Médical interruption of pregnancy in the 2nd and 3rd trimester of pregnancy: about 42 cases collged ať the Tunis Maternity and Neonatology Center “Service A”

Background: Study IMGs in the 2nd or 3rd trimester of pregnancy in department “A” of the CMNT.Methods: Descriptive and analytical cross-sectional study in the “A” obstetrics gynecology department of the CMNT from January to June 2012. The variables studied related to sociodemographic characteristics, diagnosis, management and prognosis. Undiagnosed fetal abnormalities in the 1st trimester, serious maternal pathologies are the inclusion criteria. IMGs for embryofetopathies and MFIUs were not included in the study.Results: The average age was 32 years with an average term of 27 weeks of amenorrhea and 01 day. The indication was 97.6% fetal. Fetal malformations were divided into 54.8% neurological abnormalities, 4.8% renal abnormalities, 4.8% digestive abnormalities, 4.8% bone abnormalities, 2.4% pulmonary abnormalities and 2.4% cardiac abnormalities. The foeto-pathological examination was carried out 64.3% confirming the antenatal diagnosis with an ultrasound sensitivity of 67.6% in the 2nd trimester and 83.3% in the 3rd trimester. The overall expulsion time was 30.6 hours (28 SA), an overall success rate at 24 hours of 97.6% with one uterine rupture, 3 uterine retentions and hemorrhage. No cases of maternal death or infection were observed.Conclusions: The delay in the diagnosis of fetal pathologies makes it difficult to decide on abortion for practitioners and parents. Antenatal ultrasound and fetal karyotype represented the means that made it possible to pose or suspect the diagnosis of fetal abnormality

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