Factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso

IntroductionIntrapartum stillbirth is an indicator of health and community development.ObjectiveTo identify the risk factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso.Patients and methodsA case-control study conducted from January 1 to August 30, 2019. Cases were defined as patients admitted to Yalgado Ouedraogo teaching hospital (YOTH) with a live fetus of at least 28 weeks’ gestation and who gave birth to an intrapartum stillborn, a fetus delivered without any signs of life in the first minute postpartum. Controls were defined as patients who delivered a live newborn. Study controls were gradually recruited and matched to cases. For each case, two controls were recruited and matched according to criteria such as delivery route and day of delivery. Data were cleaned in Epidata and exported to Stata for analysis. Variables with a p < 0.05 significance level in the multivariable regression were retained. Odds ratio (OR) and 95% confidence intervals are reported.ResultsEighty-three intrapartum stillbirths were documented among a total of 4,122 deliveries, a stillbirth rate of 20.1 per 1,000 births. There was a statistically significant association between intrapartum stillbirth and prior caesarean section (p = 0.045), multiparity (p = 0.03), the receipt of antenatal care (ANC) by a nurse (p = 0.005) and the disuse of the partogram (p = 0.004). We did not find a significant association between the number of ANC consultations performed (p = 0.3), whether membranes were ruptured at admission (p = 0.6), the duration of labor (p = 0.6) and intrapartum fetal death. Multivariate analysis showed that patient referral to another heath facility (OR: 3.33; 95% IC: 1.56, 7.10), no obstetric ultrasound performed (OR: 3.16; 95% IC: 2.11, 4.73), birth weight less than 2,500 g (OR: 7.49; 95% IC: 6.40, 8.76) were significantly associated with intrapartum stillbirth.ConclusionSpecific interventions must be taken to identify these risk factors of intrapartum stillbirth in order to ensure better and appropriate management

Low birth weight in newborns: epidemiological aspects and neonatal prognosis within Bogodogo teaching hospital, Burkina Faso

Background: Low birthweight is one of the main causes of neonatal death, after asphyxia and infections. This study purpose is to determine the epidemiological aspects and prognosis of this condition. Methods: This was a descriptive and analytical cross-sectional study. Data were collected prospectively from July 1st to September 30th, 2021 within Bogodogo Teaching Hospital. The study population included the overall newborns and their mothers. Results: The low birthweight frequency was estimated at 17.26% of live births. The average age was 26.06±5.8 years. Housewives accounted for 68.6% of cases against 78.9% for mothers in union. Unschooled mothers accounted for 38.3%. Mothers having medium socio-economic status accounted for 83.1% of cases. The average number of gesture was 2.60±1.62 and average parity was 2.72±1.76. Premature newborns accounted for 51.1% of cases. Females represented 55.6% of cases, giving a sex ratio of 0.80. The average weight was 1970.64±375.21 g with extremes of 900g and 2450g. The neonatal mortality rate was estimated at 9.4%. Occupation (p=0.003), marital status (p=0.001), place of residence (p=0.011), socioeconomic level (p=0.000), body mass index (p=0.001) and multiple pregnancy (p= 0.01) were statically associated with low birthweight at term. Conclusions: At the end of this study, it appears that further action is still needed to reduce low birthweight frequency, which implies improving the socio-economic conditions of the population.

Severe pre-eclampsia in the gynecology and obstetrics department of the CHR of Koudougou: epidemiological, clinical, therapeutic and prognostic aspects

Background: To study the epidemiological, clinical, therapeutic and prognostic aspects of severe pre-eclampsia in the gynecology and obstetrics department of the CHR of Koudougou.Methods: descriptive cross-sectional study with prospective collection from January 1 to December 31, 2018. The variables studied focused on clinical socio-demographic characteristics, treatment and prognosis. The women admitted to the department and meeting the criteria for severe pre-eclampsia were included, more than 20 weeks of amenorrhea with an increase in blood pressure, presence of albumin in the urine and signs of clinical or biological seriousness.Results: Severe pre-eclampsia represented 2.3% of admissions and 3% of deliveries. The clinical profile was that of a young housewife (51.2%), married (72.4%), nulliparous (44.1%) with a pregnancy in the 3rd trimester. Symptoms were dominated by headache (53.5%) and diastolic blood pressure ≥110 mmHg (66.9%), with albuminuria greater than two crosses and hyperuricemia. Magnesium sulfate and clonidine were the most commonly prescribed anticonvulsant and antihypertensive drug, respectively. Cesarean section was performed in 53% of cases.Maternal complications were noted in 57.5% of cases without death. However, the fetus took a heavy toll with 50.7% morbidity and 14% perinatal mortality.Conclusions: Severe pre-eclampsia is responsible for heavy morbidity - perinatal mortality. Improving maternal and fetal prognosis will require compliance with treatment protocols and greater accessibility of care at all levels of the health pyramid.

