Post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine rupture at the gynecology and obstetrics service of the Ignace Deen National Hospital in Guinea

Background: The aim of the work was to study post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine failure, to describe the main causes and to analyze the risk factors.Methods: It was a descriptive, comparative and analytical study lasting 2 years with data collection in 2 phases, one of which was a retrospective study lasting one year from July 2018 to June 2019 and the other a prospective study also lasting one year, from July 2019 to June 2020. It concerned all pregnant women who had been caesarized or had had a laparotomy for uterine rupture with complications and those who had not developed any complications. The parameters studied were types of complications, risk factors and maternal mortality. The Chi-square test was used to compare the two populations with a significance level p=0.05.Results: During the study period, 6141 hospitalizations were recorded among which 5682 surgical procedures were performed, i.e. 92.52% of hospitalizations. Caesarean delivery accounted for 90.55% of surgical procedures and laparotomy for uterine rupture for 1.10%. The overall maternal post-operative morbidity rate was 7.60%. Post-operative anemia was by far the most common complication (75.76%) followed by infection (23.46%). The maternal death rate was 0.92% with a ratio of 409.97 maternal deaths per 100,000 live births and more than 2/3 of these deaths were due to caesarean delivery. Anemia and septic shock were the main causes of death. Factors related to this post-operative maternal morbidity were: age greater than or equal to 40 years, multi-parity, illiteracy, emergency obstetric evacuation, low socio-economic level, poor quality of prenatal follow-up and rupture of membranes before admission.Conclusion: In the emergency context concerning majority of our cesarean deliveries and the totality of uterine ruptures predispose the mother to high significant morbidity and mortality

Obstetric emergencies in the maternity ward of the Ignace Deen national hospital CHU of Conakry: sociodemographic, therapeutic and maternal fetal prognosis aspects

Background: Despite government efforts to reduce maternal mortality, the risk of a woman dying from obstetric complications is about one in six in the poorest regions of the world compared to one in thirty thousand in North Europe. The objective was therefore to describe the clinical socio-demographic aspects and to establish the maternal and fetal prognosis of obstetric emergencies.Methods: This was a descriptive cross-sectional prospective study over a 6-month period from January 1 to June 30, 2020 carried out at the maternity ward of the Ignace Deen national hospital (Conakry university hospital) in Guinea. The study looked at a continuous series of 662 obstetric emergency cases.Results: The frequency of admission of obstetric emergencies was 22.62%. They concerned young women (29.5 years old) on average, first-time mothers (53.32%), with low income professional activities, evacuated from a peripheral maternity unit (63.14%), no schooling (44.9%), married (92.3%), using the more often a means of public transport (66.5%) and whose pregnancies were poorly monitored (63.9%). Fetal emergencies were dominated by acute fetal distress (91.3%) and maternal emergencies were dominated by hypertensive emergencies (pre-eclampsia and eclampsia 37.44%) followed by hemorrhagic emergencies (last trimester hemorrhage and postpartum hemorrhage 34.34%). Pregnant and parturient women were more frequently admitted to labor (62.7%) and gave birth more frequently by caesarean section (86.70%). the staff reacted promptly to make a treatment decision in 75.5% of cases within fifteen minutes. emergency procedures were performed in less than fifteen minutes in almost all cases (97.4%), specific treatment was carried out in less than an hour in the majority of cases (68.3%). The maternal case fatality rate was 4.1% with the main cause of death being hemorrhagic shock of 51.8%. The stillbirth rate was 17.4%.Conclusions: The anticipation of emergency obstetric care (SOU) and close collaboration between the obstetrician, the anesthesiologist-resuscitator are essential in the management of obstetric emergencies

Obstetrical complications among adolescent girls at the maternity ward of Ignace Deen National Hospital

