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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 risks. During this study, an increase in maternal-

关键词： Advanced Maternal Age Childbirth Risk Mali

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

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 gynecological pathology that exists in our department;its f

关键词： Myomas Surgery Myomectomy

Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba Assitan Farota Abdoulaye Kassogué Mohamed Diarra Dramane Touré Abdoul Salam Diarra Leyla Maïga Dicko Fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti reference Health Center Mopti Mali National centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

Anal Pathologies: What Management at the reference Health Center of Bamako’s commune V?

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Open Journal of Gastroenterology 2024年第3期14卷 87-92页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ousmane Diarra Abou A. Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra Hepato-Gastroenterology Department CHU Point G Bamako Mali Service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali Hepato-Gastroenterology Unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal Disease Anal Fissure

Mothers’ Level of Schooling, Monitoring of Their Pregnancy and Perinatal Prognosis at the reference Health centre of commune V of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 383-394页

作者： Albachar Hamidou Sitapha Dembélé Cheickna Sylla Sissoko Hamady Seydou Z. Dao Alou Samaké Saleck Doumbia Cissao Chiaka Sanogo Siaka Amara Sema Keita reference Health Center of Kayes Kayes Mali reference Health centre of commune V of the District of Bamako Bamako Mali National centre for Scientific and Technological Research in Bamako Bamako Mali Department of Gynecology and Obstetrics of the Fousseyni Daou Hospital in Kayes Kayes Mali Department of Gynecology and Obstetrics of the Gabriel Touré University Hospital Bamako Mali reference Health centre of commune III of the District of Bamako Bamako Mali reference Health centre of commune II of the District of Bamako Bamako Mali reference Health centre of commune vi of the District of Bamako Bamako Mali reference Health Center of Fana Koulikoro Mali

Introduction: The level of schooling of mothers is a determining factor in the follow-up of pregnancy and consequently the prognosis of childbirth and the quality of the newborn. Objective: The aim was to assess the impact of the level of education on the follow-up of their pregnancy and perinatal prognosis at the reference Health centre of commune V of the District of Bamako. Materials and Methods: This was a prospective, cross-sectional and analytical study aimed descriptive from August 15 to December 15, 2021. We included in this study all pregnant women who had a gestational age of at least 22 weeks of amenorrhea and who gave birth or were received in the immediate postpartum period at the maternity ward of the reference Health Center of commune V. Results: Out-of-school parturients accounted for 60% of cases. Among the parturients in school, 18% had a higher level. In our study, 14.3% of women in labour knew the date of the last menstrual period. In our series, 100% of mothers in higher and secondary school had completed an antenatal consultation (CPN) compared to 90.7% in the out-of-school mothers. CPN1 was performed in the first trimester of pregnancy in 21.1% among out-of-school parturients compared to 83.5% among higher-level parturients. The number of NPCs was greater than or equal to 4 in 47.9% of parturients. Conclusion: Women’s schooling has an impact on their socio-economic conditions on the one hand and on the monitoring and prognosis of pregnancies on the other.

关键词： Level Schooling Mothers Aftercare Pregnancy Prognosis

Epidemioclinical Profile and Immediate Outcome of Low Birth Weight at the reference Health Center in commune vi of the District of Bamako, Mali

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Open Journal of Pediatrics 2023年第2期13卷 235-243页

作者： Mariam Maiga Oumar Coulibaly Mariam Traore Hibrahima Diallo Korotoumou W. Diallo Bourama Kane Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mohamed Saydi Ag Med Elmehdi Elansari Diarra Sidy Moctar Mamadou Traore Djibril Kassogue Kadiatou Ba Pierre Togo Pediatric Service of the reference Health Center of the commune vi Bamako Mali Pediatric Department of CHU Gabriel Touré Bamako Mali Mali Hospital Bamako Mali Pediatric Service of the reference Health Center of the commune V Bamako Mali Timbuktu Regional Hospital Bamako Mali Pediatric Service of the reference Health Center of the commune II Bamako Mali

Introduction: Low birth weight is responsible for 9.1 million child deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this work was to determine the epidemio-clinical profile as well as the future of low birth weight at the reference Health Center of commune vi in the district of Bamako, Mali. Methods: Our study was descriptive and prospective over a year from April 1, 2018 to March 31, 2019. Data were taken from hospital records and newborn referral/evacuation forms. Data processing was performed using Epi Info software version 3.5.4 and Word. Results: The frequency of low birth weight was 34.94%. Multiparity accounted for 47.84%, sex ratio was 0.93, maternal arterial hypertension was present in 41.66%, genitourinary infection was in 58.37% and delivery was by low way in 86.12%. The majority of newborns had a gestational age between 28SA-33SA (56.52%) and a weight between 1501-1999 grams (47.36%). Mortality accounted for 18.66%. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

关键词： Low Birth Weight Future Risk Factors Bamako Mali

Assessment of Unmet Transfusion Needs in the Management of Immediate Postpartum Haemorrhage at the Kalaban Coro reference Health centre (MALI)

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1645-1657页

作者： Bocary Sidi Kone Kalifa Traore Mahamoudou Coulibaly Cheickna Sylla Sema Keita Yacouba Sylla Mamadou Haïdara Mahamadou Keita Sékou Bakary Keita Bamba Brehima Mamadou Kampo Dramane Fomba Yacouba Aba Coulibaly Seydou Z. Dao Modibo Dicko Department of Gynecology and Obstetrics Polyclinique Mère Enfant Mohamed VI Bamako Mali Department of Gynecology and Obstetrics National Centre for Scientific and Technological Research Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Centre Hospitalo-Universitaire Gabriel Touré de Bamako Bamako Mali Department of Gynecology and Obstetrics Fana Reference Health Centre Koulikoro Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune II of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune I of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Timbuktu Hospital Timbuktu Mali Department of gynecology and Obstetrics Reference Health Centre of Commune VI of the District of Bamako Bamako Mali

The aim was to assess transfusion needs in the management of immediate postpartum haemorrhage. Materials and Methods: this was a prospective, descriptive, analytical study from 01 January 2018 to 31 October 2018 in the gynecology and obstetrics department of the reference health center of Kalaban-Coro (Mali). Results: During the study period we recorded 32 cases of transfusion of the immediate postpartum out of 109 cases of hemorrhage or 29.35%;for a total of 2425 deliveries or a frequency of 1.31%. The main indications for blood transfusion were: postpartum haemorrhage due to tearing of the soft parts in 21.9%;retroplacental hematoma in 18.6%;uterine rupture in 12.5%;and placenta previa covering hemorrhagic in 12.5%. More than half of the transfused were evacuees, or 62.5%. Unmet transfusion requirements were 59.4%. The blood products requested were: whole blood in 99% of cases and fresh frozen plasma in only 1% of cases. Conclusion: the need for labile blood products remains a reality in obstetrics. The permanent availability of labile blood products improves the prognosis of immediate postpartum haemorrhages.

关键词： Blood Transfusion Postpartum Hemorrhage

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