Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating Syst...Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating System (MARS) has been reported to reverse severe cholestasis-linked pruritus. Here, we report the first use of MARS during a spontaneous pregnancy and its successful outcome in a patient with PFIC3 and intractable pruritus. Albumin dialysis could be considered as a pregnancy-saving procedure in pregnant women with severe cholestasis and refractory pruritus.展开更多
AIM:To develop and validate a transient micro-elastography device to measure liver stiffness(LS) in mice.METHODS:A novel transient micro-elastography(TME) device,dedicated to LS measurements in mice with a range of me...AIM:To develop and validate a transient micro-elastography device to measure liver stiffness(LS) in mice.METHODS:A novel transient micro-elastography(TME) device,dedicated to LS measurements in mice with a range of measurement from 1-170 kPa,was developed using an optimized vibration frequency of 300 Hz and a 2 mm piston.The novel probe was validated in a classical fibrosis model(CCl4) and in a transgenic murine model of systemic amyloidosis.RESULTS:TME could be successfully performed in control mice below the xiphoid cartilage,with a mean LS of 4.4 ± 1.3 kPa,a mean success rate of 88%,and an excellent intra-observer agreement(0.98).Treatment with CCl4 over seven weeks drastically increased LS as compared to controls(18.2 ± 3.7 kPa vs 3.6 ± 1.2 kPa).Moreover,fibrosis stage was highly correlated with LS(Spearman coefficient = 0.88,P < 0.01).In the amyloidosis model,much higher LS values were obtained,reaching maximum values of > 150 kPa.LS significantly correlated with the amyloidosis index(0.93,P < 0.0001) and the plasma concentration of mutant hapoA-□(0.62,P < 0.005).CONCLUSION:Here,we have established the first non-invasive approach to measure LS in mice,and have successfully validated it in two murine models of high LS.展开更多
Objective: To analyze the management of urological complications of gynecologic and obstetric surgeries. Material and Methods: We retrospectively studied 39 patients hospitalized in the Department of Urology of the Co...Objective: To analyze the management of urological complications of gynecologic and obstetric surgeries. Material and Methods: We retrospectively studied 39 patients hospitalized in the Department of Urology of the Conakry Teaching Hospital for urological complications of gynecological surgery, during 9 years. The epidemiological, diagnostic, surgical and outcome parameters have been analyzed. Results: The urological complications of gynecologic surgery represent 0.29% of admissions in the Department of Urology. The mean age was 31 years with extremes of 18 and 47 years. Etiological factors were dominated by caesarean section with 74.36% of cases. The main lesions observed were vesico-vaginal and uretero-vaginal fistulas respectively 43.6% and 41.2% of cases. The mean delay of diagnosis was 5 months (extreme: 7 days to 3 years). Urine leakage from the vagina was the main symptom. The surgical treatment consisted in 17 surgeries for vesico-vaginal fistulas, 16 surgeries for uretero-vesical reimplantation, 2 surgeries for termino terminal ureterorraphia, 2 surgeries for vesico-uterine fistulas and 1 surgery for hysterectomy. Healing was obtained in all ureteral injuries and we noted two cases of failure in vesico-vaginal fistula. Conclusion: urological complications of gynecologic surgery remain frequent. They are dominated by the vesico-vaginal and uretero-vaginal fistulas and the main etiology is caesarean section. The treatment is surgical in our context.展开更多
Objective: This study was undertaken to report on the prevalence and management of late complications in twin-to-twin transfusion syndrome (TTTS) treated by laser therapy when both twins are alive 1 week after surgery...Objective: This study was undertaken to report on the prevalence and management of late complications in twin-to-twin transfusion syndrome (TTTS) treated by laser therapy when both twins are alive 1 week after surgery. Study design: A total of 151 consecutive TTTS cases were treated by selective fetoscopic laser therapy. Cases in which both twins were alive 1 week after surgery were followed up with ultrasound and Doppler examination, including middle-cerebral artery peak systolic velocity measurement (MCA-PSV). Results: In the 151 cases treated with laser, both twins were still alive 7 days after the procedure in 101 cases. Intrauterine death of 1 and both twins occurred in 7 and 1 cases, respectively. Recurrence of TTTS with the polyhydramnios-oligohydramnios sequence occurred in 14 (14% ) cases. In another 13 (13% ) cases,amniotic fluid remained normal in both sacs, but MCA- PSV increased above 1.5 MoM in 1 twin and decreased concomitantly below 0.8 MoM in the co-twin. This was related to anemia and polycythemia, respectively, and resulted from unidirectional feto-fetal blood transfusion, mainly from former recipients into former donors. Late complications were managed accordingly by repeat laser, amnioreduction, cord coagulation, intrauterine blood transfusion, or elective delivery. Conclusion: MCA-PSV Doppler measurements are useful in the follow-up of double survivors to detect and manage late complications after selective laser therapy.展开更多
