Problem of obstetrical evacuations of patients coming from maternities outside the coverage zone of the university and hospital center of Treichville (Abidjan-Côte d’Ivoire)

Background: In developing countries, the organization of obstetrical evacuations is experiencing real problems causing certain preventable maternal and fetal morbidity and mortality. Objective of present study was to describe the sociodemographic characteristics and conditions of transfer of patients from peripheral maternities not dependent on the health coverage zone of the University and Hospital Center of Treichville (called maternity out of zone).Methods: This is a prospective and descriptive study, conducted at the maternity of the University and Hospital Center of Treichville, from 1st August 2012 to 31st July 2014 about 266 patients evacuated from maternity out of zone.Results: Only 30% of the patients had properly documented evacuation records. Patients had an average age of 26.9 years, poor follow-up of their pregnancy (92.1%), and were generally low socio-economic level: without monthly income (61.7%), not attending school (35.3%). The majority of evacuations were decided by midwives (60.9%) and were done by taxi (69.5%). In 71.4% of the cases, the patients were re-evacuated to our department with the main reason for the unavailability of the operating rooms (84.3%). 46.6% of the patients took more than 3 hours to arrive in our department and 35% arrived in an aggravated condition and sometimes without venous routes. In our department, complications occurred in 27.1% of the patients, and maternal and fetal death rates were respectively 1.5% and 21.3%.Conclusions: This study revealed malfunctions encountered during evacuations: unsafe transportation, transfer card misinformed, long transfer time

Illegals abortions and utero-digestives lesions: retrospective study of 12 cases in the Department of Gynecology and Obstetrics at the Treichville teaching hospital (Abidjan, Cote D’ivoire)

Background: Traumatic intestinal digestive damage after abortion by endo-uterine manoeuvres are not uncommon. The purpose of this study is to describe the diagnostic, therapeutic and prognostic aspects of these lesions.Methods: This is a retrospective study of 3 years on patients with a uterine lesion associated with a digestive traumatic injury during illegal abortions endo-uterine manoeuvres.Results: 12 patients with a median age of 23, 9 are included. The clinical manifestations are not specific: impairment of the general condition 33.3%; hyperthermia 83.3% (or 10 cases); digestive disorders such as diarrhoea 25%, vomiting 33.3%; abdominal pain 100%; occlusive syndrome 16.7%; acute abdominal syndrome 75%. The seat of traumatic injuries is variable. The lesions were for hail alone in 4 cases (33.3%), colon alone for 2 cases (16.7%), rectum 1 case and epiploon 2 cases. In these 3 cases, the lesions were associated, sitting on both the hail and the colon at a time. All these lesions were associated with uterine perforation of variable siege. The therapeutic management consisted of a small bowel resection with ileostomy in 5 cases or 41.7%; colon resection with colostomy 3 cases or 25%; suture lesions after beveling beiges 5 cases either 41, 7 in 2 cases, we performed haemostasis on the bleeding epiploon. Treatment of the uterine lesion was conservative 75% of the time. The evolution on the 10 patients was favorable, 83.3%. Two patients died early in the operative course after septic shock.Conclusions: The digestive lesions are a factor aggravating the prognosis of post-abortion uterine manoeuvres. Their management must be rapid and requires close collaboration between the digestive surgeon and the Gynecologist

Review of mastectomy in the department of gynecology at the Treichville teaching hospital, Abidjan-Cote d’Ivoire

Background: Mastectomy plays a key role in the management of breast cancer in our regions of sub-Saharan Africa. Because the advanced forms represent the essential stages of the diagnosis and some therapeutic means remain unavailable. Objective of this study was to report the experience of the practice of mastectomy in the treatment of breast cancer in our service.Methods: This is a retrospective and prospective, descriptive study conducted from January 1, 2013 to May 31, 2017 (age 05) at the University Hospital of Treichville involving 56 breast cancer patients who had undergone a mastectomy.Results: The frequency of the mastectomy was 28.5% and the average age of our patients was 48 years old. The majority of patients had an average socio-economic level (66%). 85.6% of our cancers discovered at advanced stages (T3 and T4). Adenocarcinoma accounted for 96% and infiltrating ductal carcinoma 82% of adenocarcinoma.Patey mastectomy associated with axillary dissection was performed in 96.4% and simple mastectomy in 3.5%. The results of axillary dissection reported lymph node invasion in 38 patients; With an average number of lymph nodes taken from 6.1 and an average number of ganglia affected is 3. Neoadjuvant chemotherapy was administered in 96.4% and adjuvant chemotherapy in 91%. Radiotherapy was performed in 34%. Complications were dominated by lymphoceles in 34% of cases. The 5-year survival of patients operating in the service is 37.8%.Conclusions: Mastectomy is at the forefront of breast cancer surgery in our service. She is supervised by chemotherapy. Radiotherapy remains inaccessible for most patients. Early detection would lead to conservative treatment and a reduction in the postoperative complication rate

