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
Background: In Togo, awareness is very low and patients regularly present with advanced stages of breast cancer. Objective: Determine the knowledge of risk factors and means of breast cancer screening by women seen in...Background: In Togo, awareness is very low and patients regularly present with advanced stages of breast cancer. Objective: Determine the knowledge of risk factors and means of breast cancer screening by women seen in gynecological consultation of the Sylvanus Olympio University Hospital (CHU SO). Methods: This was a descriptive cross-sectional study conducted at the gynecology-obstetrics clinic of the CHU SO of Lomé, from March 1 to July 15, 2022. Results: We surveyed 1,566 gynaecological outpatients. Six hundred (600) patients agreed to answer our questions freely, giving a participation rate of 38.3%. The average age of the respondents was 31.9 years old. In 25.5% of cases, the respondents were high school graduates. Five hundred and forty-five of the respondents, or 90.8% had already heard of breast cancer. The most frequent sources of information were medical staff in 34.1% of cases. The presence of nodule in the breast was cited as a clinical sign in 68.4% of cases, breast self-examination as a means of screening in 72.6% of cases, personal history of breast cancer in 51.7% of the cases has non-modifiable risks and smoking as a modifiable risk factor by 58.9% of the respondents. In 31% of cases, they performed breast cancer screening on their own. Breast self-examination was performed by 27.7% of them. Occupation and level of study were statistically associated with women’s knowledge of breast cancer. Conclusion: Most women recognize the existence of breast cancer but their knowledge about signs and risk factors remains low. Few of them, practice screening.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
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
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
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
Obstetric hysterectomy is a surgical procedure most often performed in a context of extreme emergency in an obstetric environment. The incidence of obstetric hysterectomy is differently expressed around the world. In ...Obstetric hysterectomy is a surgical procedure most often performed in a context of extreme emergency in an obstetric environment. The incidence of obstetric hysterectomy is differently expressed around the world. In the CHU-SO maternity ward, hemorrhagic obstetric emergencies are common. The extreme urgency in which patients are admitted, the insufficiency of the technical platform, associated with the challenge of the availability of blood products, often leads to performing an obstetric hysterectomy for hemostasis. It is responsible for high maternal morbidity and mortality. Since 2000 no study has been carried out on this practice in the service. Objective was to describe the practice of obstetric hysterectomy at the CHU-SO and specifically to determine the prevalence, the prognostic factors to be able to act to reduce maternal mortality. Method: A descriptive, cross-sectional, and analytical study was carried out at the Gynecology-Obstetrics clinic of the CHU-SO;from January 1, 2021, to June 30, 2022. All hysterectomies performed in an obstetric emergency context (during pregnancy, perpartum or postpartum) in the department were included in our study. We did not include cases of obstetric hysterectomies outside the SO hospital or planned non-obstetric hysterectomies. Results: We recorded 75 cases of obstetric hysterectomy and 15,625 deliveries (0.48%). The average age was 32.89 ± 5.93. The age group between 30 and 35 years old was the most affected with a rate of 37.33%. Labor and third trimester hemorrhage were the main reasons for admission, patients were referred in 80% of cases. The average parity was 3.25 ± 1.92 with utmost of 0 and 11. The pauciparous (41.67%) and multiparous (32%) were the most affected. The indications frequently found were uterine atony (44%);uterine rupture (33.33%). Subtotal inter adnexal hysterectomy was performed in 94.67%. General anesthesia practiced in 69%. They were all polytransfuses. Three poor prognostic factors were observed during our study, namely: uterine atony;the 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
Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with ...Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.展开更多