Objective: To evaluate the current management of ectopic pregnancies (EPG) at the University Hospital Centre (UHC) in Brazzaville because the practice was usually limited to total salpingectomy by laparotomy. Patients...Objective: To evaluate the current management of ectopic pregnancies (EPG) at the University Hospital Centre (UHC) in Brazzaville because the practice was usually limited to total salpingectomy by laparotomy. Patients and methods: This was a descriptive study, with retrospective data collection, conducted from July 30, 2015 to January 30, 2016. It included patient records admitted to the Obstetrical Gynecology Department of the Brazzaville University Hospital for an EP, a diagnosis made before visualization on ultrasound of an active embryo outside the uterine cavity or per laparoscopy, but often by exploratory laparotomy. Sociodemographic and clinical data, as well as the therapeutic modalities of the patients, were analyzed. Cases of women operated for EP in other health facilities and referred to the UHC for complication management and cases that were unusable were excluded. Results: We noted 39 EPs out of 4490 deliveries, representing a frequency of 0.86%. The average age of the patients was 28.9 years (extreme 18 - 46 years). The transfusion of labile blood products concerned 84.6% of patients. There was no therapeutic abstention;medical treatment was performed in 3 patients (7.7% of cases). Diagnostic and therapeutic laparoscopy was performed in 9 patients (23.1%) and laparotomy was used in 26 patients (66.7% of cases) in which 35 Salpingectomies (89.7% of cases) were performed. The immediate postoperative period was marked by anaemia (32 cases or 82.1%), surgical site infection (1 case or 2.6%) and parietal suppuration (1 case or 2.6%). Conclusion: The dissemination of therapeutic advances in the management of EP is also possible in African settings.展开更多
The aim of this work was to study the connection between periodontal diseas of women during their pregnancy and the weight of newborn infants the women gave birth to. Method: It was a case-control study and carried ou...The aim of this work was to study the connection between periodontal diseas of women during their pregnancy and the weight of newborn infants the women gave birth to. Method: It was a case-control study and carried out on the outskirts of Dakar (Senegal). The sample consisted of 129 mothers with infants of weight < 2500 g (case) and 258 mothers with infants of weight ≥ 2500 g (control). The socio-demographic variables, patterns of life, history and outcome of pregnancy were collected. The variables relating to periodontal status included the plaque index, inflammation, bleeding, loss of clinical attachment and pocket depth. Data were analyzed by the R software. Logistic regression had identified associations on the threshold of 5%. Results: The proportions of mothers with periodontitis were 70.6% among cases versus 33% in controls. Periodontitis was significantly associated with low weight (OR = 4 [2.3 - 5.7] 4) adjusted on age, BMI and other periodontal indices. Conclusion: periodontal disease appears to be involved in the occurrence of low birth weight in the African context. The introduction of an oral component in prenatal consultations is therefore necessary for the health of mothers and their children.展开更多
Preeclampsia remains a major obstetrical problem, affecting 3-5% of pregnancies and can be up to 18% in some African countries. Epidemiological studies based on the immune theory showed the relationship between exposi...Preeclampsia remains a major obstetrical problem, affecting 3-5% of pregnancies and can be up to 18% in some African countries. Epidemiological studies based on the immune theory showed the relationship between exposition to sperm and preeclampsia. Repeated exposition to seminal liquid would therefore be a protection against preeclampsia, as observed in women having frequent unprotected sex, or having had a previous normal pregnancy with the same partner. Other publications showed an increased risk of preeclampsia in patients who received sperm during an intrauterine insemination (IUI) or during an in vitro fertilization (IVF). We report a case of reoccurrence of severe preeclampsia in a mixed afro-caucasian couple having had a child delivered normally at term in the past. The couple later went for a sperm donation as a result of a chemotherapeutic treatment for Hodgkin Lymphoma which the man suffered from. The fact that the sperm was gotten from the same donor did not stop the reoccurrence. The first pregnancy gotten from sperm donation ended up into a medical termination of pregnancy (MTP) at 23 weeks 2 days of amenorrhea, and the second pregnancy issued from the same donor ended into a cesarean delivery at 28 weeks of a child with intrauterine growth retardation (IUGR).展开更多
Objective: To examine the outcome of in vitro fertilization according to the body mass index of infertile patients. Study design: Between September 2003 and May 2005, 573 patients underwent 789 in vitro fertilization ...Objective: To examine the outcome of in vitro fertilization according to the body mass index of infertile patients. Study design: Between September 2003 and May 2005, 573 patients underwent 789 in vitro fertilization cycles or ICSI because of male factor, tubal factor, and unexplained infertility were retrospectively included from our IVF database. The patients were classified in four groups: BMI< 20 kg/m2(264 cycles), 20 ≤BMI< 25(394 cycles), 25 ≤BMI< 30(83 cycles), and BMI ≥30(48 cycles). All patients had a long protocol for IVF with a combination of the GnRH agonist and recombinant FSH. Results: All parameters of ovarian response were comparable except the total required r-FSH dose. This dose was statistically higher in the group of BMI ≥30 compared to the other groups (p=0.0003). All parameters of IVF outcome were comparable, including the cancellation rate, the implantation rate, and pregnancy rates. Conclusion: Obese patients require a higher r-FSH dose to achieve follicular maturation than normal weight patients. Obesity does not affect negatively results of in vitro fertilization.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 make it possible to popularize the practice throughout the country. This extension will contribute to the fight against cervical cancer.展开更多
