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Analysis of Maternal Mortality in obstetrics and Anesthesia Resuscitation in 15 Years at chu Point“G”about 389 cases Bamako/Mali

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Open Journal of obstetrics and gynecology 2020年第2期10卷 243-253页

作者： I.Kanté M.Sima A.coulibaly M.Traoré T.Théra A.Bocoum S.Z.Daou A.Kouma S.Fané A.Traoré O.Traore Y.Traoré I.Teguété B.Maiga obstetric gynecology service of c.h.u Point“G” BamakoMali obstetric gynecology service of c.h.u Gabriel TOuRE” BamakoMali common Reference health center commune II BamakoMali obstetric gynecology service of c.h.u kati BamakoMali obstetrics gynecology service of chu hospital Du Mali BamakoMali common Reference health center commune V BamakoMali

Objective: Analyze the maternal mortality in the two departments of chu Point “G” in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at chu Point “G”. All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of chi2, the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20 - 24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%;the evacuation without any evacuation sheet: 259/389 making 66.6%), poor cPN (Prenatal consultation) quality (undone cPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389), infection (61/389 cases making 15.68%), dystocia: 50 cases making 12.85% and high blood pressure and complications (38/389 making 9.76%);indirect in 158/389 cases making 40.6% (Figures 1-3). The majority of women 65.8% (256/389) of our patients died in the gynecology and obstetrics department;in the Resuscitation department 73/389 making 18.8%;in the operating room 43/389 making 11.1% and

关键词： hemorrhage high Blood Pressure Maternal Death Partographe Prenatal consultation

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Non-Puerperal uterine Inversion with uterine Mülleroblastoma in a Teenager: A case Report of Loandjili General hospital Pointe-Noire (Republic of congo)

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Open Journal of obstetrics and gynecology 2020年第5期10卷 723-728页

作者： L. M. E. Eouani J. c. Mokoko Ngatali Sidney A. Emeka Pognabeka c. Itoua L. h. Iloki obstetrics gynecology service Loandjili General Hospital Pointe Noire Congo Faculty of health Sciences Marien Ngouabi University Brazzaville Congo obstetrics gynecology service University Health Center of Brazzaville Brazzaville Congo Department of cancerology Loandjili General Hospital Pointe Noire Congo Department of obstetric Gynaecology Teaching Hospital of Brazzaville Brazzaville Congo

Introduction: uterine inversion is a reversal of the uterus into a glove. It is an obstetric complication of deliverance. uterine inversion out from pregnancy is rare. The Müller duct is an embryonic tubular formation which will transform into the vagina, uterus, and fallopian tubes. The mixed Müllerian malignant tumor is a rare tumor to girl and woman in genital activity, which develops in the uterus at the expense of vestige of the Müller channels. The association of these two pathologies is rare. We report an observation of complicated uterine inversion mulloblastoma to a teenager. Observation: A teenager of 15 years old, admitted for a vulvar tumor, which has occurred about two months. Student in the first class of senior high school, she has no medical history, and no particular surgery. She had her threat at the age of 13, and has a regular menstrual cycle of 30 days, with 05 days of period. Two months before her admission, the patient noticed during her menstruation, the perception of soft intravaginal tissue but which disappeared when her period stopped. A week before her admission, she felt pelvic pain with expulsive colic, radiating to the external genitals, 3 days later, a protusion from the vaginal vestibule of a mass, so the volume gradually increased. It is in front of this situation that the patient consults a health center, which refers her to us for treatment. On admission, the patient was conscious with a good hemodynamic state. Vulva inspection revealed a large, rounded mass with an endovaginal implantation, with necrosis areas. This mass was resistant, bleeding in any manipulation, mobile, perceive neither the cervical relief nor the presence of the uterus. The ultrasound assessment had marked: a large abdomino-pelvic pseudo-mass with urinary repercussions right form of hydronephrosis uretero and associated with gastric distension, and MRI complete inversion of the uterus, with the uterine in the vaginal cavity associated with a large vulvovagina

关键词： Metrorrhagia Swelling uterine Inversion Medulloblastoma

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68例新生儿中器械助产与顺产所致产科凹陷性颅骨骨折的比较

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世界核心医学期刊文摘（妇产科学分册） 2005年第6期1卷 17-18页

作者： Dupuis O. Silveira R. Dupont c. 王雅楠 u. de Gynecol. Obstet . H.opital de la Croix Rousse Lyon France Dr.

A depressed skull fracture is an inward buckling of the calvarial bones and is referred to as a “ ping- pong" fracture. This study aimed to look at differences between “ spontaneous"and "instrument- associated" depressed skull fractures. This retrospective, case- control analysis included every neonate who was admitted with a depressed skull fracture between 1990 and 2000. cases after a spontaneous vaginal delivery, elective cesarean delivery, or cesarean delivery that was performed during labor without previous instrument use were classified as “ spontaneous"(n = 18 cases). cases after a delivery in which forceps or a vacuum cup had been used either successfully or unsuccessfully were classified as “ instrument- associated" (n = 50 cases). continuous data were analyzed with 2- tailed unpaired t tests; χ 2 analysis was used for nominal data. A probability value of considered statistically significant. Fifty depressed skull fractures were associated with an instrument delivery, and 18 depressed skull fractures were classified as "spontaneous." The only obstetric parameter that differed significantly between the 2 groups was the length of the active phase. Among the 68 neonates, 15 neonates underwent prolonged second stage, forceps or manual head rotation, or forceps use during elective cesarean delivery. All “ instrument- associated" cases were caused by forceps application or sequential instrument use; depressed skull fractures never occurred after isolated vacuum extraction. Every type of forceps was involved. Intracranial lesions were significantly more frequent in the instrument- associated group (30% vs 0% ; P =. 02). Two infants sustained persistent severe motor disabilities. Depressed skull fractures occur in the setting of spontaneous and operative deliveries, although the incidence is higher in the latter case. Depressed skull fractures that are associated with instrumental deliveries are significantly more likely to be associated with intracranial

关键词：凹陷性颅骨骨折真空吸引器颅内损伤病例对照分析产钳助产第二产程延长阴道分娩颅盖骨吸引术持续性

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