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Epidemiology of Maternal Deaths from 2017 to 2022 in the obstetrics and gynaecology department of the University Hospital of Tengandogo, Burkina Faso

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Open Journal of obstetrics and Gynecology 2024年第9期14卷 1335-1346页

作者： Hien Dieudonné Ouédraogo Emmanuel Nacanabo Karim Toé Rolande Bouaré Sidy Yankéné Mamdata Kaboré Vincent Kain Dantola Paul Ouédraogo Ali gynaecology and obstetrics department of the Tengandogo University Hospital Ouagadougou Burkina Faso. gynaecology and obstetrics department of Bogodogo University Hospital Ouagadougou Burkina Faso. gynaecology-obstetrics department Yalgado Oudraogo University Hospital Ouagadougou Burkina Faso. Hospital Pharmacy department of the Tengandogo University Hospital Ouagadougou Burkina Faso.

Background: Although maternal mortality is declining in most countries, it remains a significant public health problem worldwide, with high rates, particularly in developing and insecure countries like ours. Objective: To study the epidemiological factors and factors associated with the occurrence of maternal death in the Gynecology-obstetrics department of University Hospital of Tengandogo. Method: It was a retrospective case-control study with a descriptive and analytical purpose over a period of 6 years from January 1, 2017 to December 31, 2022. Cases were women with maternal deaths during the study period. Data processing and analysis were performed using Stata version 13 software. Univariate and multivariate analyses were performed with Stata version 13 software, and logistic regression modeling was used to estimate crude and adjusted odds ratios (OR), their 95% confidence intervals (CI), and the threshold for statistical significance was set at a p value < 0.05. Results: A total of 372 patients were included in the study, including 146 cases of maternal death. The in-hospital maternal mortality rate was 1933 deaths per 100,000 live births. The average age was 28.5 years. 58.9% of patients lived in rural areas. Married patients accounted for 88.7% of cases. The average parity was 3. Direct obstetrical causes were the main causes of death, accounting for 72.6%. They were dominated by post-partum hemorrhage (24.2%), puerperal infection (18.6%), pre-eclampsia/eclampsia (16.1%) and retroplacental hematoma (8.9%). Chronic anemia (12.9%) was the main indirect obstetric cause. Risk factors associated with maternal death were primiparity (OR for paucigravida and multigravida at 0.05;P = 0.001);ambulance transport (OR for patients referred and brought in by personal vehicle = 0.3, p < 0.001) and vaginal delivery (OR for cesarean deliveries = 0.4, p < 0.001). Conclusion: To reduce maternal mortality in Burkina Faso, strategies such as educating women about danger signs d

关键词： Maternal Death Epidemiology Associated Factors University Hospital of Tengandogo

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Surgical Intervention on Uterine Fibromyoma in a Country with Limited Resources: Case of the gynaecology-obstetrics department of the Communal Medical Centre of Ratoma Conakry-Guinea

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Open Journal of obstetrics and Gynecology 2020年第5期10卷 615-625页

作者： M. H. Diallo I. S. Baldé A. D. Diallo O. Baldé F. B. Diallo M. S. Fofana A. Sow A. B. Barry T. Sy N. Keita department of gynaecology-obstetrics Donka National Hospital Conakry Guinea department of Gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea Visceral Surgery department Donka National Hospital Conakry Teaching Hospital Conakry Guinea department of Gynecology-obstetrics Ratoma Communal Medical Centre Conakry Guinea.

In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform.?Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.?Patients and Method:?It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.?Results: We collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e.?a frequency of 51.92%.?Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%).?The surgical treatment was conservative in 92.60%. The total hysterectomy performed in 7.40.?Lethality was 1.4%.?Conclusion: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In our context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment is necessary for less invasive

关键词： Fibromyoma Myomectomy Hysterectomy Ratoma

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The Place of Blood Transfusion in the Management of Obstetric Emergencies in the gynaecology and obstetrics department of the Reference Health Center of Fana (Mali)

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Open Journal of obstetrics and Gynecology 2023年第4期13卷 780-791页

作者： Keita Sema Kone Bokary Sidi Fané Seydou Sylla Cheickna Samake Youssouf Traoré Momine Traoré Solomane Haidara Ramatoulaye Diabate Abdrahamane Sylla Yacouba Keita Mamadou Coulibaly Mahamoudou Haidara Mamadou Haidara Dramane Camara Daouda Fomba Dramane Kampo Mamadou Maiga Boubacar Dembele Sitapha Seydou Z. Dao Sanogo Siaka Amara obstetrics and Gynecology department Fana Reference Health Centre Koulikoro Mali Mohamed VI Mother-Child Polyclinic in Bamako Bamako Mali department of obstetrics and Gynecology Gabriel TOURE University Hospital Bamako Mali department of Gynecology and obstetrics Reference Health Centre of Koulikoro Koulikoro Mali Diola Reference Health Centre Dioila Mali obstetrics and Gynecology department Reference Health Centre of Commune I Bamako Mali obstetrics and Gynecology department Commune VI Reference Health Centre Bamako Mali department of Gynecology and obstetrics Kalaban Coro Reference Health Centre Bamako Mali department of Gynecology and obstetrics Kati Reference Health Centre Kati Mali obstetrics and Gynecology department Marakala Reference Health Centre Markala Mali department of obstetrics and Gynecology Timbuktu Hospital Timbuktu Mali National Blood Transfusion Centre Bamako Mali department of obstetrics and Gynecology Fousseyni Daou Hospital Kayes Mali obstetrics and Gynecology department Reference Health Centre of Commune II Bamako Mali