Caesarean section at Koudougou regional hospital centre: indications and prognosis

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean

Diagnostic et traitement des lesions precancereuses et cancereuses du col uterin: Connaissances et attitudes des prestataires de soins dans les maternites du district sanitaire de Boromo, Burkina Faso

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Oral misoprostol as first-line care for incomplete abortion in Burkina Faso

AbstractObjectiveTo explore 400-μg sublingual misoprostol as primary treatment in lower-level facilities with no previous experience providing postabortion care.MethodsWomen presenting with incomplete abortion were offered a single dose of 400-μg sublingual misoprostol. Incomplete abortion was defined as uterine size consistent with fewer than 12weeks of gestation, open cervical os, and reports of past or present history of vaginal bleeding. Women returned to the clinic 1week after misoprostol administration for follow-up. At that time, they were discharged if the uterine evacuation was a success or were offered a second follow-up visit or surgical completion if still incomplete.ResultsOne-hundred women received misoprostol; outcome data were unavailable for 1 woman. Complete uterine evacuation was achieved for 97 (98.0%) women. Satisfaction was high, with nearly all women indicating that they were “satisfied” (n=57 [57.6%]) or “very satisfied” (n=41 [41.4%]) with their experience. Adverse effects were considered “tolerable” by 72 of 97 (74.2%) women. Ninety-seven of 99 (98.0%) participants indicated that they would choose misoprostol for incomplete abortion care in the future and 95 of 97 (97.9%) stated that they would recommend it to a friend.ConclusionMisoprostol is a viable option for treatment of incomplete abortion at mid-level facilities.Clinical trials.gov: NCT00466999

Cancers épithéliaux primitifs de l’ovaire : aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs à Ouagadougou

Objectif : décrire les aspects épidémiologiques, diagnostiques, thérapeutiques, et évolutifs du cancer épithélial de l’ovaire à Ouagadougou.Patientes et méthodes : Il s’est agi d’une étude longitudinale et descriptive, menée entre le 1er Janvier 2012 et le 30 Septembre 2017 et portant sur 57 cas de cancers épithéliaux de l’ovaire. La survie globale a été calculée selon la méthode de Kaplan Meier. La comparaison des survies a été possible par la méthode du Log Rank.Résultats : Le cancer de l’ovaire a représenté 3,1% des cancers féminins. L’âge moyen était de 49,6 ± 16,8 ans. Le délai moyen de consultation était de 10,4 ± 8,6 mois. La distension abdominale et les douleurs abdominales étaient les principaux motifs de consultation dans respectivement 75,9 et 43,1% des cas. La taille moyenne des masses était de 9,8± 3,2 cm. Les adénocarcinomes séreux représentaient 67,8%. Les patiente s étaient d’emblée métastatiques à l’imagerie dans 55,1 %. Le traitement a été la chimiothérapie seule (8,8%) et la chimiothérapie associée à la chirurgie (40,3%). Il s’agissait d’une chirurgie régionale de l’ovaire dans 13,6% des cas et d’une réduction tumorale dans 86,4%. La médiane de survie était de 6 mois. La survie globale à 5 ans était de 47,8%.Conclusion : Le cancer épithélial survient à un âge relativement jeune. Le diagnostic est tardif. Le taux de survie est faible. L’optimisation diagnostique permettrait d’améliorer le pronostic. Mots-clés : Cancers-ovaire-diagnostic-traitement-survie. English Title: Primary ovarian cancers: epidemiological, diagnostic, therapeutic and evolutionary aspects in Ouagadougou Objective: Describe the epidemiological, diagnostic, therapeutic and evolutionary features of epithelial ovarian cancer in OuagadougouPatients and methods: Thisis a longitudinal and descriptive study over 57 cases of epithelial ovarian cancers. The study coversthe period from 1stJanuary, 2012 to 30th September, 2017. Overallsurvival was calculated using the Kaplan Meier method. Survivals were compared thanks to the Log Rank method.Results: Ovarian cancer represented 3.1% of female cancers. The patients’ average age was 49.6 ± 16.8 years. The average deadline for consultation was 10.4 ± 8.6 months. Abdominal distention and abdominal pain were the main reasons for consultation in respectively 75.9% and 43.1% of cases. The average size of the masses was 9.8 ± 3.2 cm. Serous adenocarcinomas represented 67.8% of cases. Imaging revealed that the patients were already metastatic in 55.1 % of cases. The treatment was: chemotherapy alone in 8.8% of cases and chemotherapy associated with surgery in 40.3% of cases. Regional surgery on the ovary (in 13.6% of cases) and a tumour reduction (in 86.4% of cases) were performed. Median survival was 6 months. Overall survival at 5 years was 47.8%.Conclusion: Epithelial cancer occurs at a quite young age. Diagnosis is late. Survival is low. Optimization of diagnosis could help improve prognosis. Keywords: cancers- ovary-diagnosis-treatment -survival

