Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital...Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.展开更多
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 co...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.展开更多
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. Me...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.展开更多
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-sectio...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%).展开更多
Introduction: The occurrence of intrauterine fetal death (IUFD) is a traumatic event not only for the mother and her family but also for the obstetric team. IUFD is a common event. Objective: the aim of our study is t...Introduction: The occurrence of intrauterine fetal death (IUFD) is a traumatic event not only for the mother and her family but also for the obstetric team. IUFD is a common event. Objective: the aim of our study is to describe the epidemiological, diagnostic and management aspects of IUFD at the Sylvanus Olympio University Teaching Hospital (CHU SO), Lomé. Methodology: It was a descriptive cross-sectional study with retrospective data collection process that concerned cases of IUFD from January 1st 2023 to December 31, 2023 at CHU SO. Results: The hospital prevalence of IUFD was 2.43%. The mean age of the mothers was 30.6 ± 6 years. The Multigestures represented 32.52% and primiparous women represented 29.72%. Pregnant women were referred in 88.11% of cases;47.55% had done at least 4 antenatal care visits and 4.20% had a history of IUFD. The etiological factors of IUFD were preeclampsia in 28.67% of cases, retroplacental hematoma in 28.67% and premature rupture of membranes in 4.55% of cases. Misoprostol was used for artificial induction of labor in 57.14% of cases and the delivery route was vaginal in 75.87% of cases. Conclusion: The frequency of IUFD is high and its reduction remains a challenge in low-income countries.展开更多
Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evide...Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.展开更多
Introduction: Maternal death or maternal mortality is “the death of a woman occurring during pregnancy or within 42 days of termination, regardless of duration or location, for any specific cause or aggravated b...Introduction: Maternal death or maternal mortality is “the death of a woman occurring during pregnancy or within 42 days of termination, regardless of duration or location, for any specific cause or aggravated by pregnancy or its management, but neither accidental nor fortuitous. Methods: This was a descriptive and analytical cross-sectional study carried out from January 1<sup>st</sup>, 2021 to April 30<sup>th</sup>, 2022 at the Obstetrics Gynecology Clinic of the Sylvanus Olympio University Hospital Center (SOUHC). Results: we noted 86 cases of maternal deaths after referral/evacuation i.e. a maternal mortality rate hospital of 555 maternal deaths per 100,000 LB. The average age of the patients was 31.1 ± 6.3 years with extremes of 15 and 45 years. In 33.7% of cases our patients were resellers. Multiparas represented 33.7% of the sample, they had performed less than three antenatal consultations. Postpartum hemorrhage was the reference reason in 33.7%. In 74.4% of cases, the patients referred had arrived by taxi. In 87.9% of cases, the patients had died of direct obstetric causes. Immediate postpartum hemorrhage accounted for 44.6% of cases and anemia, 36.4%. There is a statistically significant association between the availability of blood product and the avoidability of maternal death after obstetrical referral and/or evacuation (p value = 0.0188 0.05). Conclusion: Determining responsibility for maternal death is not always easy. There is an urgent need to strengthen the policy of reducing maternal mortality in Togo. This remains possible by developing communication strategies and a solid referral/counter-referral system.展开更多
Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gyneco...Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1<sup>st</sup> to the 30th of June 2022 at the CHU SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.展开更多
Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a ...Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5<sup>th</sup> post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Active management of the third period of labor (AM...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomd</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">è </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabaweré Peripheral Care Unit). </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). </span><b><span style="font-family:Verdana;">Conclusion and Suggestion:</span></b><span style="font-family:Verdana;"> The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.</span></span></span></span>展开更多
