Kara

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Causes of Infertility of Couples Residing in Libreville

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Advances in Reproductive Sciences 2024年第1期12卷 75-82页

作者： Opheelia Makoyo Komba Ulysse Minkobame Pamphile Assoumou Reteno Retno Elsy Ntsame Anouchka Mewi Jacques Albert Bang Ntamack Jean François Meye département de gynécologie obstétrique Université des sciences de la santé d’Owendo Libreville Gabon

Introduction: According to the World Health Organization, globally one in six people experience infertility in their lifetime. Infertility is considered as a major and global public health issue. In most cases, women bear the burden of infertility to protect the male ego. Although men and women are equally likely to have fertility problems. The aim of this study was to identify the causes of infertility of couples residing in Libreville. Patients and Methods: This was a retrospective descriptive study performed over 2 years, from 1st January 2021 to 31st december 2022. data was obtained from 162 couples attending the assisted reproduction department of the mother and child hospitals in Libreville. Statistical analysis was done using IBM SPSS Statistics version 22.0 software. Results: during the study period, 28.5% of couples could afford IVF treatment. The average for woman age was 39.1 ± 4.06 while the average age for male patients was 41.53 ± 7.08 years with minimum and maximum age of 34 et 66 years. More than half (58.6%) of female partners were employed in the public sector. Half of the male partners (50%) were employed in the private sector. The median duration of infertility was 6 years. Approximately 49.4% of couples were diagnosed with primary infertility. The most common causes of infertility in female patients were Fallopian tubes obstruction (53.2%), uterine factors (24.2%) and hormonal problems (19.6%). With regards to male factors infertility, testicular causes were predominant (53.6%). Oligoasthenoteratozoospermia were the major semen abnormalities (55.7%) found after semen evaluation. Both male and female partners were sub-fertile in 47.5% of cases. Unexplained infertility was found in 11% of couples. Conclusion: This study showed that the diagnostic of infertility faced by couples residing in Libreville should involve both male and female partner.

关键词： Epidemiology Gabon Infertility

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obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

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Open Journal of obstetrics and gynecology 2024年第1期14卷 69-76页

作者： Logbo-Akey Kossi Edem Bassowa Akila Ketevi Tina Kambote Yendoubé Patchidi Kibandou Amewouho Kofi Ajavon dédé Régina Aboubakari Abdoul-Samadou Service de gynécologie-obstétrique CHU Kara Université de Kara Kara Togo Service de gynécologie-obstétrique CHU Campus Université de Lomé Lomé Togo Service de gynécologie-obstétrique CHU Sylvanus Olympio Université de Lomé Togo Faculté des sciences de la santé Université de Lomé Lomé Togo Service de gynécologie-obstétrique CHR Tomdé Université de Kara Togo

Introduction: obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the obstetrics and gynecology department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3rd trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.

关键词： obstetric Emergency Kara University Hospital

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Review of Maternal deaths over 3 and a Half Years at the Kara University Hospital Center, Northern Togo: About 65 Cases

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Open Journal of obstetrics and gynecology 2024年第5期14卷 682-692页

作者： Logbo-Akey Kossi Edem dédé Régine diane Ajavon Kambote Yendoubé Tenete Assiaham douaguibe Banguilane Agoro Sibabe Aboubakari Abdoul-Samadou dé partement de Gyn&#233cologie-Obst&#233trique Universit&#233 de Kara Kara Togo Hopital Mè re-Enfat SOS Kara Kara Togo dé partement de Gyn&#233cologie-Obst&#233trique Universit&#233 de Lom&#233 Lom&#233 Togo direction ré gionale de la sant&#233 Kara Togo

Objective: To analyze maternal deaths, identify causes and dysfunctions leading to these deaths in order to contribute to the implementation of strategies to reduce maternal mortality at CHU Kara. Method: Cross-sectional descriptive study involving 65 cases of maternal deaths recorded at CHU-Kara from January 1, 2018 to June 30, 2021. Results: Our study focused on 65 cases of maternal deaths recorded at the maternity ward of CHU-Kara. The average age was 30 years, with a range of 15 to 45 years. They were mostly housewives (52.3%), uneducated (38.5%), multiparous (41.5%), and referred (86.2%). The causes were mainly direct obstetric causes (81.54%), with preeclampsia and its complications (28.30%) and immediate postpartum hemorrhage (20.75%) being the most common. However, uterine rupture (20.5%) and post-abortion sepsis (16.4%) were the most lethal etiologies. delayed evacuation (46.43%), inadequate transportation (91%), and insufficient prenatal care (72.31%) were the dysfunctions before referral. Within the CHU Kara, delays in management (58.46%), unavailability of blood and labile products (18%), and insufficient monitoring were the dysfunctions identified. Ninety-five point four percent (95.4%) of the deaths were preventable. Conclusion: The magnitude of intrahospital maternal deaths, the various dysfunctions observed in the occurrence of maternal deaths before referral/evacuation and within the hospital highlight the importance of effectively implementing recommendations from audits in the fight against maternal mortality. The majority of the deaths were preventable (95.38%).

