Effect of premature rupture of membranes on the maternal and fetal prognosis during childbirth at the gynecology-obstetrics department of the Matam Communal Medical Center, Conakry, Guinea

Background: Premature rupture of membranes (RPM) is defined by rupture of the amnion and chorion before entering labor within 24 hours leading to vaginal discharge of amniotic fluid without uterine contractions. Objective of this study was to improving the management of premature Ruptures of the membranes received in the service.Methods: This was a descriptive and analytical prospective study lasting six months from January 1 to June 30 2016.Results: During the study period, we collected 108 cases of RPM out of 1543 deliveries, representing a hospital frequency of 7%. RPM had more frequently concerned pregnant women aged 25-29 (37.04%), housewife (37.03%), primiparous (45.37%) and referral (52.78%). 95.37% were single pregnancies with cephalic presentation (80%) received between 37-42 weeks (84.26%). Management mainly consisted of antibiotic prophylaxis (100%), fetal pulmonary maturation and childbirth. The vagina was the main mode of delivery (62.04%). The maternal prognosis was dominated by chorioamnionitis (12.96%). The fetal one was made up of respiratory distress (40.71%) and prematurity (12.39%).Conclusions: RPM is frequent at the Matam municipal medical center. It is essential for its prevention to ensure health education of the population in general and genital hygiene in particular, to make a coherent prenatal follow-up while putting a particular accent on the detection and the treatment of genital infections

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

Management of pre-eclampsia and its complications in the department of gynecology and obstetrics at Donka national hospital Conakry, Guinea

Background: Vascular-renal syndrome, also known as pre-eclampsia, is a condition specific to pregnancy, usually occurring in the last trimester of pregnancy. Pregnant women are sometimes at risk of unpredictable obstetrical complications such as: hemorrhage, kidney failure, HELLP syndrome, sometimes even brain damage requiring prompt care and multidisciplinary collaboration. Vascular-renal syndromes are the third leading cause of maternal death and also the world's leading cause of perinatal death. Objectives of this study were to analyse the management of vascular-renal syndromes. Calculate their frequency, describe the sociodemographic characteristics of patients, describe the clinical and biological signs of patients, evaluate the maternal-fetal prognosis.Methods: The study was conducted in the department of obstetrics and gynecology of Donka National Hospital. It was a prospective, descriptive, cross-sectional, 6-month study from March 1st to August 31st, 2015, of pregnant women with pre-eclampsia.Results: The study included 217 cases of pre-eclampsia out of a total of 3054 patients, i.e. a proportion of 7.10%. The proportion of pre-eclampsia was high in patients aged between 15 and 19 years, housewife, married, primary. The predisposing factors were primigestitis, obesity and twinkling. The clinic was dominated by headaches and visual disturbances. Severe preeclampsia in 78.49%, eclampsia in 21.65% or simple hypertension in 1.75%. Maternal and fetal complications were dominated by eclampsia 26.26%, PPH (2.63%), eclamptic coma (0.46%), acute fetal distress 27.19%, and fetal death in utero (11.40%). In order to improve maternal and fetal prognosis it is necessary to provide multidisciplinary care, which unfortunately is not always available in our context.Conclusions: Obstetric emergency is a frequent situation for which a better management would improve the maternal-fetal prognosis