This is a prospective and descriptive study carried out at the gynecology and obstetrics department of the reference health center of Fana from 01 May 2019 to 30 November or 7 months. The main objective was to study the role of blood transfusion in the management of obstetric emergencies. During the study period we recorded 434 cases of obstetric emergencies of which 116 cases required an emergency blood transfusion or 26.73%. The most frequently found indications for blood transfusion are hemorrhages of the immediate postpartum 46.6% followed by severe malaria on pregnancy 27.6%. Blood remains the most prescribed and available Labile blood product in the department. Maternal prognosis was improved in 92.2%.

关键词： Obstetric Emergencies Blood Transfusion Hemovigilance

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The Maternal Deaths at the obstetrics and gynaecology department of the Ignace Deen National Hospital, University Teaching Hospital (CHU) Conakry, Guinea

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Open Journal of obstetrics and Gynecology 2019年第5期9卷 597-603页

作者： Boubacar Siddi Diallo Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane Diallo Oumou Hawa Bah Saran Camara Ibrahima Sory Balde Telly Sy Yolande Hyjazi Namory Keita University department of Gynecology-obstetrics Donka National Hospital Conakry Guinea University department of Gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the gynaecology obstetrics department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.

关键词： Review Maternal Deaths

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Care Taking of Obstetric Emergencies in the department of gynaecology and obstetrics at Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

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Open Journal of obstetrics and Gynecology 2019年第5期9卷 604-611页

作者： Boubacar Siddi Diallo Ibrahima Sory Balde Ibrahima Conte Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Abdourahmane Diallo Oumou Hawa Bah Fatoumata Binta Sow Telly Sy Yolande Hyjazi Namory Keita University department of Gynecology-obstetrics Donka National Hospital Conakry Guinea University department of Gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the obstetrics and gynaecology department of the Donka National Hospital, CHU Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refu

关键词： Obstetric Emergency Care Taking

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Delivery Complications of the Single Fat Large Foetus (Macrosomia) with Teenagers at the obstetrics and gynaecology department of the Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

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Open Journal of obstetrics and Gynecology 2019年第5期9卷 624-630页

作者： Boubacar Siddi Diallo Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane Diallo Oumou Hawa Bah Mouctar Sylla Ibrahima Sory Balde Telly Sy Namory Keita University department of Gynecology-obstetrics Donka National HospitalConakryGuinea University department of Gynecology-obstetrics Ignace Deen National HospitalConakryGuinea

Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the obstetrics and gynaecology department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.

关键词： Teenager Large Foetus Complications

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Controversies around the treatment of peritoneal metastases of colorectal cancer

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 260-264页

作者： Francisco J Morera-Ocon Clara Navarro-Campoy Ticiano Guastella Francisco Landete-Molina department of General Surgery Hospital General de RequenaRequena 46340Spain department of Gynecology and obstetrics Hospital 9 OctubreValencia 46015Spain department of Pathology Hospital General de RequenaRequena 46340Spain

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal *** resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal ***,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the *** tool is required in those patients to achieve more local control of the *** groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin *** patients present with complex surgical issues to manage,and consequently a large burden of complications has to be ***,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

关键词： Colorectal cancer Peritoneal metastasis Hyperthermic intraoperative chemotherapy Treatment strategies Peritoneal Surface Oncology GroupInternational

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Adenomyosis uterine innervation in mice correlates to nerve growth factor expression,inflammation,and vascularization

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Neural Regeneration Research 2010年第1期5卷 15-20页

作者： Yan Li Shaofen Zhang Xian Xia Shien Zou department of gynaecology Obstetrics and Gynaecology H~spital of Fudan University Shanghai 200011 China