Les suppurations pariétales post-cesariennes au Centre Hospitalier Universitaire Yalgado Ouedraogo, Burkina-Faso: aspects epidemiologiques, cliniques, thérapeutiques et pronostiques

Les infections des sites opératoires sont fréquemment rencontrées dans les pays en développement. La césarienne étant l'une des interventions chirurgicales la plus pratiquée chez les femmes dans le monde, nous avons initié cette étude sur les aspects épidémiologiques, cliniques, thérapeutiques et pronostiques des suppurations pariétales post-césariennes dans le département de gynécologie-obstétrique du CHU Yalgado Ouédraogo en vue de réduire leur survenue. Il s'est agi d'une étude transversale à visée descriptive menée du 1er avril 2015 au 30 septembre 2015 soit une période de 6 mois. Soixante-dix cas de suppurations pariétales ont été notés sur 1998 cas de césariennes soit une incidence de 3,5%. L'âge moyen des patientes était de 26,2 ans ± 6,1. Les patientes étaient majoritairement des femmes au foyer (77%). La césarienne a été réalisée en urgence chez toutes les patientes. La suppuration a été diagnostiquée surtout à la 1ère semaine (60%). Le germe identifié était le staphylocoque aureus dans 37,8% des cas. Une reprise chirurgicale de la paroi abdominale a été nécessaire dans 34,3% des cas. L'évolution a été favorable chez toutes les patientes. La suppuration pariétale post césarienne reste fréquente. La prise en charge nécessite parfois une reprise chirurgicale. Une meilleure identification des facteurs favorisant cette affection par d'étude plus poussée pourrait permettre de réduire de façon significative leur incidence et par conséquent améliorer le pronostic maternel

Maternal Mortality at the Dori Regional Hospital in Northern Burkina Faso, 2014-2016

Background: Maternal mortality is of considerable magnitude. It is particularly relevant to developing countries, including those in Sub-Saharan Africa. The aim of this work was to study the cases of maternal deaths in the Dori Regional Hospital, Burkina Faso in the Sahel region, by analyzing the epidemiological aspects of these deaths in order to guide decision-making. Methods: This was a descriptive cross-sectional study which spanned the period from January 1, 2014 to December 31, 2016. Cases of maternal death and live births that occurred in the hospital during this period were collected by documentary review. Results: A total of 141 maternal deaths and 2,626 live births were recorded with a maternal mortality ratio of 5,369 for 100,000 live births. In 99 (72.20%) cases, death occurred in the postpartum. A home delivery had been reported in 33.70% of cases. Direct obstetric causes were found in 72.10% of cases. They were mainly represented by infections (32.40%) and hemorrhages (23%). Anemia was the indirect cause of death in 25 women (17.80%). The delay in health care access and the lack of blood products contributed to maternal deaths in 64.50% and 26.20% of cases. Conclusion and Global Health Implications: An intensification of awareness-raising messages about the importance of the rapid use of health care is necessary. Also, systematic audits of maternal deaths in the care environment and in the community would make it possible to clarify the determinants of maternal mortality in the Sahel region and to provide adequate solutions. Key words: Maternal Death • Maternal Mortality • Women’s Health • Burkin Faso • Dori Hospital • Sahel Regio