Ob</span><span style="font-family:Verdana;">jectives:</span></span></b><span style="font-family:""><span style="font-family:Verdana;"> Descr...Ob</span><span style="font-family:Verdana;">jectives:</span></span></b><span style="font-family:""><span style="font-family:Verdana;"> Describe the socio-demographic characteristics, describe the main indications for LEEP and present the main complications. </span><b><span style="font-family:Verdana;">Methodology:</span></b> </span><span style="font-family:""><span style="font-family:Verdana;">This was a cross-sectional and descriptive study with consecutive recruitment of the study population through cervical cancer screening campaigns throughout the country during the period July 1, 2017 to April 30, 2019. Included were all patients eligible for LEEP and having benefited from this therapeutic method during our study period. Data were collected from a registry and recorded on a questionnaire developed for this study. These data were analyzed using Epi info 3.5.1 software. The following parameters were studied: patient age, indication for LEEP, intraoperative and postoperative complications, histological examination of the specimens, and postoperative surveillance and screening follow-up one year after LEEP. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 12</span></span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;">595 women were screened for precancerous cervical lesions. A total of 474 women had precancerous lesions. Of these women, 227 had undergone loop resection, a rate of 47.9%. The main indications for LEEP were extensive lesions (68.7%), lesions penetrating the internal cervical os (12.8%). Incidents occurred in 7.5% of patients during the procedure. Post-operative complications occurred in 14.7% of cases. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">LEEP is a better way to treat precancerous lesions but is not well known by medical staff. The equipment of health facilities and the training of medical staff will 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
<strong>Background</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> The use of modern contraceptive methods contrib...<strong>Background</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> The use of modern contraceptive methods contributes to the reduction of maternal and neonatal mortality. The initiation of a contraceptive method in the immediate postpartum period is one of the strategies to avoid missing out on contraceptive opportunities. This strategy will reduce the unmet need for contraception which is still high in the country. </span><b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:Verdana;">: To describe the knowledge and attitudes of pregnant women and the practices of women who have given birth about immediate postpartum contraception. </span><b><span style="font-family:Verdana;">Methodology</span></b><span style="font-family:Verdana;">: This was a cross-sectional and descriptive study </span><span style="font-family:Verdana;">conducted at the main clinic of ATBEF from 20th March to 20th October 2020</span><span style="font-family:Verdana;">. Our study included pregnant women whose gestational age was greater than or equal to 37 weeks of amenorrhea who came for prenatal consultation or for any other consultation and then gave birth in the center. Data collection was based on a survey form. Data analysis and entry was done with the Epi </span><span style="font-family:Verdana;">info 2000 version 6.04 software. The parameters studied were: socio-demographic</span><span style="font-family:Verdana;"> characteristics, knowledge and attitudes of pregnant women about contraception in the immediate postpartum period, and contraceptive practices of the women who gave birth. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: During the study period, 201 women were selected for the survey. The average age of the respondents was 26.2 years. They were nulliparous in 41.3% of cases. Our respondents had knowledge of modern contraceptive methods in 82.10% of cases. About 59.2% of the respondents had an unfavourabl展开更多
<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Medical termination of pregnancy is a therapy that considerably reduces th...<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> This was a retrospective and descriptive study conducted at </span><a name="_Hlk92000043"></a><span style="font-family:Verdana;">the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> a period of 9 years. All patients who underwent a </span><a name="_Hlk91999250"></a><span style="font-family:Verdana;">medical termination of pregnancy during the study period and whose term of pregnancy was <28 weeks of amenorrhea were included in this study. Information was collected on a survey sheet from the patients’ clinical records, admission and hospitalisation registers, referral forms and operative report registers. Data were entered and analyzed using Excel, World and epi-info 7.2.2. The main variables studied were hospital frequency, diagnostic means, main indications, means of evacuation and maternal prognosis. Result: 25 patients were identified and represented 0.5% of deliveries. </span><a name="_Hlk92000366"></a><span style="font-family:Verdana;">Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical ultrasound was performed in 100% of patients. T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
Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowle...Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.展开更多
Background: The elderly cancers are worldwide a major public health issue. Their exact incidence is unknown in Togo. The purpose of this study was to describe epidemiological and histological data of cancers in the el...Background: The elderly cancers are worldwide a major public health issue. Their exact incidence is unknown in Togo. The purpose of this study was to describe epidemiological and histological data of cancers in the elderly in Togo. Materials and Methods: This was a cross-sectional and descriptive study of cases of elderly cancers diagnosed at the laboratory of pathology of the university teaching hospital of Lomé from 1995 to 2014 (20 years). Cases of examination on samples of the elderly (biopsy, excision, surgical specimens) were collected from the data records of that laboratory. Results: Overall, 792/5200 cases of elderly cancer were collected representing 15.2% of all cancers diagnosed in the laboratory. The annual incidence was 39.6 cases. Patient age ranged from 65 to 103 years old, with a mean of 68.5 ± 4 years old. The sex ratio (M/F) was 1.3. At pathological level, the study material included pieces (n=290 cases;36.6%) and biopsies (n=502 cases;63.4%). Cancers located preferably in prostate in men (38%), and in women the most frequent locations were cervix (16.2%) and breast (15.8%). We noticed four histological groups: carcinomas (n = 706 cases;89.1%), sarcomas (n = 43 cases;5.5%), lymphoma (n = 34 cases;4.3%) and melanoma (n = 9 cases;1.1%). Carcinomas were dominated by adenocarcinomas (50.1%) and squamous cell carcinomas (33.8%);Kaposi’s sarcoma (32.6%) was the most common histological type in sarcomas. Conclusion: Our results showed that the elderly cancers were frequent in Togo, locating mostly in uterus cervix and breast in female, and prostate in men. This study could help to advocate the establishment of a cancer registry in Togo.展开更多
This was a cross-sectional and descriptive study conducted from January 2<sup><span style="font-family:Verdana;">nd</span></sup><span style="font-family:Verdana;"> to ...This was a cross-sectional and descriptive study conducted from January 2<sup><span style="font-family:Verdana;">nd</span></sup><span style="font-family:Verdana;"> to march 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2019 in the township</span><b> </b><span style="font-family:Verdana;">of Hihéatro in Togo. We included in the study, women who had given birth at least once at home and who accepted to undergo the survey. Data were collected, using a pre-planned and pre-tested survey sheet, by a team of four trained interviewers under the responsibility of a supervisor. Interviews were carried out in the homes of the respondents after obtaining their informed consent. The parameters studied were the number of births at home, socio-demographic characteristics, and reasons for births at home and maternal and fetal prognosis. 411 women gave birth at home in the township. The average number of </span><span style="font-family:;" "=""><span style="font-family:Verdana;">births at home per woman was 2 with extremes of 1 and 7 births per</span><span style="font-family:Verdana;"> woman. The average age of the women was 28.4 years with the extremes of 15 and 38 years. The 25 - 34 age group represented 67.1% of cases. The average parity of the patients was 2. Multiparas represented 59.8% of cases. The main reasons for giving births at home by the interviewees were insufficient financial means in 36% of cases and the lack of means of transport in 28% of cases. Maternal morbidity was marked by 14.1% perineal tear, 1.6% </span><span style="font-family:Verdana;">hysterectomy. Four hundred and eleven newborns were registered. Of </span><span style="font-family:Verdana;">these newborns, 4.4% were stillborn and 8.8% did not cry at birth. Free obstetric care and increased awareness on the importance of assisted deliveries will improve the maternal-fetal prognosis.</span></span>展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Dysgerminoma is a germ cell tumor of the ovary usually found in young women....<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Dysgerminoma is a germ cell tumor of the ovary usually found in young women. It represents 1% to 2% of all ovarian cancers. The preoperative</span><span><span style="font-family:Verdana;"> diagnosis is generally difficult. The surgery and the pathology study are therefore essential for the </span><span style="font-family:Verdana;">diagnosis,</span><span style="font-family:Verdana;"> and optimal management. The incidence of pregnancy with dysgerminoma is extremely low. The treatment and management during pregnancy often jeopardize the </span><span style="font-family:Verdana;">materno-fetal</span><span style="font-family:Verdana;"> prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant woman. </span><b><span style="font-family:Verdana;">Observation: </span></b><span style="font-family:Verdana;">Patient</span><span style="font-family:Verdana;"> was an 18-year-old, female with no known past medical history, who presented to the emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous uterus (height 42</span></span></span><span style="font-family:""> </span><span style="font-family:Verdana;">cm). An ultrasound showed an active pregnancy, and a large vascularized, finely echogenic, multi-partitioned, thick-walled liquid ovarian tumor. Ca125 was 231.5</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">IU/ml. Ovarian dysgerminoma was suspected. The </span><span style="font-family:Verdana;">surgery</span><span style="font-family:Verdana;"> and the pathology study of the surgical specimen confirmed the suspected diagnosis. </span><span style="font-family:Verdana;">Patient</span><span style="font-family:Verdana;"> died on </span><span style="font-family:Verdana;">postoperative</span><span style="font-family:Verdana;"> day 8. </span></span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:""><span style=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展开更多
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Background: In Togo, awareness is very low and patients regularly present with advanced stages of breast cancer. Objective: Determine the knowledge of risk factors and means of breast cancer screening by women seen in gynecological consultation of the Sylvanus Olympio University Hospital (CHU SO). Methods: This was a descriptive cross-sectional study conducted at the gynecology-obstetrics clinic of the CHU SO of Lomé, from March 1 to July 15, 2022. Results: We surveyed 1,566 gynaecological outpatients. Six hundred (600) patients agreed to answer our questions freely, giving a participation rate of 38.3%. The average age of the respondents was 31.9 years old. In 25.5% of cases, the respondents were high school graduates. Five hundred and forty-five of the respondents, or 90.8% had already heard of breast cancer. The most frequent sources of information were medical staff in 34.1% of cases. The presence of nodule in the breast was cited as a clinical sign in 68.4% of cases, breast self-examination as a means of screening in 72.6% of cases, personal history of breast cancer in 51.7% of the cases has non-modifiable risks and smoking as a modifiable risk factor by 58.9% of the respondents. In 31% of cases, they performed breast cancer screening on their own. Breast self-examination was performed by 27.7% of them. Occupation and level of study were statistically associated with women’s knowledge of breast cancer. Conclusion: Most women recognize the existence of breast cancer but their knowledge about signs and risk factors remains low. Few of them, practice screening.
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Obstetric hysterectomy is a surgical procedure most often performed in a context of extreme emergency in an obstetric environment. The incidence of obstetric hysterectomy is differently expressed around the world. In the CHU-SO maternity ward, hemorrhagic obstetric emergencies are common. The extreme urgency in which patients are admitted, the insufficiency of the technical platform, associated with the challenge of the availability of blood products, often leads to performing an obstetric hysterectomy for hemostasis. It is responsible for high maternal morbidity and mortality. Since 2000 no study has been carried out on this practice in the service. Objective was to describe the practice of obstetric hysterectomy at the CHU-SO and specifically to determine the prevalence, the prognostic factors to be able to act to reduce maternal mortality. Method: A descriptive, cross-sectional, and analytical study was carried out at the Gynecology-Obstetrics clinic of the CHU-SO;from January 1, 2021, to June 30, 2022. All hysterectomies performed in an obstetric emergency context (during pregnancy, perpartum or postpartum) in the department were included in our study. We did not include cases of obstetric hysterectomies outside the SO hospital or planned non-obstetric hysterectomies. Results: We recorded 75 cases of obstetric hysterectomy and 15,625 deliveries (0.48%). The average age was 32.89 ± 5.93. The age group between 30 and 35 years old was the most affected with a rate of 37.33%. Labor and third trimester hemorrhage were the main reasons for admission, patients were referred in 80% of cases. The average parity was 3.25 ± 1.92 with utmost of 0 and 11. The pauciparous (41.67%) and multiparous (32%) were the most affected. The indications frequently found were uterine atony (44%);uterine rupture (33.33%). Subtotal inter adnexal hysterectomy was performed in 94.67%. General anesthesia practiced in 69%. They were all polytransfuses. Three poor prognostic factors were observed during our study, namely: uterine atony;the
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Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.
