Satisfaction of patients received in emergencies in the department of obstetrics and gynecology at the Yalgado Ouedraogo teaching hospital: comparative study before and after the introduction of free care

Background: The quality of care perceived by the users of health care services is an important indicator of the quality of care. The aim of this study was to assess the satisfaction of patients received in obstetric and gynecological emergencies department of Yalgado Ouedraogo Teaching Hospital before and after the introduction of free care.Methods: This was a cross-sectional investigation. Data collection was carried out from February to July 2016, covering the last three months before the start of free care and the first three months of implementation of this free policy in Burkina Faso.Results: A total of 620 patients formed the sample. The reception (p=0.0001), the waiting period (p=0.0001), respect for treatment schedules (p=0.0001), respect for intimacy (p=0.0001), communication between providers and patients (p=0.007), the comfort of the delivery room (p=0.003) and the comfort of the ward room (p=0.002) were more favorably appreciated by patients before the free treatment than during that period. Overall patient satisfaction was better before the effectiveness of free care (p=0.003).Conclusions: The realization of free care process was followed by a lower patient’s satisfaction reflecting an alteration in the quality of health care services. A situational analysis of this free health care process is necessary in order to make corrective measures. Also adequate preventive measures should be adopted before any implementation to a larger scale of this free policy

Audit of the first caesarean section in a reference hospital in the African environment

Background The practice of a first caesarean section can condition the future obstetric prognosis. The aim of this work was to study the indications of the first caesarean sections at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou. Methods: This was a cross-sectional study with prospective collection. The data were collected from 1 March to 30 May 2018. The women who benefited from caesarean section for the first time were the study population. The review of the documents, the interview with the patients and the expert opinion were the techniques used. The expert opinion made it possible to determine whether or not the caesarean section was preventable. Results: The first caesarean sections accounted for 62.5% (280/448) of all caesarean sections and 34.6% (280/810) of all childbirths in the period. Caesarean section was urgently performed in 95% of cases. It was mostly an obstetrical indication. Probable fetal asphyxia was the first major indication (27.5%) followed by preeclampsia/eclampsia (15.7%) and uterine pre-rupture syndrome (8.9%). Caesarean section was found to be avoidable in 53 cases (18.9%). Probable fetal asphyxia was the most common indication (22.4%) of these preventable caesarean sections. Conclusions: The good management of preeclampsia, the strengthening of the birth room in fetal and maternal monitoring equipment, the close coaching of physicians in specialization and the periodic audits of practices would reduce the preventable caesarean sections

Knowledge and practice of emergency contraception among female students of public university of Ouagadougou, Burkina Faso, West Africa

Background: Female students are exposed to unsafe sex, sources of unwanted pregnancy and abortions. It is recognized that emergency contraception can effectively prevent pregnancy. The purpose of this study was to evaluate the knowledge and practices of Ouagadougou public university students in relation to emergency contraception in order to propose solutions to reduce the proportion of unwanted pregnancies among female students.Methods: This was a cross-sectional study conducted between May 1st and October 31st, 2016 in the public universities of Ouagadougou. A questionnaire was administered to a sample of 732 students randomly selected.Results: The average age of female students was 22.7 years old. The age group 19 to 24 was the most represented (68.03%). Of the students surveyed, 87% knew or had heard of emergency contraception. The students only used the emergency contraceptive pill. The emergency contraceptive use rate was 44.42%. Approximately, 83% of users were aware of the delay in using emergency contraception. The reasons for using emergency contraception were condom breakage (25.10%) and unprotected sex (74.9%). Female students purchased the contraceptive directly in pharmacies (93.61%).Conclusions: Emergency contraception gives women a last chance to avoid an unwanted pregnancy after unprotected sex.  Awareness and free availability of emergency contraception (EC) could improve the reproductive health of female students

Maternal mortality by direct obstetric causes in an urban referral hospital: case of Boulmiougou District Hospital in Ouagadougou, Burkina Faso

Background: Complications during pregnancy and childbirth are the leading causes of death and disability for women of childbearing age. Objective of this study was to study maternal mortality of direct obstetric origin at the Boulmiougou district hospital from 2010 to 2014.Methods: This was a retrospective cross-sectional descriptive and analytical study of maternal deaths by direct obstetric cause at the maternity ward of Boulmiougou District Hospital during the period from January 1st 2010 to December 31st, 2014, i.e. 5 years.Results: The maternal mortality rate by direct obstetric cause of 147.68 maternal deaths per 100,000 live births. The average age of the patients was 27.09 years old. The direct causes of maternal death were hemorrhage (47.06%), hypertensive disorders (20.59%), infections (14.71%) and unsafe abortion (11.76%). Contributing factors to maternal deaths were delay in evacuation (47.06%) and delay in care (38.23%).Conclusions: Maternal mortality remains high in the Boulmiougou District Hospital. To effectively combat maternal mortality, it is important to focus on the continuous training of staff and the strengthening of the technical platform

Bilateral Tubal Pregnancy without Known Risk Factor

Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy

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