<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public hea...<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public health problem in </span><span style="font-family:Verdana;">the world. Complications during pregnancy and childbirth are the main</span><span style="font-family:Verdana;"> causes </span><span style="font-family:Verdana;">of maternal mortality in low-income countries. It is estimated that 15% of</span><span style="font-family:Verdana;"> deaths are related to these complications. Studies have shown that women </span><span style="font-family:Verdana;">have little or no acquaintance on sign danger and complications during</span><span style="font-family:Verdana;"> pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Complications during pregnancy and childbirth are common among </span><span style="font-family:Verdana;">pregnant women in Guinea. Many women have knowledge about various</span><span style="font-family:Verdana;"> sorts </span><span style="font-family:Verdana;">of complications related to pregnancy and childbirth. These complications </span><span style="font-family:Verdana;">were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the </span><span style="font-family:Verdana;">health facility was another attitude identified. Lack of financial means, the</span><span style="font-family:Verdana;"> distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that women’s knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and especially the identification of sign danger during pregnancy and childbirth is </span><span style="font-family:Verdana;">essential to reduce maternal and neonatal mortality in our less equipped </span><span style="font-family:Verdana;">countries.</span></span>展开更多
Objective: To study the epidemiological, histological and therapeutic characteristics of endometrial cancer in the Gynecology-Obstetrics department of the Donka National Hospital, CHU of Conakry. Methods: We conducted...Objective: To study the epidemiological, histological and therapeutic characteristics of endometrial cancer in the Gynecology-Obstetrics department of the Donka National Hospital, CHU of Conakry. Methods: We conducted a retrospective descriptive study of 86 patients with endometrial cancer treated in the Gynecology-Obstetrics department of the Donka National Hospital from January 1, 2011, to December 31, 2021, based on their medical records. We analysed the epidemiological, histological and therapeutic aspects of the disease. Results: Endometrial cancer accounted for 3.1% of the 2793 gynecological pathology cases registered in the department during the study period, ranking third. The mean age of the patients was 63 ± 5 years. Most of them were uneducated (59.3%), postmenopausal (91.9%), nulliparous (30.2%), obese (65.1%) and hypertensive (77.1%). More than half of the patients (53.4%) were diagnosed at stage I. Endometrioid adenocarcinoma was the predominant histological type (68.6%). Surgery was performed in 96.6% of the patients, and chemotherapy in 14.0%. After a mean follow-up of 15 months, 84.5% of the patients were alive. Conclusion: Endometrial cancer is a common gynecological malignancy in our department. Endometrioid adenocarcinoma is the most frequent histological subtype. Surgery is the main treatment modality.展开更多
Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a ...Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a retrospective descriptive study of 7 years from 1 January 2006 to 31 December 2012. Records of invasive cervical cancer were histologically confirmed. The clinical and therapeutic data collected were transferred to Epi info 7 and SSPS version 18 software with a significance level p as used to provide information on the vital condition after confidential agreement. Kaplan Meier was used to assess the overall survival rate. Results: Invasive cancer of the cervix was frequent (58.79%) with an annual median rate of 16.7%, with extremes of 5.8% and 20.6%. 88.70% of the patients was referred from regions of the country (54.02%);the median age was 50 years with extremes of 16 and 84 years and a peak of 29.6% between 35 and 44 years;76.20% were housewives;uneducated women were about 60.12%;Stage III was about 45.3%. Most of the patients were confirmed histologically after 30 days (68%). The means of treatment were surgery about 91 (29.26%), palliation 75 (24.12%), radiotherapy 59 (18.97%) and chemotherapy 41 (13.18%) with surgery (9, 65%) or radiotherapy (4.82%). The main complication was metrorrhagia, 164 cases (56.55%), with overall survival rate of 51.8% at 2 years and 5.1% at 5 years. Conclusion: Invasive cervical cancer in later stages is treated for low survival in the context of our work. Early detection and treatment of precancerous lesions would reduce the incidence and mortality of this cancer.展开更多
Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergenci...Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the Department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refurbish providers of basic facilities, promptness in the management of the admission of emergencies and the availability of blood products.展开更多
Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. M...Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the emergencies in the structures of superior level.展开更多
