X-ray pelvimetry: prognosis of delivery by cephalous-pelvic confrontation in Cotonou

Background: The mechanical dystocia constitutes one of the causes of maternal death during labour. Reducing the incidence of complications of dystocia means recognize the factors induce dystocia. That justifies X-ray pelvimetry and cephalic fetal ultrasonography to predict the outcome of labour. This survey aims at establishing the prognosis of labour by a cephalous-pelvic confrontation.Methods: This study was realised at CUGO and HOMEL, reference maternity hospitals in Cotonou from 28th March to 4th August 2006. That was a prospective study. During prenatal visit, pregnant women who had pelvis abnormality were recruited after their consent after counselling about exploration of their pelvis and fetal cephalic diameters. Pregnant women in their ninth month underwent to X-ray pelvimetry and fetal biometric ultrasonography.Results: During that study, 122 pregnant women in their ninth month were recruited. Favourable prognosis (36.89%): natural delivery 31.15%; (concordance rate is 84.44%). Uncertain prognosis (18.85%): caesarean section (10.66%), natural delivery (7.37%). Unfavourable prognosis (44.26%): 40.16% deliveries by caesarean section. Concordance rate is 90.74%.Conclusions: The cephalous-pelvic confrontation is a reliable prognosis method. It is recommendable in our maternity hospitals to prevent complications of dystocia, a cause of maternal death

Global evidence of gender equity in academic health research: a scoping review

Objectives: To chart the global literature on gender equity in academic health research. Design: Scoping review. Participants: Quantitative studies were eligible if they examined gender equity within academic institutions including health researchers. Primary and secondary outcome measures: Outcomes related to equity across gender and other social identities in academia: (1) faculty workforce: representation of all genders in university/faculty departments, academic rank or position and salary; (2) service: teaching obligations and administrative/non-teaching activities; (3) recruitment and hiring data: number of applicants by gender, interviews and new hires for various rank; (4) promotion: opportunities for promotion and time to progress through academic ranks; (5) academic leadership: type of leadership positions, opportunities for leadership promotion or training, opportunities to supervise/mentor and support for leadership bids; (6) scholarly output or productivity: number/type of publications and presentations, position of authorship, number/value of grants or awards and intellectual property ownership; (7) contextual factors of universities; (8) infrastructure; (9) knowledge and technology translation activities; (10) availability of maternity/paternity/parental/family leave; (11) collaboration activities/opportunities for collaboration; (12) qualitative considerations: perceptions around promotion, finances and support. Results: Literature search yielded 94 798 citations; 4753 full-text articles were screened, and 562 studies were included. Most studies originated from North America (462/562, 82.2%). Few studies (27/562, 4.8%) reported race and fewer reported sex/gender (which were used interchangeably in most studies) other than male/female (11/562, 2.0%). Only one study provided data on religion. No other PROGRESS-PLUS variables were reported. A total of 2996 outcomes were reported, with most studies examining academic output (371/562, 66.0%). Conclusions: Reviewed literature suggest a lack in analytic approaches that consider genders beyond the binary categories of man and woman, additional social identities (race, religion, social capital and disability) and an intersectionality lens examining the interconnection of multiple social identities in understanding discrimination and disadvantage. All of these are necessary to tailor strategies that promote gender equity. Trial registration number: Open Science Framework: https://osf.io/8wk7e/

Issue reproductive des femmes apres traitement chirurgical de la grossesse extra-uterine à Cotonou, Benin.

La grossesse extra-utérine, est une pathologie obstétricale qui porte une atteinte profonde à l\'intégrité de l\'appareil reproducteur de la femme. Cette étude vise à apprécier l\'issue reproductive après traitement chirurgical et identifier les facteurs de risque de infertilité secondaire. Cette étude, descriptive et rétrospective, a été réalisée à la Clinique Universitaire de Gynécologie- Obstétrique de Cotonou. 758 cas de grossesses extra-utérines ont été recensés du 1er Janvier 1996 au 31 Décembre 2005. Les femmes recrutées sont toutes des patientes qui avaient bénéficié d\'un traitement chirurgical de la grossesse extra-utérine. Celles qui ont été suivies pour désir de maternité étaient de 140. La fréquence de la grossesse extra-utérine était de 2,89%. Les patientes âgées de 20 à 34 ans, représentaient 76,6% des cas. Les principales localisations de la GEU étaient tubaires 97,4%. La principale intervention chirurgicale relevée était la salpingectomie dans 93% des cas. L\'issue reproductive était marquée par 40% de grossesse intra-utérine, 5% de récidive de grossesse extra-utérine et 55% d\'infertilité. Le délai de survenue de la grossesse avait été de 12 à 18 mois chez 41,3% des femmes et de 19 à 25 mois pour 22,2%. Les facteurs de risques de d\'infertilité après traitement étaient : l\'âge de 24 à 30 ans (p=0,0000004), l\'antécédent de grossesse extrautérine (p=0,0049602), l\'infection génitale (p=0,0000064), l\'annexe controlatérale inflammatoire (p=0,0473848), les adhérences (p=0,00712129) Les décès maternels enregistrés étaient au nombre de 3, soit 0,4%. Il importe d\'améliorer sa prise en charge par une technologie chirurgicale moins mutilante. Par ailleurs l\'issue reproductive dépend des facteurs de risque qu\'il faut aussi prévenir ou traiter lors du suivi gynécologique et obstétrical.Ectopic pregnancy is an obstetrical pathology that seriously affects the woman\'s reproductive system. The objective of this study was to appraise the reproductive outcome after surgical treatment and identify the risk factors of secondary infertility. This descriptive and retrospective study was carried out in the Gynaecology and Obstetrics clinic of the University of Cotonou in Benin. Seven hundred and fifty eight cases of ectopic pregnancies were enrolled from 1st January 1996 to 31st December 2005. The women recruited in the study were all patients who had benefited from surgical treatment for ectopic pregnancy. One hundred and forty were followed up for secondary infertility. The frequency of ectopic pregnancies was 2.89%. Patients within the 20 to 34 years age group accounted for 76.6% of the cases. The main localization was tubal in 97.4% of the patients. Salpingectomy was the main surgical intervention in 93% of the patients. The reproductive outcome showed 40% of intra-uterine pregnancies, 5% recurrence of ectopic pregnancies and 55% secondary infertility. Pregnancy occurred within 12 to 18 months in 41.3% of the women, and 19 to 25 months in 22.2%. The risk factors of secondary infertility after treatment were: age of 24 to 30 years (p=0.0000004), a past history of ectopic pregnancy (p=0.0049602), genital infection (p=0.0000064), inflamed controlateral adnexae (p=0.0473848), adhesions (p=0.00712129). Three (0.4%) maternal death cases were noted. We thus concluded that there is need to improve ectopic pregnancy management with less mutilating surgical techniques. In addition, since the reproductive outcome depends on some risk factors, these also have to be prevented and treated during gynaecological and obstetrical consultations. Keywords: kEctopic pregnancy - Surgical treatment - Reproductive outcome.Clinics in Mother and Child Health Vol. 4 (2) 2007 pp. 741-74