关键词： Review of Maternal deaths CHU Kara Togo

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Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

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Open Journal of obstetrics and gynecology 2024年第1期14卷 162-174页

作者： dédé Régine diane Ajavon Metoukam Andrée Josiane douaguibe Baguilane Ketevi Améyo Ayoko Logbo Akey Kossi Edem Kambote Yendoube M’bortche Bingo Amadou Abdoulatif Aboubakari Abdoul Samadou Faculty of Health Sciences University of Kara Kara Togo Faculty of Health Sciences University of Lomé Lomé Togo Service de gynécologie obstétrique du CHU Sylvanus Olympio Lomé Togo

Female contraception uses both hormonal and non-hormonal methods. The aim of the study is to determine the impact of female contraception on uterine vascularisation and the endometrium. Method: It was a descriptive comparative study with an analytical aim. It took place at the University Clinic of obstetrics gynaecology and the Radiology and Medical imaging department of Sylvanus Olympio University Hospital in Lomé over a two-month period from May 15, 2023 to July 15, 2023. Group 1 included women using a modern contraceptive method and group 2 women not using a modern contraceptive method. Epidata 3.1 and R 4.0.4 software were used to process the data. Results: Each group included 50 women. There were no significant differences in uterine and endometrial biometrics. All women on contraception had their zone 1 vascularized, without vascularisation of zone 2, without significant difference with women without contraception The pulsatility index was greater than 3 in 51% (n = 51) of women, including 62.7% (n = 32) of women without contraception and 37.3% (n = 19) of women on contraception, with a statistically significant difference (p = 0.009). Conclusion: Contraceptive methods do not influence the biometry of the uterus. However, uterine artery doppler indices can predict abnormal uterine bleeding.

关键词： Contraception Endometrium Uterine Artery doppler

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Practice of obstetrical Hysterectomy at the Sylvanus Olympio University Hospital Center: Indications and Maternal Prognosis

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Open Journal of obstetrics and gynecology 2023年第10期13卷 1730-1737页

作者： Baguilane douaguibe dédé Régina Ajavon Komi Migbenya Pakienyedou Tongou Francis Bararmna-Bagou Romario Mawougbe Samadou Aboubakari Service de gynécologie obstétrique du CHU Sylvanus Olympio Lomé Togo Service de gynécologie obstétrique du CHU Kara Kara Togo

obstetric hysterectomy is a surgical procedure most often performed in a context of extreme emergency in an obstetric environment. The incidence of obstetric hysterectomy is differently expressed around the world. In the CHU-SO maternity ward, hemorrhagic obstetric emergencies are common. The extreme urgency in which patients are admitted, the insufficiency of the technical platform, associated with the challenge of the availability of blood products, often leads to performing an obstetric hysterectomy for hemostasis. It is responsible for high maternal morbidity and mortality. Since 2000 no study has been carried out on this practice in the service. Objective was to describe the practice of obstetric hysterectomy at the CHU-SO and specifically to determine the prevalence, the prognostic factors to be able to act to reduce maternal mortality. Method: A descriptive, cross-sectional, and analytical study was carried out at the gynecology-obstetrics clinic of the CHU-SO;from January 1, 2021, to June 30, 2022. All hysterectomies performed in an obstetric emergency context (during pregnancy, perpartum or postpartum) in the department were included in our study. We did not include cases of obstetric hysterectomies outside the SO hospital or planned non-obstetric hysterectomies. Results: We recorded 75 cases of obstetric hysterectomy and 15,625 deliveries (0.48%). The average age was 32.89 ± 5.93. The age group between 30 and 35 years old was the most affected with a rate of 37.33%. Labor and third trimester hemorrhage were the main reasons for admission, patients were referred in 80% of cases. The average parity was 3.25 ± 1.92 with utmost of 0 and 11. The pauciparous (41.67%) and multiparous (32%) were the most affected. The indications frequently found were uterine atony (44%);uterine rupture (33.33%). Subtotal inter adnexal hysterectomy was performed in 94.67%. General anesthesia practiced in 69%. They were all polytransfuses. Three poor prognostic factors were observe

关键词： obstetric Hysterectomy Indications Maternal Prognosis CHU-SO

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Treatment of Precancerous Lesions of the Cervix of the Uterus by Leep: Experience of the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of obstetrics and gynecology 2021年第12期11卷 1675-1684页

作者： Bingo Kignomon M’bortche Baguilane douaguibe Kossi Edem Logbo-Akey dédé Regina Ajavon Tina Ayoko Ketevi Ketevi Solim-Biou djato Francis Baramna-Bagou Abdoul-Samadou Aboubakari Koffi Akpadza Clinique Principale de l’Association Togolaise Pour le Bien-Etre Familial (ATBEF) Lomé Togo Service de gynécologie-obstétrique du CHU Sylvanus Olympio Lomé Togo Service de gynécologie-obstétrique du CHU Kara Kara Togo Service de gynécologie-obstétrique du CHR Tsévié Tsévié Togo

Objectives: describe the socio-demographic characteristics, describe the main indications for LEEP and present the main complications. Methodology: This was a cross-sectional and descriptive study with consecutive rec... 详细信息