Objectives: The objectives of this article are to: 1) Determine the prevalence of parturient that escapes from the ETME, 2) Determine the rate of acceptability or non-acceptability of the HIV tests, 3) Describe the ep...Objectives: The objectives of this article are to: 1) Determine the prevalence of parturient that escapes from the ETME, 2) Determine the rate of acceptability or non-acceptability of the HIV tests, 3) Describe the epidemiological profile and 4) Describe the factors explaining the lack of screening during pregnancy. Methodology: This report is based on an eventual descriptive study carried out in the Maternity Ward at the Ratoma Medical Centre for the past six months. The study took place over six (6) months from June 15 to December 15, 2016. The data were collected by individual interviews using a data collection sheet and prenatal consultation booklet that were administered to parturients in their language of comprehension. Each unscreened parturient received in the delivery room or in immediate postpartum received pre- and post-test HIV/AIDS counseling with immediate announcement of the outcome for all those who accepted the principle. For parturients who were in the active phase of work, counseling/testing was done in the immediate postpartum period. The data were manually collected from the pre-established fact sheets, captured using the Word, Excel and PowerPoint software packages of the 2007 Office and analyzed by the Epi-Info software (version 3.5.4). The limitations of the study were the lack of adequate room for the HIV testing council, the refusal of HIV testing by some parturients and the lack of achievement of CD4 levels in the hospital laboratory. Outcomes: The survey indicated that out of the 41.80% (177/423) of pregnant women that have recently given birth, ignore their HIV status. About 36.90% (66/177) rejected the screening and the 6.4% (7/111) that accepted were HIV/AIDS positive. The epidemiological study revolved around the following categories of women aged between 24 and 33 (42.85%), 1) Married (100%), 2) Housewives (57.14%), 3) Out-of-school (57.14), 4) Lack prenatal follow-up (42.85%), 5) Ignorance of the existence of HIV (71.42%). Reason Invoked for the Unawareness: No screening was proposed for prenatal follow-up (90.40%). Conclusion: The HIV testing approach in the work room could serve as a catch-up strategy to reduce vertical transmission and thus increase the operational coverage of the PMTCT service. The upgrading providers of basic facilities would be necessary in order to offer the HIV screening in refocused prenatal consultations, which could reduce the catch-up/contamination in the work room.展开更多
Objectives: The objectives of this work were to calculate the frequency of MFIU, to describe the epidemiological profile, to identify the étiologies and to establish the maternal prognosis. Methodology: It was ab...Objectives: The objectives of this work were to calculate the frequency of MFIU, to describe the epidemiological profile, to identify the étiologies and to establish the maternal prognosis. Methodology: It was about a prospective survey of analytic type spreading on one period of twelve (12) month achieved to the service of Obstetric Gynecology of the hospital National Donka, FALLEN from Conakry. Results: On 5226 childbirths, we recorded 208 cases of MFIU, either a frequency of 3.98%. The epidemiological profile was the one of a teenager or aged woman (more of 35 ans) with respectively (8.17%) and (7.20%), sans follow-up prénatal (10.41%), nullipare (6.02%), célibataire (7.80%), ménagère (5.02%) and non scolarisée (5.16%). The MFIU occurred in the age group of 32 - 36 SA. L’absence of the MAF was the main motive of consultation 94.23%. All cases of MFIU benefitted from a confirmation scan. The vasculo-renal syndromes and their complications were the main étiologie 43.75%;follow-up of the malaria is 13.94%. The majority of the gestantes were delivered by low way 98.08%. The induction of work has been made mainly to the misoprostol (Cytotec 200 μg) either 81.86% against 10.78% of Syntocinon in drip. The maternal morbidity has especially been dominated especially by the hemorrhages in the case of long length retention and the infections when the membranes are broken either 1.44% against 98.56% of case of good maternal prognosis. No maternal death has been recorded. Conclusion: The prenatal consultation offer recentered and the one of medical correct cares of the vasculo-renal syndromes and the malaria could reduce the cases of death fœtale efficiently in utero.展开更多
Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retros...Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the Gynaecology Obstetrics Department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.展开更多
After an extensional stage giving rise to tholeiitic basalts and gabbros, the south western part of Kédougou Kéniéba Inlier (KKI) was affected by three phases of compressionnal deformation. The first ph...After an extensional stage giving rise to tholeiitic basalts and gabbros, the south western part of Kédougou Kéniéba Inlier (KKI) was affected by three phases of compressionnal deformation. The first phase (D1) was related to NE-SW stress that led to northeastward thrusting. Early granitoids would be implemented during this tectonic event. The second phase (D2) was due to East-West compressional stress that created combined strike sleep faults: NNW-SSE and NNE-SSW respectively sinistral and dextral. During this phase, some volcanic rocks and gabbros were mylonitized, hydrothermalized and transformed into quartzites. These quartzites were considered as sedimentary rocks in previous studies. Granitic plutons and andesites took place during this tectonic phase. D3 deformation occurred towards the end of the Eburnean orogeny. It would be held in two episodes. In the first episode, WNW-ESE stresses created conjugate shears: sinistral NNW-SSE and dextral NE-SW. In the second episode, stresses moved toward the NE-SW direction and made the resulting brittle structures arranged in NS dextral corridors.展开更多
Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk ...Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.展开更多
文摘<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public health problem in </span><span style="font-family:Verdana;">the world. Complications during pregnancy and childbirth are the main</span><span style="font-family:Verdana;"> causes </span><span style="font-family:Verdana;">of maternal mortality in low-income countries. It is estimated that 15% of</span><span style="font-family:Verdana;"> deaths are related to these complications. Studies have shown that women </span><span style="font-family:Verdana;">have little or no acquaintance on sign danger and complications during</span><span style="font-family:Verdana;"> pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Complications during pregnancy and childbirth are common among </span><span style="font-family:Verdana;">pregnant women in Guinea. Many women have knowledge about various</span><span style="font-family:Verdana;"> sorts </span><span style="font-family:Verdana;">of complications related to pregnancy and childbirth. These complications </span><span style="font-family:Verdana;">were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the </span><span style="font-family:Verdana;">health facility was another attitude identified. Lack of financial means, the</span><span style="font-family:Verdana;"> distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that women’s knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and especially the identification of sign danger during pregnancy and childbirth is </span><span style="font-family:Verdana;">essential to reduce maternal and neonatal mortality in our less equipped </span><span style="font-family:Verdana;">countries.</span></span>
文摘Objective: To study the epidemiological, histological and therapeutic characteristics of endometrial cancer in the Gynecology-Obstetrics department of the Donka National Hospital, CHU of Conakry. Methods: We conducted a retrospective descriptive study of 86 patients with endometrial cancer treated in the Gynecology-Obstetrics department of the Donka National Hospital from January 1, 2011, to December 31, 2021, based on their medical records. We analysed the epidemiological, histological and therapeutic aspects of the disease. Results: Endometrial cancer accounted for 3.1% of the 2793 gynecological pathology cases registered in the department during the study period, ranking third. The mean age of the patients was 63 ± 5 years. Most of them were uneducated (59.3%), postmenopausal (91.9%), nulliparous (30.2%), obese (65.1%) and hypertensive (77.1%). More than half of the patients (53.4%) were diagnosed at stage I. Endometrioid adenocarcinoma was the predominant histological type (68.6%). Surgery was performed in 96.6% of the patients, and chemotherapy in 14.0%. After a mean follow-up of 15 months, 84.5% of the patients were alive. Conclusion: Endometrial cancer is a common gynecological malignancy in our department. Endometrioid adenocarcinoma is the most frequent histological subtype. Surgery is the main treatment modality.
文摘Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a retrospective descriptive study of 7 years from 1 January 2006 to 31 December 2012. Records of invasive cervical cancer were histologically confirmed. The clinical and therapeutic data collected were transferred to Epi info 7 and SSPS version 18 software with a significance level p as used to provide information on the vital condition after confidential agreement. Kaplan Meier was used to assess the overall survival rate. Results: Invasive cancer of the cervix was frequent (58.79%) with an annual median rate of 16.7%, with extremes of 5.8% and 20.6%. 88.70% of the patients was referred from regions of the country (54.02%);the median age was 50 years with extremes of 16 and 84 years and a peak of 29.6% between 35 and 44 years;76.20% were housewives;uneducated women were about 60.12%;Stage III was about 45.3%. Most of the patients were confirmed histologically after 30 days (68%). The means of treatment were surgery about 91 (29.26%), palliation 75 (24.12%), radiotherapy 59 (18.97%) and chemotherapy 41 (13.18%) with surgery (9, 65%) or radiotherapy (4.82%). The main complication was metrorrhagia, 164 cases (56.55%), with overall survival rate of 51.8% at 2 years and 5.1% at 5 years. Conclusion: Invasive cervical cancer in later stages is treated for low survival in the context of our work. Early detection and treatment of precancerous lesions would reduce the incidence and mortality of this cancer.
文摘Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the Department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refurbish providers of basic facilities, promptness in the management of the admission of emergencies and the availability of blood products.
文摘Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the emergencies in the structures of superior level.