Background: Genetically engineered animals are essential for gaining a proper understanding of the disease mechanisms of cystic fibrosis(CF). The rat is a relevant laboratory model for CF because of its zootechnical c...Background: Genetically engineered animals are essential for gaining a proper understanding of the disease mechanisms of cystic fibrosis(CF). The rat is a relevant laboratory model for CF because of its zootechnical capacity, size, and airway characteristics, including the presence of submucosal glands.Methods: We describe the generation of a CF rat model(F508 del) homozygous for the p.Phe508 del mutation in the transmembrane conductance regulator(Cftr) gene. This model was compared to new Cftr-/-rats(CFTR KO). Target organs in CF were examined by histological staining of tissue sections and tooth enamel was quantified by micro-computed tomography. The activity of CFTR was evaluated by nasal potential difference(NPD) and short-circuit current measurements. The effect of VX-809 and VX-770 was analyzed on nasal epithelial primary cell cultures from F508 del rats.Results: Both newborn F508 del and Knock out(KO) animals developed intestinal obstruction that could be partly compensated by special diet combined with an osmotic laxative. The two rat models exhibited CF phenotypic anomalies such as vas deferens agenesis and tooth enamel defects. Histology of the intestine, pancreas, liver, and lungs was normal. Absence of CFTR function in KO rats was confirmed ex vivo by short-circuit current measurements on colon mucosae and in vivo by NPD, whereas residual CFTR activity was observed in F508 del rats. Exposure of F508 del CFTR nasal primary cultures to a combination of VX-809 and VX-770 improved CFTR-mediated Cl-transport.Conclusions: The F508 del rats reproduce the phenotypes observed in CFTR KO animals and represent a novel resource to advance the development of CF therapeutics.展开更多
Objective:To evaluate clinical reliability compared to intrapartum ultrasound as a tool to diagnose occiput posterior position and to investigate the proportion of rotations occurring during labour. Patients and metho...Objective:To evaluate clinical reliability compared to intrapartum ultrasound as a tool to diagnose occiput posterior position and to investigate the proportion of rotations occurring during labour. Patients and methods:350 women in labor with a singleton fetus in a vertex position were prospectively studied using ultrasound and obstetrical examination. Outcome of labor was also monitored. Results:Reliability of clinical examination is 85,7%,initial occiput posterior position represented 40,2%and most rotated in an anterior position (84,8%) while only 0,6%of initial anterior positions delivered in occiput posterior position. Logistic regression did not allow to find significant predictor of occiput posterior position rotation. Discussion and conclusion:Clinical examination is relatively reliable for posterior position diagnosis and in most cases,initially occipitoposterior positions rotate anteriorly.展开更多
Objective: To evaluate complications that occurred during the post-partum period for patients with preeclampsia or HELLP syndrome. Study design: Retrospective analysis of 453 patients. The main outcome measures were m...Objective: To evaluate complications that occurred during the post-partum period for patients with preeclampsia or HELLP syndrome. Study design: Retrospective analysis of 453 patients. The main outcome measures were maternal complications during post-partum period: fever >38.5° C with proved infection, abdominal or perineal abscess, thrombo-embolic events, reoperation, need for blood transfusion, acute renal failure, eclampsia or disseminated intravascular coagulation. Statistic tests included univariate and multivariate analysis with stepwise descending logistic regression. Results: Patients were divided into 305 preeclampsia (67.3% ) and 20 HELLP syndrome (4.4% ), 128 (28.3% ) had both. Eighty-five patients (18.8% ) had at least one post-partum complication. The most frequent complication was infection: fever (41 patients, 9.1% ) and abscess (30 patients, 6.6% ). Twenty-six transfusions (5.7% ), 10 disseminated intravascular coagulation (2.2% ), seven thrombo-embolic events (1.5% ), seven reoperations (1.5% ) and one eclampsia (0.2% ) were observed. There was no acute renal failure, no pulmonary oedema and no maternal death. Stepwise logistic regression showed five independent risk factors associated with post-partum complications: ascites or pulmonary oedema (OR: 1.84, 95% CI: 1.01- 3.37), platelet count < 100 000/mm3 (OR: 1.96, 95% CI: 1.18- 3.26), serum acid uric > 360 μ mol/l (OR: 2.36, 95% CI: 1.22- 4.52), serum creatinine > 120 μ mol/l (OR: 2.99, 95% CI: 1.32- 6.78), and proteinuria > 5 g/l (OR: 1.80, 95% CI: 1.06- 3.05). Conclusion: We conclude that severity criteria for preeclampsia or HELLP syndrome combined with caesarean section increased the risk of complication during the post-partum period.展开更多