Problem of obstetrical evacuations of patients coming from maternities outside the coverage zone of the university and hospital center of Treichville (Abidjan-Côte d’Ivoire)

Background: In developing countries, the organization of obstetrical evacuations is experiencing real problems causing certain preventable maternal and fetal morbidity and mortality. Objective of present study was to describe the sociodemographic characteristics and conditions of transfer of patients from peripheral maternities not dependent on the health coverage zone of the University and Hospital Center of Treichville (called maternity out of zone).Methods: This is a prospective and descriptive study, conducted at the maternity of the University and Hospital Center of Treichville, from 1st August 2012 to 31st July 2014 about 266 patients evacuated from maternity out of zone.Results: Only 30% of the patients had properly documented evacuation records. Patients had an average age of 26.9 years, poor follow-up of their pregnancy (92.1%), and were generally low socio-economic level: without monthly income (61.7%), not attending school (35.3%). The majority of evacuations were decided by midwives (60.9%) and were done by taxi (69.5%). In 71.4% of the cases, the patients were re-evacuated to our department with the main reason for the unavailability of the operating rooms (84.3%). 46.6% of the patients took more than 3 hours to arrive in our department and 35% arrived in an aggravated condition and sometimes without venous routes. In our department, complications occurred in 27.1% of the patients, and maternal and fetal death rates were respectively 1.5% and 21.3%.Conclusions: This study revealed malfunctions encountered during evacuations: unsafe transportation, transfer card misinformed, long transfer time

Illegals abortions and utero-digestives lesions: retrospective study of 12 cases in the Department of Gynecology and Obstetrics at the Treichville teaching hospital (Abidjan, Cote D’ivoire)

Background: Traumatic intestinal digestive damage after abortion by endo-uterine manoeuvres are not uncommon. The purpose of this study is to describe the diagnostic, therapeutic and prognostic aspects of these lesions.Methods: This is a retrospective study of 3 years on patients with a uterine lesion associated with a digestive traumatic injury during illegal abortions endo-uterine manoeuvres.Results: 12 patients with a median age of 23, 9 are included. The clinical manifestations are not specific: impairment of the general condition 33.3%; hyperthermia 83.3% (or 10 cases); digestive disorders such as diarrhoea 25%, vomiting 33.3%; abdominal pain 100%; occlusive syndrome 16.7%; acute abdominal syndrome 75%. The seat of traumatic injuries is variable. The lesions were for hail alone in 4 cases (33.3%), colon alone for 2 cases (16.7%), rectum 1 case and epiploon 2 cases. In these 3 cases, the lesions were associated, sitting on both the hail and the colon at a time. All these lesions were associated with uterine perforation of variable siege. The therapeutic management consisted of a small bowel resection with ileostomy in 5 cases or 41.7%; colon resection with colostomy 3 cases or 25%; suture lesions after beveling beiges 5 cases either 41, 7 in 2 cases, we performed haemostasis on the bleeding epiploon. Treatment of the uterine lesion was conservative 75% of the time. The evolution on the 10 patients was favorable, 83.3%. Two patients died early in the operative course after septic shock.Conclusions: The digestive lesions are a factor aggravating the prognosis of post-abortion uterine manoeuvres. Their management must be rapid and requires close collaboration between the digestive surgeon and the Gynecologist

Review of mastectomy in the department of gynecology at the Treichville teaching hospital, Abidjan-Cote d’Ivoire

Background: Mastectomy plays a key role in the management of breast cancer in our regions of sub-Saharan Africa. Because the advanced forms represent the essential stages of the diagnosis and some therapeutic means remain unavailable. Objective of this study was to report the experience of the practice of mastectomy in the treatment of breast cancer in our service.Methods: This is a retrospective and prospective, descriptive study conducted from January 1, 2013 to May 31, 2017 (age 05) at the University Hospital of Treichville involving 56 breast cancer patients who had undergone a mastectomy.Results: The frequency of the mastectomy was 28.5% and the average age of our patients was 48 years old. The majority of patients had an average socio-economic level (66%). 85.6% of our cancers discovered at advanced stages (T3 and T4). Adenocarcinoma accounted for 96% and infiltrating ductal carcinoma 82% of adenocarcinoma.Patey mastectomy associated with axillary dissection was performed in 96.4% and simple mastectomy in 3.5%. The results of axillary dissection reported lymph node invasion in 38 patients; With an average number of lymph nodes taken from 6.1 and an average number of ganglia affected is 3. Neoadjuvant chemotherapy was administered in 96.4% and adjuvant chemotherapy in 91%. Radiotherapy was performed in 34%. Complications were dominated by lymphoceles in 34% of cases. The 5-year survival of patients operating in the service is 37.8%.Conclusions: Mastectomy is at the forefront of breast cancer surgery in our service. She is supervised by chemotherapy. Radiotherapy remains inaccessible for most patients. Early detection would lead to conservative treatment and a reduction in the postoperative complication rate