Objectives: Describe the socio-demographic characteristics, describe the main indications for LEEP and present the main complications. Methodology: This was a cross-sectional and descriptive study with consecutive recruitment of the study population through cervical cancer screening campaigns throughout the country during the period July 1, 2017 to April 30, 2019. Included were all patients eligible for LEEP and having benefited from this therapeutic method during our study period. Data were collected from a registry and recorded on a questionnaire developed for this study. These data were analyzed using Epi info 3.5.1 software. The following parameters were studied: patient age, indication for LEEP, intraoperative and postoperative complications, histological examination of the specimens, and postoperative surveillance and screening follow-up one year after LEEP. Results: During the study period, 12,595 women were screened for precancerous cervical lesions. A total of 474 women had precancerous lesions. Of these women, 227 had undergone loop resection, a rate of 47.9%. The main indications for LEEP were extensive lesions (68.7%), lesions penetrating the internal cervical os (12.8%). Incidents occurred in 7.5% of patients during the procedure. Post-operative complications occurred in 14.7% of cases. Conclusion: dana;">LEEP is a better way to treat precancerous lesions but is not well known by medical staff. The equipment of health fa

关键词： Precancerous Lesions Cervical Cancer LEEP

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Sexual Assault: Epidemiological Profile and Clinical Aspects at the Brazzaville University Hospital Center

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Open Journal of obstetrics and gynecology 2020年第2期10卷 326-332页

作者： L. M. E. Eouani J. C. Mokoko C. Itoua N. S. Sekangue Potokouen Mpia L. H. Iloki Service de gynécologie obstétrique Hopital Général de Loandjili de Pointe-Noire Pointe-Noire Congo UniversitéMarien NGOUABI de Brazzaville Brazzaville Congo Service de gynécologie obstétrique Centre Hospitalier Universitaire de Brazzaville Brazzaville Congo.

Objective: to identify the socio-demographic profile of the alleged victims of sexual assault, to define the characteristics of the aggressors, to describe the types of clinical lesions, and to analyze the link between these different parameters.?during the study period, 5620 clients were admitted to gynecological emergencies, including 150 for sexual assault (2.6%). The alleged victims of aggression were 14 years old on average [range: 2?-?49 years]. Among these clients, there were 147 (98%) women and 3 (2%) men [sex ratio: 0.02]. They had a primary education level of 38%, secondary to 42.7%, and single in 87.2% of cases. Clients came from home (69.3%) or police station (24.7%). The perpetrator was male, with an average age of 25.5 years [range: 16 to 35 years]. Regarding the relationship with the victim, the neighborhood accounted for 83%. The perpetrator was alone in 76.7% of cases, two (14%) or more (16.7%), up to 18.?The aggressor’s home was the place of aggression (39.3%). The threats were made using knives (49.3%) and firearms (8.5%). The perpetrator used either his sex (79.9%), his fingers (34.2%) or an object (2.7%). The route of entry was vaginal (94.6%), anal (21.7%) and oral (10%). The abuser used the condom in 74.7% of cases.?Customers had viewed within 24 hours (40.7%). The general state and hemodynamics at admission was normal for all clients. Physical injuries were injuries (23%) and scrapes (34.5%). External genitalia included perineal tears (28%), vaginal tears (8.6%), hymenal tears (7.3%), and old deflowering (72.7%). The hymen was intact in 20%.?The bi-varied analysis found a correlation with a statistically significant difference in the age range of the alleged victims with the number of aggressors, the time of aggression, the path and type of penetration, and the weapon used for the threat.

关键词： Sexual Assault Firearm Stab Perineal Tear Vaginal Tear Hymenal Tear

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Relationship between Uricemia and Other Biochemical Markers with the Materno-Fetal Complications during Pre-Eclampsia

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Open Journal of obstetrics and gynecology 2017年第13期7卷 1255-1261页

作者： B. d. Tshibuela N. N. Kayembe M. J. Muwonga N. K. Nganga N. Ngole J. P. Elongi département de Biologie Médicale Service de Biologie Cliniques Cliniques Universitaires de Kinshasa Kinshasa Congo département de gynécologie-obstétrique Hopital Générale de Référence de Kinshasa Kinshasa Congo

Goal: determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study of 75 pre-eclamptic women in three maternities in Kinshasa, democratic Republic of Congo, during the January to december 2013. The values of the following biochemical markers: uricemia, proteinuria and creatinemia were correlated with maternal and fetal prognosis. Results: This study showed that hyper uricemia associated with massive proteinuria and a high creatinine level correlated with an unfavorable pregnancy outcome and the occurrence of major materno-fetal complications such as eclampsia (X-squared = 24.3598, ddl = 2, p-value = 0.000005) and low birth weight (p = 0.001, R2 = 0.08). Conclusion: In view of these results, it appears necessary to ensure these biochemical markers systematically in the monitoring of pre-eclampsia.

关键词： Uricemia Biochemical Markers Maternal-Fetal Complications Pre-Eclampsia

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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 provi... 详细信息

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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