Aim: To evaluate 15 years practice of coelioscopic Treatment of ectopicpregnancy in the Surgery Department “A” at the University Hospital Point G. Material and Methods: We conducted a descriptive retrospective study...Aim: To evaluate 15 years practice of coelioscopic Treatment of ectopicpregnancy in the Surgery Department “A” at the University Hospital Point G. Material and Methods: We conducted a descriptive retrospective study at the Surgery Department “A” at the University Hospital Point G from January 2001 to August 2015. Inclusion criteria were all pregnant women with ectopic pregnancy treated with coelioscopy. Sociodemographic, clinical, paracclinical and therapeutic aspects were recorded. Results: In 15 years, 42 cases of ectopic pregnancy out of 3840 gynecologic coelioscopies (1.04%) were collected. The average age was 28.5 years old with the extremes of 16 and 41 years old. Metrorragia was associated to pain in 83.3% (35/42);amenorrhea was found in 66.7% (28/41). Physical exam revealed pain with abdominal defense in 59.5% (25/42), adnexal mass in 31% (13/42), and pelvic contracture in 9.5% (4/42). In pre-operative, ectopic pregnancy was diagnosed complicated in 71.4% (30/42) and uncomplicated in 28.6% (12/42). Patients underwent salpingectomy in 85.7% (36/42), delivery from the fallopian tube in 9.8% (4/42), and hemostatic salpingectomy in 4.4% (2/42). The average duration of hospital stay was 1.88 day with the extremes of 1 and 7 days. The postoperative evolution was favorable in 97.6% (41/42), infection at the site of surgery was reported in 2.4% (1/42). Not a single death was registered. Conclusion: Treatment of ectopic pregnancy is of routine at the surgery department “A” in Point G. Fertility is preserved in the future.展开更多
Objective: Analyze the maternal mortality in the two departments of CHU Point “G” in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study...Objective: Analyze the maternal mortality in the two departments of CHU Point “G” in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point “G”. All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of Chi2, the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20 - 24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%;the evacuation without any evacuation sheet: 259/389 making 66.6%), poor CPN (Prenatal consultation) quality (undone CPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389), infection (61/389 cases making 15.68%), dystocia: 50 cases making 12.85% and high blood pressure and complications (38/389 making 9.76%);indirect in 158/389 cases making 40.6% (Figures 1-3). The majority of women 65.8% (256/389) of our patients died in the gynecology and obstetrics department;in the Resuscitation department 73/389 making 18.8%;in the operating room 43/389 making 11.1% and the deaths that were observed on arrivals represented 17/389 making 4.4%. In our study, 10.3% (40/389) of our patients died in the antepartum, 57.1% (222/389) in perpartum, and 32.6% (127/389) in the postpartum (Figure 4). The need not covered in blood transfusion represented 91.5% the cases either 356/389. Conclusion: The frequency of maternal deaths is very high in our country. Reducing the rate of maternal deaths requires improving the SONU (cares obstetrical and neonatal emergency).展开更多
文摘Aim: To evaluate 15 years practice of coelioscopic Treatment of ectopicpregnancy in the Surgery Department “A” at the University Hospital Point G. Material and Methods: We conducted a descriptive retrospective study at the Surgery Department “A” at the University Hospital Point G from January 2001 to August 2015. Inclusion criteria were all pregnant women with ectopic pregnancy treated with coelioscopy. Sociodemographic, clinical, paracclinical and therapeutic aspects were recorded. Results: In 15 years, 42 cases of ectopic pregnancy out of 3840 gynecologic coelioscopies (1.04%) were collected. The average age was 28.5 years old with the extremes of 16 and 41 years old. Metrorragia was associated to pain in 83.3% (35/42);amenorrhea was found in 66.7% (28/41). Physical exam revealed pain with abdominal defense in 59.5% (25/42), adnexal mass in 31% (13/42), and pelvic contracture in 9.5% (4/42). In pre-operative, ectopic pregnancy was diagnosed complicated in 71.4% (30/42) and uncomplicated in 28.6% (12/42). Patients underwent salpingectomy in 85.7% (36/42), delivery from the fallopian tube in 9.8% (4/42), and hemostatic salpingectomy in 4.4% (2/42). The average duration of hospital stay was 1.88 day with the extremes of 1 and 7 days. The postoperative evolution was favorable in 97.6% (41/42), infection at the site of surgery was reported in 2.4% (1/42). Not a single death was registered. Conclusion: Treatment of ectopic pregnancy is of routine at the surgery department “A” in Point G. Fertility is preserved in the future.
文摘Objective: Analyze the maternal mortality in the two departments of CHU Point “G” in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point “G”. All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of Chi2, the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20 - 24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%;the evacuation without any evacuation sheet: 259/389 making 66.6%), poor CPN (Prenatal consultation) quality (undone CPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389), infection (61/389 cases making 15.68%), dystocia: 50 cases making 12.85% and high blood pressure and complications (38/389 making 9.76%);indirect in 158/389 cases making 40.6% (Figures 1-3). The majority of women 65.8% (256/389) of our patients died in the gynecology and obstetrics department;in the Resuscitation department 73/389 making 18.8%;in the operating room 43/389 making 11.1% and the deaths that were observed on arrivals represented 17/389 making 4.4%. In our study, 10.3% (40/389) of our patients died in the antepartum, 57.1% (222/389) in perpartum, and 32.6% (127/389) in the postpartum (Figure 4). The need not covered in blood transfusion represented 91.5% the cases either 356/389. Conclusion: The frequency of maternal deaths is very high in our country. Reducing the rate of maternal deaths requires improving the SONU (cares obstetrical and neonatal emergency).