A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presente...A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for submucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.展开更多
The objective of this study was to analyze the indications of cesarean sections performed in a Level II clinic and to evaluate early maternal and neonatal outcome in the context of decentralization of obstetric and em...The objective of this study was to analyze the indications of cesarean sections performed in a Level II clinic and to evaluate early maternal and neonatal outcome in the context of decentralization of obstetric and emergency newborn care. Material and Method: This was a retrospective descriptive and analytical study conducted at the maternity CSNC over a period of 12 months from 1 July 2010 to 30 June 2011. It included all women in childbirth by caesarean section and excluded patients admitted for management of complications of cesarean section performed in another structure. Results: During the study period, 595 caesarean sections were performed on a total of 4410 births, a rate of 13.5%. The average age of patients was 27 years. The mean parity was 2. The patients came from them even 55%. They were admitted with a single uterine scar in 28.40% of cases and bi-scar in 25.4% of cases. A pathology was associated with pregnancy in 31.6% of cases. These pathologies were dominated by vascular and renal syndromes (75.5%), anemia (13.8%) and the obstacles previa (10.1%). Caesarean sections were performed in 517 patients in emergency. The technique of Misgav Ladach was the most common 75.1%. The average hospital stay was 4.2 days with extremes of 0 and 15 days. Postoperative maternal mortality was 0.34%. Operative follow-up was simple in 98.3% of patients. Two patients (0.34%) died after surgery. In 92.4% of the cases, the newborns were alive. The Apgar score in the first minute was favorable (greater than or equal to 7/10) in 503 newborns (95.1%) and unfavorable (less than 7/10) in 47 cases (8.55%). At the fifth minute, he was favorable in 98.5% of the cases. Overall stillbirth was 72.26‰ with a total of 43 stillbirths including 3 macerated stillbirths. Conclusion: Cesarean section is by far the most accomplished action in gynecology and obstetrics. Its ease of implementation and low cost, and of course his results in terms of reduction of maternal-fetal morbidity and mortality make a key intervention and allowed its extension.展开更多
The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the...The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the Department “C” of Obstetrics and Gynecology of the Maternity and Neonatology Centre of Tunis (WTSC). The average age in those patients was 55.14 ± 8.47 years with extremes of 40 and 82 years. The majority of the patients (72%) were under the age of 60 years. In sixty-one patients (89%), no urine leak has been detected and they were healed. In three patients (4%) there was improvement with partial recovery. Three other (4%) did not notice any improvement after the surgery. No case of dysuria or rejection of the strip has been reported. It was concluded that the declared satisfaction rate is 93%.展开更多
Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study...Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study of 75 pre-eclamptic women in three maternities in Kinshasa, Democratic Republic of Congo, during the January to December 2013. The values of the following biochemical markers: uricemia, proteinuria and creatinemia were correlated with maternal and fetal prognosis. Results: This study showed that hyper uricemia associated with massive proteinuria and a high creatinine level correlated with an unfavorable pregnancy outcome and the occurrence of major materno-fetal complications such as eclampsia (X-squared = 24.3598, ddl = 2, p-value = 0.000005) and low birth weight (p = 0.001, R2 = 0.08). Conclusion: In view of these results, it appears necessary to ensure these biochemical markers systematically in the monitoring of pre-eclampsia.展开更多
The occurrence of pregnancy is relatively rare in patients with portal hypertension, and has been reported as clinical cases. However, few studies have evaluated the effectiveness of injecting histoacryl during pregna...The occurrence of pregnancy is relatively rare in patients with portal hypertension, and has been reported as clinical cases. However, few studies have evaluated the effectiveness of injecting histoacryl during pregnancy. The choice of treatment for varicose bleeding during pregnancy has been described in the literature based on the elastic ligature. We report the second case, to our knowledge, of treatment of bleeding gastric varices by injection of histoacryl with good maternal and fetal development.展开更多
Introduction: References are frequent and most often carried out in emergency situations. The objective of this study was to describe the epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Me...Introduction: References are frequent and most often carried out in emergency situations. The objective of this study was to describe the epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Methodology: This was a retrospective cross-sectional descriptive study conducted from September 1, 2022, to February 28, 2023, at CHU-Kara, focusing on obstetric referrals to the Gynecology-Obstetrics department. Result: 828 patients were referred for obstetric reasons out of 1295 admissions, representing a frequency of 63.9%. The average age was 25.04 years. They were primigravida (38.3%), unemployed (62.7%). Motorcycles were the main means of transportation, accounting for 53.1% of cases. The average distance to reach the referral center was 31.6 km, covered in an average of 71 minutes. In 40.7% of cases, patients had less than 4 prenatal consultations and were referred in peripartum (56.6%) for pre-eclampsia (14%), post-term pregnancy (11.8%), dystocia (10.5%). Eighty-six point nine percent (86.9%) of the referred patients were able to deliver during their stay in the department, of which 61.7% had vaginal deliveries. The maternal and perinatal mortality rates were 0.7% and 14.9%, respectively. Conclusion: Obstetric referrals to Kara University Hospital are frequent during the perpartum period and are often carried out by motorbike.展开更多