Background: The objective of this study was to highlight obstetrical complications that occurred among adolescent girls who delivered at the ward and to identify factors associated with the occurrence of such complications.Methods: This was a prospective study of descriptive and analytical type extending over a period of one year from September 1, 2016 to August 31, 2017 carried out at the maternity ward of Ignace Deen National Hospital at Conakry Teaching Hospital (CHU). It covered a continuous series of 1034 deliveries among adolescent girls.Results: The frequency of childbirth among adolescent girls was 16.7%. The main complications identified were dystocia, severe preeclampsia, eclampsia, retroplacental hematoma, placenta previa, uterine rupture, severe anemia, postpartum hemorrhage and puerperal endometritis. These complications occurred among adolescent girls aged 18 to 19, christian, skin and pelvic bones secondary school or university students. Factors associated with such complications were the marital status (p=0.010), the gestational age (p=0.012), the number of prenatal consultations (p=0.001), the place of prenatal consultation (p=0.001), the reason for admission (p=0.000) and the mode of admission (p=0.000).Conclusions: Childbirth among adolescent girls is frequent in this context; complications are numerous but they are preventable in the vast majority of cases

Fetal death in utero: epidemiological aspects, management and maternal prognosis in the obstetrics and gynecology department of the community medical centre of Ratoma

Background: Fetal death in utero (FDIU) often represents a tragedy badly lived, sometimes incomprehensible. It is considered as a failure of pregnancy's progress and monitoring. It is a frequent problem in obstetrical practice. Objective of study was to contribute to the study of FDIU in the maternity ward of the Ratoma municipal medical center.Methods: This was a prospective study of analytical type conducted over a period of 6 months from 1 January to 30 June 2017.Results: During this study period, we recorded 54 cases of FDIU out of a total of 1256 deliveries, or a frequency of 4.3%. The average age of our patients was 28.5 years with extremes of 16 to 39 years, the most represented age group was 25 to 34 years, with a frequency of 44.4%. The absence of active fetal movement was the main reason for consultation, with a frequency of 51.9%, and housewives were the most affected, with a frequency of 61.1%. The 70.4% of our patients gave birth by vaginal delivery and oxytocin was the most commonly used drug for induction of labor, i.e., 77.8%. The immediate maternal prognosis was 100% favorable and no case of maternal death was recordedConclusions: In-utero fetal death is a frequent obstetrical pathology, the awareness of women for the realization of ANC as well as the early management of risk factors detected during ANC constitutes an element of great importance. Therefore, a regular follow-up of all pregnant women even in the absence of risk factors proves necessary

Implementation of active management of the third period of childbirth for the prevention of immediate post-partum bleeding in four regional maternity hospitals of Conakry, Guinea

Background: The objective of this study was to determine the frequency, skills level of health care service providers; to identify complications and difficulties related to the implementation of AMTPC/GATPA.Methods: It was about prospective study, descriptive of 6 months (1st March to 31st August 2014) carried out in the maternity hospitals of Faranah, Kindia, Mamou and Nzérékoré. It concerned the parturient women who had recently given birth and the personnel that carried out AMTPC/GATPA in these hospitals.Results: During the study period of 1,254 out of 1,305 births had benefited of AMTPC/GATPA, a frequency of 96.1%. The midwives were the most represented personnel in the implementation of GATPA (44.1%). In 46.4% of the cases, the health care service providers acquired this competence from the initial training. The release was obtained in the first trial in 64.9% cases. The duration of implementation of GATPA was less than 5 minutes in 72.6% cases. The different stages were respected in 91.5% cases. Complications were dominated by retention of placental fragments (10.2%). Lack of oxytocin was the main difficulty (36.6%).Conclusions: The sustainability of this achievement would depend on the systematic and correct implementation of AMTPC/GATPA at all childbirth attendants and the effective management of oxytocin

Evaluation of structure and natural regeneration status of woody plant species in sudanian domain : Case of eastern part of National Park of Sena Oura, Chad