文摘Objectives: The objectives of this article are to: 1) Determine the prevalence of parturient that escapes from the ETME, 2) Determine the rate of acceptability or non-acceptability of the HIV tests, 3) Describe the epidemiological profile and 4) Describe the factors explaining the lack of screening during pregnancy. Methodology: This report is based on an eventual descriptive study carried out in the Maternity Ward at the Ratoma Medical Centre for the past six months. The study took place over six (6) months from June 15 to December 15, 2016. The data were collected by individual interviews using a data collection sheet and prenatal consultation booklet that were administered to parturients in their language of comprehension. Each unscreened parturient received in the delivery room or in immediate postpartum received pre- and post-test HIV/AIDS counseling with immediate announcement of the outcome for all those who accepted the principle. For parturients who were in the active phase of work, counseling/testing was done in the immediate postpartum period. The data were manually collected from the pre-established fact sheets, captured using the Word, Excel and PowerPoint software packages of the 2007 Office and analyzed by the Epi-Info software (version 3.5.4). The limitations of the study were the lack of adequate room for the HIV testing council, the refusal of HIV testing by some parturients and the lack of achievement of CD4 levels in the hospital laboratory. Outcomes: The survey indicated that out of the 41.80% (177/423) of pregnant women that have recently given birth, ignore their HIV status. About 36.90% (66/177) rejected the screening and the 6.4% (7/111) that accepted were HIV/AIDS positive. The epidemiological study revolved around the following categories of women aged between 24 and 33 (42.85%), 1) Married (100%), 2) Housewives (57.14%), 3) Out-of-school (57.14), 4) Lack prenatal follow-up (42.85%), 5) Ignorance of the existence of HIV (71.42%). Reason Invoked for the Unawareness: No screening was proposed for prenatal follow-up (90.40%). Conclusion: The HIV testing approach in the work room could serve as a catch-up strategy to reduce vertical transmission and thus increase the operational coverage of the PMTCT service. The upgrading providers of basic facilities would be necessary in order to offer the HIV screening in refocused prenatal consultations, which could reduce the catch-up/contamination in the work room.
文摘Objectives: The objectives of this work were to calculate the frequency of MFIU, to describe the epidemiological profile, to identify the étiologies and to establish the maternal prognosis. Methodology: It was about a prospective survey of analytic type spreading on one period of twelve (12) month achieved to the service of Obstetric Gynecology of the hospital National Donka, FALLEN from Conakry. Results: On 5226 childbirths, we recorded 208 cases of MFIU, either a frequency of 3.98%. The epidemiological profile was the one of a teenager or aged woman (more of 35 ans) with respectively (8.17%) and (7.20%), sans follow-up prénatal (10.41%), nullipare (6.02%), célibataire (7.80%), ménagère (5.02%) and non scolarisée (5.16%). The MFIU occurred in the age group of 32 - 36 SA. L’absence of the MAF was the main motive of consultation 94.23%. All cases of MFIU benefitted from a confirmation scan. The vasculo-renal syndromes and their complications were the main étiologie 43.75%;follow-up of the malaria is 13.94%. The majority of the gestantes were delivered by low way 98.08%. The induction of work has been made mainly to the misoprostol (Cytotec 200 μg) either 81.86% against 10.78% of Syntocinon in drip. The maternal morbidity has especially been dominated especially by the hemorrhages in the case of long length retention and the infections when the membranes are broken either 1.44% against 98.56% of case of good maternal prognosis. No maternal death has been recorded. Conclusion: The prenatal consultation offer recentered and the one of medical correct cares of the vasculo-renal syndromes and the malaria could reduce the cases of death fœtale efficiently in utero.
文摘Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the Gynaecology Obstetrics Department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.
文摘After an extensional stage giving rise to tholeiitic basalts and gabbros, the south western part of Kédougou Kéniéba Inlier (KKI) was affected by three phases of compressionnal deformation. The first phase (D1) was related to NE-SW stress that led to northeastward thrusting. Early granitoids would be implemented during this tectonic event. The second phase (D2) was due to East-West compressional stress that created combined strike sleep faults: NNW-SSE and NNE-SSW respectively sinistral and dextral. During this phase, some volcanic rocks and gabbros were mylonitized, hydrothermalized and transformed into quartzites. These quartzites were considered as sedimentary rocks in previous studies. Granitic plutons and andesites took place during this tectonic phase. D3 deformation occurred towards the end of the Eburnean orogeny. It would be held in two episodes. In the first episode, WNW-ESE stresses created conjugate shears: sinistral NNW-SSE and dextral NE-SW. In the second episode, stresses moved toward the NE-SW direction and made the resulting brittle structures arranged in NS dextral corridors.
文摘Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.