The aim of our work is the study of nutrition diabetic women, and the study of the health status of their newborns in West of Algeria. Our study was performed on 165 diabetic mothers aged 20 to 45 years and 161 newbor...The aim of our work is the study of nutrition diabetic women, and the study of the health status of their newborns in West of Algeria. Our study was performed on 165 diabetic mothers aged 20 to 45 years and 161 newborns admitted to the hospital specialized in obstetrics and gynecology of Sidi Bel Abbes. A food survey and anthropometric study were achieved in our population, clinical and socioeconomic data were recorded in an identification card. Our results show that the average age of women with diabetes is 33.26 ± 5.15 ans. The socio-economic survey shows that 47.32% of women have an average monthly income;their education level is low with only 8.06% having a higher level. Anthropometric parameters show that 48.08% of elderly diabetic women aged 30 to 40 years are overweight BMI > 25. Dietary survey indicates that women experienced iron, calcium and vitamin B9 deficiency. The results of clinical data have shown the existence of gestational diabetes with a rate of 50.90%;macrosomia is dominant in their newborns with a rate of 22.26%. We noted the presence of hypoglycemia in 18.01% and inutero death in 12.42%.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 state of hemodynamic shock before the operation;lack of blood transfusion. The maternal death rate was 21.33%. Conclusion: Obstetric hysterectomy is a very mutilating and complicated surgical procedure and is still common practice in Africa. The maternal prognosis is still reserved with a very high mortality rate in Togo.展开更多
文摘Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating System (MARS) has been reported to reverse severe cholestasis-linked pruritus. Here, we report the first use of MARS during a spontaneous pregnancy and its successful outcome in a patient with PFIC3 and intractable pruritus. Albumin dialysis could be considered as a pregnancy-saving procedure in pregnant women with severe cholestasis and refractory pruritus.
文摘AIM:To develop and validate a transient micro-elastography device to measure liver stiffness(LS) in mice.METHODS:A novel transient micro-elastography(TME) device,dedicated to LS measurements in mice with a range of measurement from 1-170 kPa,was developed using an optimized vibration frequency of 300 Hz and a 2 mm piston.The novel probe was validated in a classical fibrosis model(CCl4) and in a transgenic murine model of systemic amyloidosis.RESULTS:TME could be successfully performed in control mice below the xiphoid cartilage,with a mean LS of 4.4 ± 1.3 kPa,a mean success rate of 88%,and an excellent intra-observer agreement(0.98).Treatment with CCl4 over seven weeks drastically increased LS as compared to controls(18.2 ± 3.7 kPa vs 3.6 ± 1.2 kPa).Moreover,fibrosis stage was highly correlated with LS(Spearman coefficient = 0.88,P < 0.01).In the amyloidosis model,much higher LS values were obtained,reaching maximum values of > 150 kPa.LS significantly correlated with the amyloidosis index(0.93,P < 0.0001) and the plasma concentration of mutant hapoA-□(0.62,P < 0.005).CONCLUSION:Here,we have established the first non-invasive approach to measure LS in mice,and have successfully validated it in two murine models of high LS.
文摘Objective: To analyze the management of urological complications of gynecologic and obstetric surgeries. Material and Methods: We retrospectively studied 39 patients hospitalized in the Department of Urology of the Conakry Teaching Hospital for urological complications of gynecological surgery, during 9 years. The epidemiological, diagnostic, surgical and outcome parameters have been analyzed. Results: The urological complications of gynecologic surgery represent 0.29% of admissions in the Department of Urology. The mean age was 31 years with extremes of 18 and 47 years. Etiological factors were dominated by caesarean section with 74.36% of cases. The main lesions observed were vesico-vaginal and uretero-vaginal fistulas respectively 43.6% and 41.2% of cases. The mean delay of diagnosis was 5 months (extreme: 7 days to 3 years). Urine leakage from the vagina was the main symptom. The surgical treatment consisted in 17 surgeries for vesico-vaginal fistulas, 16 surgeries for uretero-vesical reimplantation, 2 surgeries for termino terminal ureterorraphia, 2 surgeries for vesico-uterine fistulas and 1 surgery for hysterectomy. Healing was obtained in all ureteral injuries and we noted two cases of failure in vesico-vaginal fistula. Conclusion: urological complications of gynecologic surgery remain frequent. They are dominated by the vesico-vaginal and uretero-vaginal fistulas and the main etiology is caesarean section. The treatment is surgical in our context.