文摘Ob</span><span style="font-family:Verdana;">jectives:</span></span></b><span style="font-family:""><span style="font-family:Verdana;"> Describe the socio-demographic characteristics, describe the main indications for LEEP and present the main complications. </span><b><span style="font-family:Verdana;">Methodology:</span></b> </span><span style="font-family:""><span style="font-family:Verdana;">This was a cross-sectional and descriptive study with consecutive recruitment of the study population through cervical cancer screening campaigns throughout the country during the period July 1, 2017 to April 30, 2019. Included were all patients eligible for LEEP and having benefited from this therapeutic method during our study period. Data were collected from a registry and recorded on a questionnaire developed for this study. These data were analyzed using Epi info 3.5.1 software. The following parameters were studied: patient age, indication for LEEP, intraoperative and postoperative complications, histological examination of the specimens, and postoperative surveillance and screening follow-up one year after LEEP. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 12</span></span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;">595 women were screened for precancerous cervical lesions. A total of 474 women had precancerous lesions. Of these women, 227 had undergone loop resection, a rate of 47.9%. The main indications for LEEP were extensive lesions (68.7%), lesions penetrating the internal cervical os (12.8%). Incidents occurred in 7.5% of patients during the procedure. Post-operative complications occurred in 14.7% of cases. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">LEEP is a better way to treat precancerous lesions but is not well known by medical staff. The equipment of health facilities and the training of medical staff will
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<strong>Background</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> The use of modern contraceptive methods contributes to the reduction of maternal and neonatal mortality. The initiation of a contraceptive method in the immediate postpartum period is one of the strategies to avoid missing out on contraceptive opportunities. This strategy will reduce the unmet need for contraception which is still high in the country. </span><b><span style="font-family:Verdana;">Objective</span></b><span style="font-family:Verdana;">: To describe the knowledge and attitudes of pregnant women and the practices of women who have given birth about immediate postpartum contraception. </span><b><span style="font-family:Verdana;">Methodology</span></b><span style="font-family:Verdana;">: This was a cross-sectional and descriptive study </span><span style="font-family:Verdana;">conducted at the main clinic of ATBEF from 20th March to 20th October 2020</span><span style="font-family:Verdana;">. Our study included pregnant women whose gestational age was greater than or equal to 37 weeks of amenorrhea who came for prenatal consultation or for any other consultation and then gave birth in the center. Data collection was based on a survey form. Data analysis and entry was done with the Epi </span><span style="font-family:Verdana;">info 2000 version 6.04 software. The parameters studied were: socio-demographic</span><span style="font-family:Verdana;"> characteristics, knowledge and attitudes of pregnant women about contraception in the immediate postpartum period, and contraceptive practices of the women who gave birth. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: During the study period, 201 women were selected for the survey. The average age of the respondents was 26.2 years. They were nulliparous in 41.3% of cases. Our respondents had knowledge of modern contraceptive methods in 82.10% of cases. About 59.2% of the respondents had an unfavourabl
文摘<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> This was a retrospective and descriptive study conducted at </span><a name="_Hlk92000043"></a><span style="font-family:Verdana;">the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> a period of 9 years. All patients who underwent a </span><a name="_Hlk91999250"></a><span style="font-family:Verdana;">medical termination of pregnancy during the study period and whose term of pregnancy was <28 weeks of amenorrhea were included in this study. Information was collected on a survey sheet from the patients’ clinical records, admission and hospitalisation registers, referral forms and operative report registers. Data were entered and analyzed using Excel, World and epi-info 7.2.2. The main variables studied were hospital frequency, diagnostic means, main indications, means of evacuation and maternal prognosis. Result: 25 patients were identified and represented 0.5% of deliveries. </span><a name="_Hlk92000366"></a><span style="font-family:Verdana;">Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical ultrasound was performed in 100% of patients. T
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Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.