Many scientific studies confirmed that plants have an important ecological role maintaining the productivity of the environment and regulating the global climate. In order to valorize the wild phytogenetic resources for the efficient in situconservation and sustainable use in Sudano-zambezian region, a study was carried out in Sudanian domainprovidingquantitative informations on the community structure and natural regeneration status of woody plant species.The study site is the eastern part of National Park of Sena Oura in Chad. Adults plants (trees and shrubs) were systématically collected in 10 linear transects (20 m x 1000 m). Juvenile plants (saplings and seedlings) weresystematically collected within 40 plots (20 m × 20 m). These plots were randomly stablished in the transects, at a rate of four plots per transect.In total, 84 adults plants species grouped in 58 genera and 29 families and 66 juvenile plants species grouped in 45 genera and 27 families were inventoried. Bell andreverse J-shaped patterns of selected woody species were identified.The stand regeneration status wasgood.The stand regeneration rate were SRR = 52.29% and Hymenocardia acida (SIR = 17.95%), Combretum collinum (SIR = 14.12%), Annona Senegalensis (SIR = 6.67%) and Isoberlinia doka (SIR = 6.22%) had the most important specific index of regeneration. The specific structures showed that the structure of the total stand is the result of the dynamics of all species and their interactions.The global stand regeneration status was good.The obtained results provided quantitative informations on the community structure and natural regeneration status of woody plant species for the efficient conservation and sustainable use

Prophylactic and emergency cesareans: a comparative study on 718 observations at the maternity ward of Ignace Deen National hospital

Background: The objective of the study is to compare the frequency, the socio-demographic characteristics, the indications, the fetal maternal prognosis and the Robson classification of prophylactic and emergency caesarean sections.Methods: This was a comparative study of prophylactic and emergency caesarean sections at the maternity of Ignace Deen national hospital. It was a 12 month (July 1, 2016 to June 30, 2017) descriptive and analytical study.Results: Prophylactic caesarean sections accounted for 12, 51% of caesarean sections and 3.96% of deliveries at the ward. Prophylactic caesarean sections involved pregnant women aged from 20 to 29, holder of higher education degrees (51.54%), married (92.76%) employed (56.83%) and whose prenatal visit was provided by the obstetrician (73.54%). While the emergency caesarean section concerned parturient aged between 20 and 34, mostly non-schooled (36.49%), transferred patients (80.22%) and nulliparous (58.5%). Surgical indications were mainly scarred uterus (32.32%) and maternal pathologies (18.11%) prophylaxis; bleeding in the last quarter (25.90%) acute fetal distress (20.33%) in emergency. Groups 6 and 5 of the Robson classification were the most represented with a 2.23% morbidity and a zero maternal lethality in prophylaxis versus groups 5 and 6 with a 10.03% morbidity and a 1.67% maternal lethality in emergency.Conclusions: Improving this prognosis would be achieved through an increase in the frequency of prophylactic caesarean sections

Study of the physicochemical quality of water in the Sebi-Ponty basin at Diamniadio (Senegal)

The Sebi-Ponty dam has a basin that is widely used by the population for agro-pastoral activities (animal watering, agriculture, etc.). This basin covers an average area of 106,000 m2 and an average depth of 7 m or about a volume of 435,000 m3. The origin of the water is rainfall (runoff and direct descent). The availability of water is estimated to eight months taking into account the water being drawn, infiltration and evaporation. A qualitative knowledge of the contents of this pool will be a great benefit to those activities of the population. Itrsquos in this context that this study was carried out by this group of researchers, following physic-chemical compositions were targeted: turbidity, color, temperature, conductivity, pH, hardness alkalinity, nitrite, iron, phosphate, boron, and chlorine concentrations. The physico-chemical results obtained on samples taken in the basin between October and December showed that the concentrations of boron, iron and nitrite exceeded the levels recommended by the standard for agro pastoral needs. While turbidity, color, temperature, conductivity, pH, hardness, alkalinity, phosphate and chlorine are at acceptable levels