文摘Objective: This study was undertaken to report on the prevalence and management of late complications in twin-to-twin transfusion syndrome (TTTS) treated by laser therapy when both twins are alive 1 week after surgery. Study design: A total of 151 consecutive TTTS cases were treated by selective fetoscopic laser therapy. Cases in which both twins were alive 1 week after surgery were followed up with ultrasound and Doppler examination, including middle-cerebral artery peak systolic velocity measurement (MCA-PSV). Results: In the 151 cases treated with laser, both twins were still alive 7 days after the procedure in 101 cases. Intrauterine death of 1 and both twins occurred in 7 and 1 cases, respectively. Recurrence of TTTS with the polyhydramnios-oligohydramnios sequence occurred in 14 (14% ) cases. In another 13 (13% ) cases,amniotic fluid remained normal in both sacs, but MCA- PSV increased above 1.5 MoM in 1 twin and decreased concomitantly below 0.8 MoM in the co-twin. This was related to anemia and polycythemia, respectively, and resulted from unidirectional feto-fetal blood transfusion, mainly from former recipients into former donors. Late complications were managed accordingly by repeat laser, amnioreduction, cord coagulation, intrauterine blood transfusion, or elective delivery. Conclusion: MCA-PSV Doppler measurements are useful in the follow-up of double survivors to detect and manage late complications after selective laser therapy.
文摘Objective: To evaluate the current management of ectopic pregnancies (EPG) at the University Hospital Centre (UHC) in Brazzaville because the practice was usually limited to total salpingectomy by laparotomy. Patients and methods: This was a descriptive study, with retrospective data collection, conducted from July 30, 2015 to January 30, 2016. It included patient records admitted to the Obstetrical Gynecology Department of the Brazzaville University Hospital for an EP, a diagnosis made before visualization on ultrasound of an active embryo outside the uterine cavity or per laparoscopy, but often by exploratory laparotomy. Sociodemographic and clinical data, as well as the therapeutic modalities of the patients, were analyzed. Cases of women operated for EP in other health facilities and referred to the UHC for complication management and cases that were unusable were excluded. Results: We noted 39 EPs out of 4490 deliveries, representing a frequency of 0.86%. The average age of the patients was 28.9 years (extreme 18 - 46 years). The transfusion of labile blood products concerned 84.6% of patients. There was no therapeutic abstention;medical treatment was performed in 3 patients (7.7% of cases). Diagnostic and therapeutic laparoscopy was performed in 9 patients (23.1%) and laparotomy was used in 26 patients (66.7% of cases) in which 35 Salpingectomies (89.7% of cases) were performed. The immediate postoperative period was marked by anaemia (32 cases or 82.1%), surgical site infection (1 case or 2.6%) and parietal suppuration (1 case or 2.6%). Conclusion: The dissemination of therapeutic advances in the management of EP is also possible in African settings.
文摘The aim of this work was to study the connection between periodontal diseas of women during their pregnancy and the weight of newborn infants the women gave birth to. Method: It was a case-control study and carried out on the outskirts of Dakar (Senegal). The sample consisted of 129 mothers with infants of weight < 2500 g (case) and 258 mothers with infants of weight ≥ 2500 g (control). The socio-demographic variables, patterns of life, history and outcome of pregnancy were collected. The variables relating to periodontal status included the plaque index, inflammation, bleeding, loss of clinical attachment and pocket depth. Data were analyzed by the R software. Logistic regression had identified associations on the threshold of 5%. Results: The proportions of mothers with periodontitis were 70.6% among cases versus 33% in controls. Periodontitis was significantly associated with low weight (OR = 4 [2.3 - 5.7] 4) adjusted on age, BMI and other periodontal indices. Conclusion: periodontal disease appears to be involved in the occurrence of low birth weight in the African context. The introduction of an oral component in prenatal consultations is therefore necessary for the health of mothers and their children.
文摘Preeclampsia remains a major obstetrical problem, affecting 3-5% of pregnancies and can be up to 18% in some African countries. Epidemiological studies based on the immune theory showed the relationship between exposition to sperm and preeclampsia. Repeated exposition to seminal liquid would therefore be a protection against preeclampsia, as observed in women having frequent unprotected sex, or having had a previous normal pregnancy with the same partner. Other publications showed an increased risk of preeclampsia in patients who received sperm during an intrauterine insemination (IUI) or during an in vitro fertilization (IVF). We report a case of reoccurrence of severe preeclampsia in a mixed afro-caucasian couple having had a child delivered normally at term in the past. The couple later went for a sperm donation as a result of a chemotherapeutic treatment for Hodgkin Lymphoma which the man suffered from. The fact that the sperm was gotten from the same donor did not stop the reoccurrence. The first pregnancy gotten from sperm donation ended up into a medical termination of pregnancy (MTP) at 23 weeks 2 days of amenorrhea, and the second pregnancy issued from the same donor ended into a cesarean delivery at 28 weeks of a child with intrauterine growth retardation (IUGR).
