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

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