文摘Background: The elderly cancers are worldwide a major public health issue. Their exact incidence is unknown in Togo. The purpose of this study was to describe epidemiological and histological data of cancers in the elderly in Togo. Materials and Methods: This was a cross-sectional and descriptive study of cases of elderly cancers diagnosed at the laboratory of pathology of the university teaching hospital of Lomé from 1995 to 2014 (20 years). Cases of examination on samples of the elderly (biopsy, excision, surgical specimens) were collected from the data records of that laboratory. Results: Overall, 792/5200 cases of elderly cancer were collected representing 15.2% of all cancers diagnosed in the laboratory. The annual incidence was 39.6 cases. Patient age ranged from 65 to 103 years old, with a mean of 68.5 ± 4 years old. The sex ratio (M/F) was 1.3. At pathological level, the study material included pieces (n=290 cases;36.6%) and biopsies (n=502 cases;63.4%). Cancers located preferably in prostate in men (38%), and in women the most frequent locations were cervix (16.2%) and breast (15.8%). We noticed four histological groups: carcinomas (n = 706 cases;89.1%), sarcomas (n = 43 cases;5.5%), lymphoma (n = 34 cases;4.3%) and melanoma (n = 9 cases;1.1%). Carcinomas were dominated by adenocarcinomas (50.1%) and squamous cell carcinomas (33.8%);Kaposi’s sarcoma (32.6%) was the most common histological type in sarcomas. Conclusion: Our results showed that the elderly cancers were frequent in Togo, locating mostly in uterus cervix and breast in female, and prostate in men. This study could help to advocate the establishment of a cancer registry in Togo.
文摘This was a cross-sectional and descriptive study conducted from January 2<sup><span style="font-family:Verdana;">nd</span></sup><span style="font-family:Verdana;"> to march 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2019 in the township</span><b> </b><span style="font-family:Verdana;">of Hihéatro in Togo. We included in the study, women who had given birth at least once at home and who accepted to undergo the survey. Data were collected, using a pre-planned and pre-tested survey sheet, by a team of four trained interviewers under the responsibility of a supervisor. Interviews were carried out in the homes of the respondents after obtaining their informed consent. The parameters studied were the number of births at home, socio-demographic characteristics, and reasons for births at home and maternal and fetal prognosis. 411 women gave birth at home in the township. The average number of </span><span style="font-family:;" "=""><span style="font-family:Verdana;">births at home per woman was 2 with extremes of 1 and 7 births per</span><span style="font-family:Verdana;"> woman. The average age of the women was 28.4 years with the extremes of 15 and 38 years. The 25 - 34 age group represented 67.1% of cases. The average parity of the patients was 2. Multiparas represented 59.8% of cases. The main reasons for giving births at home by the interviewees were insufficient financial means in 36% of cases and the lack of means of transport in 28% of cases. Maternal morbidity was marked by 14.1% perineal tear, 1.6% </span><span style="font-family:Verdana;">hysterectomy. Four hundred and eleven newborns were registered. Of </span><span style="font-family:Verdana;">these newborns, 4.4% were stillborn and 8.8% did not cry at birth. Free obstetric care and increased awareness on the importance of assisted deliveries will improve the maternal-fetal prognosis.</span></span>
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Dysgerminoma is a germ cell tumor of the ovary usually found in young women. It represents 1% to 2% of all ovarian cancers. The preoperative</span><span><span style="font-family:Verdana;"> diagnosis is generally difficult. The surgery and the pathology study are therefore essential for the </span><span style="font-family:Verdana;">diagnosis,</span><span style="font-family:Verdana;"> and optimal management. The incidence of pregnancy with dysgerminoma is extremely low. The treatment and management during pregnancy often jeopardize the </span><span style="font-family:Verdana;">materno-fetal</span><span style="font-family:Verdana;"> prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant woman. </span><b><span style="font-family:Verdana;">Observation: </span></b><span style="font-family:Verdana;">Patient</span><span style="font-family:Verdana;"> was an 18-year-old, female with no known past medical history, who presented to the emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous uterus (height 42</span></span></span><span style="font-family:""> </span><span style="font-family:Verdana;">cm). An ultrasound showed an active pregnancy, and a large vascularized, finely echogenic, multi-partitioned, thick-walled liquid ovarian tumor. Ca125 was 231.5</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">IU/ml. Ovarian dysgerminoma was suspected. The </span><span style="font-family:Verdana;">surgery</span><span style="font-family:Verdana;"> and the pathology study of the surgical specimen confirmed the suspected diagnosis. </span><span style="font-family:Verdana;">Patient</span><span style="font-family:Verdana;"> died on </span><span style="font-family:Verdana;">postoperative</span><span style="font-family:Verdana;"> day 8. </span></span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:""><span style=
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