文摘Objective: To examine the outcome of in vitro fertilization according to the body mass index of infertile patients. Study design: Between September 2003 and May 2005, 573 patients underwent 789 in vitro fertilization cycles or ICSI because of male factor, tubal factor, and unexplained infertility were retrospectively included from our IVF database. The patients were classified in four groups: BMI< 20 kg/m2(264 cycles), 20 ≤BMI< 25(394 cycles), 25 ≤BMI< 30(83 cycles), and BMI ≥30(48 cycles). All patients had a long protocol for IVF with a combination of the GnRH agonist and recombinant FSH. Results: All parameters of ovarian response were comparable except the total required r-FSH dose. This dose was statistically higher in the group of BMI ≥30 compared to the other groups (p=0.0003). All parameters of IVF outcome were comparable, including the cancellation rate, the implantation rate, and pregnancy rates. Conclusion: Obese patients require a higher r-FSH dose to achieve follicular maturation than normal weight patients. Obesity does not affect negatively results of in vitro fertilization.
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 make it possible to popularize the practice throughout the country. This extension will contribute to the fight against cervical cancer.
基金TEFOR,Grant/Award Number:RIIINSB-0014France Life Imaging,Grant/Award Number:ANR-11-INBS-0006+6 种基金Swiss Cystic Fibrosis Foundation CFCHFondation Maladies RaresInfrastructures Biologie-SantéIHU-CESTI,Grant/Award Number:ANR-10-IBHU-005IRSR Pays de la LoireVaincre la MucoviscidoseSwiss National Foundation,Grant/Award Number:310030_172909
文摘Background: Genetically engineered animals are essential for gaining a proper understanding of the disease mechanisms of cystic fibrosis(CF). The rat is a relevant laboratory model for CF because of its zootechnical capacity, size, and airway characteristics, including the presence of submucosal glands.Methods: We describe the generation of a CF rat model(F508 del) homozygous for the p.Phe508 del mutation in the transmembrane conductance regulator(Cftr) gene. This model was compared to new Cftr-/-rats(CFTR KO). Target organs in CF were examined by histological staining of tissue sections and tooth enamel was quantified by micro-computed tomography. The activity of CFTR was evaluated by nasal potential difference(NPD) and short-circuit current measurements. The effect of VX-809 and VX-770 was analyzed on nasal epithelial primary cell cultures from F508 del rats.Results: Both newborn F508 del and Knock out(KO) animals developed intestinal obstruction that could be partly compensated by special diet combined with an osmotic laxative. The two rat models exhibited CF phenotypic anomalies such as vas deferens agenesis and tooth enamel defects. Histology of the intestine, pancreas, liver, and lungs was normal. Absence of CFTR function in KO rats was confirmed ex vivo by short-circuit current measurements on colon mucosae and in vivo by NPD, whereas residual CFTR activity was observed in F508 del rats. Exposure of F508 del CFTR nasal primary cultures to a combination of VX-809 and VX-770 improved CFTR-mediated Cl-transport.Conclusions: The F508 del rats reproduce the phenotypes observed in CFTR KO animals and represent a novel resource to advance the development of CF therapeutics.
文摘Objective:To evaluate clinical reliability compared to intrapartum ultrasound as a tool to diagnose occiput posterior position and to investigate the proportion of rotations occurring during labour. Patients and methods:350 women in labor with a singleton fetus in a vertex position were prospectively studied using ultrasound and obstetrical examination. Outcome of labor was also monitored. Results:Reliability of clinical examination is 85,7%,initial occiput posterior position represented 40,2%and most rotated in an anterior position (84,8%) while only 0,6%of initial anterior positions delivered in occiput posterior position. Logistic regression did not allow to find significant predictor of occiput posterior position rotation. Discussion and conclusion:Clinical examination is relatively reliable for posterior position diagnosis and in most cases,initially occipitoposterior positions rotate anteriorly.
文摘Objective: To evaluate complications that occurred during the post-partum period for patients with preeclampsia or HELLP syndrome. Study design: Retrospective analysis of 453 patients. The main outcome measures were maternal complications during post-partum period: fever >38.5° C with proved infection, abdominal or perineal abscess, thrombo-embolic events, reoperation, need for blood transfusion, acute renal failure, eclampsia or disseminated intravascular coagulation. Statistic tests included univariate and multivariate analysis with stepwise descending logistic regression. Results: Patients were divided into 305 preeclampsia (67.3% ) and 20 HELLP syndrome (4.4% ), 128 (28.3% ) had both. Eighty-five patients (18.8% ) had at least one post-partum complication. The most frequent complication was infection: fever (41 patients, 9.1% ) and abscess (30 patients, 6.6% ). Twenty-six transfusions (5.7% ), 10 disseminated intravascular coagulation (2.2% ), seven thrombo-embolic events (1.5% ), seven reoperations (1.5% ) and one eclampsia (0.2% ) were observed. There was no acute renal failure, no pulmonary oedema and no maternal death. Stepwise logistic regression showed five independent risk factors associated with post-partum complications: ascites or pulmonary oedema (OR: 1.84, 95% CI: 1.01- 3.37), platelet count < 100 000/mm3 (OR: 1.96, 95% CI: 1.18- 3.26), serum acid uric > 360 μ mol/l (OR: 2.36, 95% CI: 1.22- 4.52), serum creatinine > 120 μ mol/l (OR: 2.99, 95% CI: 1.32- 6.78), and proteinuria > 5 g/l (OR: 1.80, 95% CI: 1.06- 3.05). Conclusion: We conclude that severity criteria for preeclampsia or HELLP syndrome combined with caesarean section increased the risk of complication during the post-partum period.
