Objectives: To describe our management strategy of ovulation disorders. Patients and methods: From a retrospective collection of data from the records, we identified over a period of one year (January 2016-December 20...Objectives: To describe our management strategy of ovulation disorders. Patients and methods: From a retrospective collection of data from the records, we identified over a period of one year (January 2016-December 2016), 47 patients followed in gynecology department of University and Hospital Centers of Yopougon and Treichville in Abidjan (Cote d’Ivoire) for ovulation disorders. The diagnosis of dysovulation was made following a hormonal check up and a follicular monitoring ultrasound. These patients underwent a specific treatment according to the type of dysovulation they presented. Results: The average age was 31.9 years with a significant proportion of nulliparous (66%). Body mass index was high in 44.7% of patients, of whom 19.1% were obese and 25.6% overweight. The hormonal balance was disrupted in 48.9% of cases. Polycystic ovary syndrome (WHO type IIb dysovulation) was the most common pathology (36%). The proposed treatments were dominated by clomiphene citrate (31.9%) and gonadotrophins (25.5%). 14.9% of pregnancies were obtained. Conclusion: This study allows us to offer better management of ovulation disorders, but this necessarily entails a careful exploration and an appropriate treatment.展开更多
Background The use of uterine balloon tamponade(UBT)devices for intrauterine packing and management of vaginal bleeding by uterine atony has shown promising results in improving the quality of care and reducing matern...Background The use of uterine balloon tamponade(UBT)devices for intrauterine packing and management of vaginal bleeding by uterine atony has shown promising results in improving the quality of care and reducing maternal mortality.Objective This report aims to provide an overview of progress made in implementing UBT devices in northern Cote d'Ivoire.Material and methods A four-year retrospective study was conducted in the North-East(163,645),North-Center(351,909),and North-West(57,983).In 2017,UBT was adopted by members of the healthcare system.Subsequently,5 national and 32 regional trainers have been trained.The training session was a theoretical and practical program with a low simulator.UBT is a male condom tied to a urinary catheter,filled with liquid.Positive outcomes included stopping bleeding,avoiding the need for surgery,and preventing maternal deaths(MD).In 2018,3,515 UBT devices were distributed.In 2019,monitoring tools and transmission circuits of the data were validated.In 2020,the collection of data and local manufacturing was launched.Results During the process,978 health workers,mainly midwife(52.0%)and nurses(32.2%)out of the 1,295 assigned were trained.The number of trained individuals decreased from 209 in 2019 to 160 in 2020.A total of 1,715 UBT devices were locally manufactured,adding to the existing gift of 5,080 devices,with total availability of 6,795.The distribution of devices increased from 2017 to 2019 but decreased in 2020.Success rates increased from 87.3%in 2017(365/418)to 95.0%in 2019(556/585)and slightly decreased in 2020 to 98.0%(681/695).Adverse outcomes(144/2,193),included MD(35/2,193)and medical evacuation to the surgical center(109/2,193).Conclusion The implementation of UBT in northern Cote d'Ivoire successfully reduced maternal death rates caused by immediate post-partum hemorrhage(IPPH).However,to ensure sustainability,further improvements are needed,including increased monitoring,ongoing training,and device availability.展开更多
文摘Objectives: To describe our management strategy of ovulation disorders. Patients and methods: From a retrospective collection of data from the records, we identified over a period of one year (January 2016-December 2016), 47 patients followed in gynecology department of University and Hospital Centers of Yopougon and Treichville in Abidjan (Cote d’Ivoire) for ovulation disorders. The diagnosis of dysovulation was made following a hormonal check up and a follicular monitoring ultrasound. These patients underwent a specific treatment according to the type of dysovulation they presented. Results: The average age was 31.9 years with a significant proportion of nulliparous (66%). Body mass index was high in 44.7% of patients, of whom 19.1% were obese and 25.6% overweight. The hormonal balance was disrupted in 48.9% of cases. Polycystic ovary syndrome (WHO type IIb dysovulation) was the most common pathology (36%). The proposed treatments were dominated by clomiphene citrate (31.9%) and gonadotrophins (25.5%). 14.9% of pregnancies were obtained. Conclusion: This study allows us to offer better management of ovulation disorders, but this necessarily entails a careful exploration and an appropriate treatment.
文摘Background The use of uterine balloon tamponade(UBT)devices for intrauterine packing and management of vaginal bleeding by uterine atony has shown promising results in improving the quality of care and reducing maternal mortality.Objective This report aims to provide an overview of progress made in implementing UBT devices in northern Cote d'Ivoire.Material and methods A four-year retrospective study was conducted in the North-East(163,645),North-Center(351,909),and North-West(57,983).In 2017,UBT was adopted by members of the healthcare system.Subsequently,5 national and 32 regional trainers have been trained.The training session was a theoretical and practical program with a low simulator.UBT is a male condom tied to a urinary catheter,filled with liquid.Positive outcomes included stopping bleeding,avoiding the need for surgery,and preventing maternal deaths(MD).In 2018,3,515 UBT devices were distributed.In 2019,monitoring tools and transmission circuits of the data were validated.In 2020,the collection of data and local manufacturing was launched.Results During the process,978 health workers,mainly midwife(52.0%)and nurses(32.2%)out of the 1,295 assigned were trained.The number of trained individuals decreased from 209 in 2019 to 160 in 2020.A total of 1,715 UBT devices were locally manufactured,adding to the existing gift of 5,080 devices,with total availability of 6,795.The distribution of devices increased from 2017 to 2019 but decreased in 2020.Success rates increased from 87.3%in 2017(365/418)to 95.0%in 2019(556/585)and slightly decreased in 2020 to 98.0%(681/695).Adverse outcomes(144/2,193),included MD(35/2,193)and medical evacuation to the surgical center(109/2,193).Conclusion The implementation of UBT in northern Cote d'Ivoire successfully reduced maternal death rates caused by immediate post-partum hemorrhage(IPPH).However,to ensure sustainability,further improvements are needed,including increased monitoring,ongoing training,and device availability.