Introduction: Home birth or unassisted birth means for a woman to make the decision to give birth at home, not alone in absolute terms, but without professional assistance, be it that of a midwife, a doctor or any oth...Introduction: Home birth or unassisted birth means for a woman to make the decision to give birth at home, not alone in absolute terms, but without professional assistance, be it that of a midwife, a doctor or any other person with midwifery qualifications. Methods: This was a descriptive cross-sectional study conducted from November 04<sup>th</sup> to December 21<sup>st</sup>, 2019 and from August 17<sup>th</sup> to August 21<sup>st</sup>, 2020, in the community of Dagbati, in 33 women who gave birth at home, received at the USP of Dagbati and during advanced strategies;who were registered or not in the delivery register of USP Dagbati and who agreed to participate in the survey freely and in an informed manner. Results: Of the 48 deliveries that took place in the locality during our study period, 33 took place at home, with a rate of 68.7%. The average age of the women giving birth was 26.33 years with extremes of 15 and 47 years. In 42.4% of cases, they were farmers. Twenty-seven women who gave birth had farmer spouses (81.9%). The distance between their house and the health center was greater than 2 km in 78.8% of cases. Among the reasons for giving birth at home, the lack of financial means was mentioned in 60.6%. In 63.6%, the family had assisted the women in giving birth. Conclusion: Home birth is still a reality in our communities, despite the increased number of health facilities. The sensitization of the population, the improvement of the conditions of accessibility to the health center, the quality of obstetric care, and also, the improvement of the living conditions of women will surely allow a total abandonment of home births.展开更多
Objectives: The objective of this study was to evaluate the indications for cesarean section (CS) and some related characteristics in Sylvanus Olympio University Hospital Center in Togo. Methods: We analyzed all CS pe...Objectives: The objective of this study was to evaluate the indications for cesarean section (CS) and some related characteristics in Sylvanus Olympio University Hospital Center in Togo. Methods: We analyzed all CS performed from January 1, 2020 to December 31, 2020. Results: Total number of 8676 women were delivered, of which 4583 were by CS (52.8%), emergent vs. planned;69.6% vs. 30.4%. Acute fetal asphyxia was the leading indication (25.4%), followed by pre-eclampsia/eclampsia (17.3%), and pelvic anomalies (12.2%). Analysis showed that 51% of cases had definite indications for CS, whereas in remaining cases, CS was performed for non-definite-indications. Conclusion: CS should be done based on definite indications. We must take an effort to educate this in this area, which, avoiding unnecessary CS, might reduce the CS rate in this area.展开更多
Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prog...Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.展开更多
Objective: Determine the maternal mortality rate, the epidemiological profile, the causes of death and the dysfunctions noted. Patients and method: This was a cross-sectional and descriptive study from January 1 to De...Objective: Determine the maternal mortality rate, the epidemiological profile, the causes of death and the dysfunctions noted. Patients and method: This was a cross-sectional and descriptive study from January 1 to December 31, 2020. All maternal deaths during pregnancy or within 42 days after its termination fitting the World Health Organisation definition criteria that occurred in the seven districts of Kara region<span style="font-family:Verdana;"> were included</span><span style="font-family:Verdana;">. The data were processed using Excel microsoft. Results: A total of 41 maternal deaths occurred among 23,456 live births, accounting for a maternal mortality ratio of 174.8 deaths per 100,000 live births. The followings were observed: the average age of 30 years;88% married;39% multiparous;78% housewives without income</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> 5% students. Hemorrhage, preeclampsia, and complications of abortion were the main direct obstetric causes, while anemia was the main indirect obstetric cause. Factors related to deaths were inadequate quality of health care and lack of universal health insurance</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The various maternal death audit reports </span><span style="font-family:Verdana;">found that 94.4% of deaths were preventable. Conclusion: Most maternal deaths</span><span style="font-family:Verdana;"> would be prevented in the Kara region if women during pregnancy and the postpartum period received quality health care and the community was involved in decision-making about their health.</span></span>展开更多
文摘Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.
文摘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.
文摘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.
文摘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%).
文摘Introduction: The occurrence of intrauterine fetal death (IUFD) is a traumatic event not only for the mother and her family but also for the obstetric team. IUFD is a common event. Objective: the aim of our study is to describe the epidemiological, diagnostic and management aspects of IUFD at the Sylvanus Olympio University Teaching Hospital (CHU SO), Lomé. Methodology: It was a descriptive cross-sectional study with retrospective data collection process that concerned cases of IUFD from January 1st 2023 to December 31, 2023 at CHU SO. Results: The hospital prevalence of IUFD was 2.43%. The mean age of the mothers was 30.6 ± 6 years. The Multigestures represented 32.52% and primiparous women represented 29.72%. Pregnant women were referred in 88.11% of cases;47.55% had done at least 4 antenatal care visits and 4.20% had a history of IUFD. The etiological factors of IUFD were preeclampsia in 28.67% of cases, retroplacental hematoma in 28.67% and premature rupture of membranes in 4.55% of cases. Misoprostol was used for artificial induction of labor in 57.14% of cases and the delivery route was vaginal in 75.87% of cases. Conclusion: The frequency of IUFD is high and its reduction remains a challenge in low-income countries.
文摘Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.