文摘A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for submucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.
文摘The objective of this study was to analyze the indications of cesarean sections performed in a Level II clinic and to evaluate early maternal and neonatal outcome in the context of decentralization of obstetric and emergency newborn care. Material and Method: This was a retrospective descriptive and analytical study conducted at the maternity CSNC over a period of 12 months from 1 July 2010 to 30 June 2011. It included all women in childbirth by caesarean section and excluded patients admitted for management of complications of cesarean section performed in another structure. Results: During the study period, 595 caesarean sections were performed on a total of 4410 births, a rate of 13.5%. The average age of patients was 27 years. The mean parity was 2. The patients came from them even 55%. They were admitted with a single uterine scar in 28.40% of cases and bi-scar in 25.4% of cases. A pathology was associated with pregnancy in 31.6% of cases. These pathologies were dominated by vascular and renal syndromes (75.5%), anemia (13.8%) and the obstacles previa (10.1%). Caesarean sections were performed in 517 patients in emergency. The technique of Misgav Ladach was the most common 75.1%. The average hospital stay was 4.2 days with extremes of 0 and 15 days. Postoperative maternal mortality was 0.34%. Operative follow-up was simple in 98.3% of patients. Two patients (0.34%) died after surgery. In 92.4% of the cases, the newborns were alive. The Apgar score in the first minute was favorable (greater than or equal to 7/10) in 503 newborns (95.1%) and unfavorable (less than 7/10) in 47 cases (8.55%). At the fifth minute, he was favorable in 98.5% of the cases. Overall stillbirth was 72.26‰ with a total of 43 stillbirths including 3 macerated stillbirths. Conclusion: Cesarean section is by far the most accomplished action in gynecology and obstetrics. Its ease of implementation and low cost, and of course his results in terms of reduction of maternal-fetal morbidity and mortality make a key intervention and allowed its extension.
文摘The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the Department “C” of Obstetrics and Gynecology of the Maternity and Neonatology Centre of Tunis (WTSC). The average age in those patients was 55.14 ± 8.47 years with extremes of 40 and 82 years. The majority of the patients (72%) were under the age of 60 years. In sixty-one patients (89%), no urine leak has been detected and they were healed. In three patients (4%) there was improvement with partial recovery. Three other (4%) did not notice any improvement after the surgery. No case of dysuria or rejection of the strip has been reported. It was concluded that the declared satisfaction rate is 93%.
文摘Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study of 75 pre-eclamptic women in three maternities in Kinshasa, Democratic Republic of Congo, during the January to December 2013. The values of the following biochemical markers: uricemia, proteinuria and creatinemia were correlated with maternal and fetal prognosis. Results: This study showed that hyper uricemia associated with massive proteinuria and a high creatinine level correlated with an unfavorable pregnancy outcome and the occurrence of major materno-fetal complications such as eclampsia (X-squared = 24.3598, ddl = 2, p-value = 0.000005) and low birth weight (p = 0.001, R2 = 0.08). Conclusion: In view of these results, it appears necessary to ensure these biochemical markers systematically in the monitoring of pre-eclampsia.
文摘The occurrence of pregnancy is relatively rare in patients with portal hypertension, and has been reported as clinical cases. However, few studies have evaluated the effectiveness of injecting histoacryl during pregnancy. The choice of treatment for varicose bleeding during pregnancy has been described in the literature based on the elastic ligature. We report the second case, to our knowledge, of treatment of bleeding gastric varices by injection of histoacryl with good maternal and fetal development.
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The aim of our work is the study of nutrition diabetic women, and the study of the health status of their newborns in West of Algeria. Our study was performed on 165 diabetic mothers aged 20 to 45 years and 161 newborns admitted to the hospital specialized in obstetrics and gynecology of Sidi Bel Abbes. A food survey and anthropometric study were achieved in our population, clinical and socioeconomic data were recorded in an identification card. Our results show that the average age of women with diabetes is 33.26 ± 5.15 ans. The socio-economic survey shows that 47.32% of women have an average monthly income;their education level is low with only 8.06% having a higher level. Anthropometric parameters show that 48.08% of elderly diabetic women aged 30 to 40 years are overweight BMI > 25. Dietary survey indicates that women experienced iron, calcium and vitamin B9 deficiency. The results of clinical data have shown the existence of gestational diabetes with a rate of 50.90%;macrosomia is dominant in their newborns with a rate of 22.26%. We noted the presence of hypoglycemia in 18.01% and inutero death in 12.42%.
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 state of hemodynamic shock before the operation;lack of blood transfusion. The maternal death rate was 21.33%. Conclusion: Obstetric hysterectomy is a very mutilating and complicated surgical procedure and is still common practice in Africa. The maternal prognosis is still reserved with a very high mortality rate in Togo.