BACKGROUND： Studies have shown that abnormal innervation is an important factor impacting occurrence and development of pathological pain in endometriosis. OBJECTIVE： To observe uterine innervation of adenomyosis mice and to analyze the cause of innervation changes due to nerve growth factor （NGF） expression, inflammation, and vascularization. DESIGN, TIME AND SETTING： This randomized, controlled, animal experiment was performed at the Research Institute of obstetrics and Gynecology Hospital, and Central Laboratory of Zhongshan Hospital, Fudan University from March to December 2008. MATERIALS： Tamoxifen was provided by Fudan Forward, China. Rabbit anti-mouse NGF was purchased from Santa Cruz Corporation, USA; rabbit anti-protein gene product 9.5 （PGP9.5） and rabbit anti-substance P （SP） were purchased from Chemicon, USA. METHODS： A total of 40 newborn ICR mice were randomly assigned to adenomyosis model and control groups, with 20 animals in each group. Mice in the adenomyosis model group were orally administrated 2.7 μmol/kg tamoxifen on days 2-5 after birth, while the controls were not treated. MAIN OUTCOME MEASURES： Both uteri from all mice were harvested at days 135-145 after birth Expressions of polyclonal PGP9.5 and SP were immunohistochemically detected to demonstrate pan- and sensory nerve fibers. Microvessel density was quantified in the endometrium and myometrium using immunochemical staining for polyclonal rabbit anti-CD31, which stained vessels. Gene expression for NGF, high-affinity tyrosine kinase receptor （trkA）, p75 neuretrophin receptor （p75NTR）, bradykinin receptor-1 （BKR-1）, and 2 （BKR-2）, as well as substance P receptor （neurokininl receptor, NK1-R）, were detected by reverse transcription-polymerase chain reaction. NGF-13 protein expression was detected by Western blot analysis. RESULTS： More nerve fibers were stained with PGP9.5 in the endometrium and myometrium, and with SP in the endometrium, in adenomyosis mice compared with controls （P 〈 0.0

关键词： adenomyosis innervation nerve growth factor inflammation vascularization

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Therapeutic effect of okra extract on gestational diabetes mellitus rats induced by streptozotocin

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Asian Pacific Journal of Tropical Medicine 2015年第12期8卷 1010-1013页

作者： Zhao-Hua Tian Feng-Tai Miao Xia Zhang Qiao-Hong Wang Na Lei Li-Chen Guo department of gynaecology and obstetrics People's Hospital of Zhengzhou department of gynaecology and obstetrics Second Affiliated Hospital of Zhengzhou University department of gynaecology and obstetrics Central Hospital of Shanghai Jiading District

Objective:To explore the effect of okra extract on gestational diabetes mellitus(GDM) rats and its probable molecular ***:A total of 30 female SD rats were caged with male rats for pregnancy,27 pregnant rats were obtained and *** pregnant rats were equally randomized into the control group,GDM group and intervention *** the pregnancy was verified,GDM group and intervention group were given 45 mg/kg streptozotocin by peritoneal injection for inducing GDM,control group was given equal volume of citrate *** the model was established successfully,intervention group was administered orally the solution containing 200 mg/kg/d okra extract,the other groups were given the diet and water *** the 19 th day of pregnancy,the blood samples and fetal rats of all groups were collected,fetal rats weight and placental weight was recorded and the serum glucose,lipids,serum insulin and C-peptide of pregnant rats before the delivery were ***:The pregnant rats weight before the delivery,fetal rats weight and placental weight of GDM group were lower than control group and intervention group(P0.05).Antioxidant enzymes levels of GDM group in liver and pancreas tissues were lower than the other groups,and after treatment of okra extract,antioxidant enzymes levels in liver and pancreas tissues were equivalent to control group(P>0.05).Conclusions:Okra extract,rich in antioxidant substances,could avoid the excessive consuming of antioxidant enzymes,then,suppresses the oxidative stress and insulin resistance,thereby improving blood glucose level of GDM rats.

关键词： Okra extract Gestational diabetes mellitus Pregnan

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Seasonality in human semen quality of smokers and non-smokers: effect of temperature

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Asian Journal of Andrology 2004年第3期6卷 243-247页

作者： Robert Kunzle Michael D.Mueller Alexander W.Huber Heinz Drescher Nick A.Bersinger department of obstetrics and gynaecology University of BerneBerneCH-3010SwitzerlandDepartment of Obstetrics and GynaecologyUniversity of BerneBerneCH-3010SwitzerlandDepartment of Obstetrics and GynaecologyUniversity of BerneBerneCH-3010SwitzerlandMCL LaboratoriesDudingenSwitzerlandDepartment of Obstetrics and GynaecologyUniversity of BerneBerneCH-3010Switzerland

Aim: To analyse the possible effect of seasonal variation on semen parameters. Methods: The participants consisted of 1688 men attending the andrology laboratory between 1991 and 1997 for reduced fertility in the couple. Semen analysis was performed according to the WHO manual. The 84 individual months of the study period were each assigned to one of the three groups according to the average monthly outside temperature; Group A (temperature 13.3℃). Results: When comparing the different sperm parameters, the morphology was significantly better in Group C. However, when the smokers were analysed separately, this difference disappeared and significant seasonal variations were found in sperm density, total sperm count, motility and total motile sperm; they were deteriorated in the warmer season. In non-smokers, no such negative effect of increased temperature was observed. Conclusion: Sperm quality is influenced by seasonal factors. Increased environmental temperature, (maybe also light exposure) has an additional negative effect on the spermato-genesis in smokers, leading to reduced sperm quality in men with borderline fertility.

关键词： sperm quality seasonal temperature fertility smoking

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