文摘Introduction: Maternal death or maternal mortality is “the death of a woman occurring during pregnancy or within 42 days of termination, regardless of duration or location, for any specific cause or aggravated by pregnancy or its management, but neither accidental nor fortuitous. Methods: This was a descriptive and analytical cross-sectional study carried out from January 1<sup>st</sup>, 2021 to April 30<sup>th</sup>, 2022 at the Obstetrics Gynecology Clinic of the Sylvanus Olympio University Hospital Center (SOUHC). Results: we noted 86 cases of maternal deaths after referral/evacuation i.e. a maternal mortality rate hospital of 555 maternal deaths per 100,000 LB. The average age of the patients was 31.1 ± 6.3 years with extremes of 15 and 45 years. In 33.7% of cases our patients were resellers. Multiparas represented 33.7% of the sample, they had performed less than three antenatal consultations. Postpartum hemorrhage was the reference reason in 33.7%. In 74.4% of cases, the patients referred had arrived by taxi. In 87.9% of cases, the patients had died of direct obstetric causes. Immediate postpartum hemorrhage accounted for 44.6% of cases and anemia, 36.4%. There is a statistically significant association between the availability of blood product and the avoidability of maternal death after obstetrical referral and/or evacuation (p value = 0.0188 0.05). Conclusion: Determining responsibility for maternal death is not always easy. There is an urgent need to strengthen the policy of reducing maternal mortality in Togo. This remains possible by developing communication strategies and a solid referral/counter-referral system.
文摘Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1<sup>st</sup> to the 30th of June 2022 at the CHU SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.
文摘Background: Massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5<sup>th</sup> post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomd</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">è </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabaweré Peripheral Care Unit). </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). </span><b><span style="font-family:Verdana;">Conclusion and Suggestion:</span></b><span style="font-family:Verdana;"> The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.</span></span></span></span>
文摘Introduction: Home birth or unassisted birth means for a woman to make the decision to give birth at home, not alone in absolute terms, but without professional assistance, be it that of a midwife, a doctor or any other person with midwifery qualifications. Methods: This was a descriptive cross-sectional study conducted from November 04<sup>th</sup> to December 21<sup>st</sup>, 2019 and from August 17<sup>th</sup> to August 21<sup>st</sup>, 2020, in the community of Dagbati, in 33 women who gave birth at home, received at the USP of Dagbati and during advanced strategies;who were registered or not in the delivery register of USP Dagbati and who agreed to participate in the survey freely and in an informed manner. Results: Of the 48 deliveries that took place in the locality during our study period, 33 took place at home, with a rate of 68.7%. The average age of the women giving birth was 26.33 years with extremes of 15 and 47 years. In 42.4% of cases, they were farmers. Twenty-seven women who gave birth had farmer spouses (81.9%). The distance between their house and the health center was greater than 2 km in 78.8% of cases. Among the reasons for giving birth at home, the lack of financial means was mentioned in 60.6%. In 63.6%, the family had assisted the women in giving birth. Conclusion: Home birth is still a reality in our communities, despite the increased number of health facilities. The sensitization of the population, the improvement of the conditions of accessibility to the health center, the quality of obstetric care, and also, the improvement of the living conditions of women will surely allow a total abandonment of home births.
文摘Objectives: The objective of this study was to evaluate the indications for cesarean section (CS) and some related characteristics in Sylvanus Olympio University Hospital Center in Togo. Methods: We analyzed all CS performed from January 1, 2020 to December 31, 2020. Results: Total number of 8676 women were delivered, of which 4583 were by CS (52.8%), emergent vs. planned;69.6% vs. 30.4%. Acute fetal asphyxia was the leading indication (25.4%), followed by pre-eclampsia/eclampsia (17.3%), and pelvic anomalies (12.2%). Analysis showed that 51% of cases had definite indications for CS, whereas in remaining cases, CS was performed for non-definite-indications. Conclusion: CS should be done based on definite indications. We must take an effort to educate this in this area, which, avoiding unnecessary CS, might reduce the CS rate in this area.
文摘Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.
文摘Objective: Determine the maternal mortality rate, the epidemiological profile, the causes of death and the dysfunctions noted. Patients and method: This was a cross-sectional and descriptive study from January 1 to December 31, 2020. All maternal deaths during pregnancy or within 42 days after its termination fitting the World Health Organisation definition criteria that occurred in the seven districts of Kara region<span style="font-family:Verdana;"> were included</span><span style="font-family:Verdana;">. The data were processed using Excel microsoft. Results: A total of 41 maternal deaths occurred among 23,456 live births, accounting for a maternal mortality ratio of 174.8 deaths per 100,000 live births. The followings were observed: the average age of 30 years;88% married;39% multiparous;78% housewives without income</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> 5% students. Hemorrhage, preeclampsia, and complications of abortion were the main direct obstetric causes, while anemia was the main indirect obstetric cause. Factors related to deaths were inadequate quality of health care and lack of universal health insurance</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The various maternal death audit reports </span><span style="font-family:Verdana;">found that 94.4% of deaths were preventable. Conclusion: Most maternal deaths</span><span style="font-family:Verdana;"> would be prevented in the Kara region if women during pregnancy and the postpartum period received quality health care and the community was involved in decision-making about their health.</span></span>
