Immediate postpartum insertion of intrauterine devices: experience of maternity ward of the university and teaching hospital of Treichville, Abidjan

Background: In Côte d’Ivoire, where the rate of undesired pregnancies is high, we were the first Maternity centre, to benefit from training on immediate postpartum insertion of intrauterine devices (IUD).  The objective of this study is to share our experience and present the results of this practice in our hospital.Methods: It was a prospective and descriptive cohort study from the 11th of November 2013 to the 30th of April 2016 including the patients who delivered at the maternity of CHU Treichville (University Hospital Centre, Abidjan, Côte d’Ivoire), and had immediate postpartum IUD insertion, with a control 6 weeks later and then 3 months later.Results: 790 IUD have been, inserted to women with average age and gravidity of respectively 31.3 years old (13-52 years) and 4.4 (1-12 pregnancies). Most of our patients had a low socioeconomic status (poor education: 51.1%; not married: 59.9%). The counseling occurred during the latent phase of the labour for 57.2% of the women and the major parts of the IUD (59, 1%) were insert during a caesarean section. We noticed a poor rate of default patients (14 lost after 3 months), no complications but 9% of side effects (spontaneous expulsion, missing string). During the follow up period, four patients decided to remove the device. One of them for pelvic pain and three for a non-motivated request of the patients.Conclusions: Our experience shows that on immediate postpartum insertion of IUD is possible in our environment

Diagnosis and management of benign ovarian tumors at the Ignace Deen Maternity Hospital of Conakry University Hospital in Guinea

Background: Benign ovarian tumors are a common reason for consultation and intervention in gynecology. The objective of this was to describe the clinical, ultrasonographic, histological and therapeutic aspects of benign ovarian tumors in the department.Methods: This is a retrospective and descriptive study of three years and six months from January 1, 2016, to June 30, 2019, which focused on the records of women-operated during this period of benign ovarian tumors.Results: The incidence of benign ovarian tumors was 12.58%. The circumstances of discovery were dominated by disorders of the menstrual cycle (35.05%) followed by infertility (20.78%), the sensation of a pelvic mass (19.48%), and pelvic pain. (15.58%). The ultrasound report was in favor of a serous cyst in 74% of cases, a mucoid cyst in 14% of cases, a dermoid cyst in 9% and an endometriotic cyst in 3%. Histology revealed a serous cystadenoma in 70.13% of the cases, a mucinous cystadenoma in 16.88% of the cases, a mature poly tissue teratoma in 9.09% of the cases and an endometrial cyst in 3.90 % of the cases. Cystectomy was the most performed surgical procedure (71%).Conclusions: Benign ovarian tumors are common in our practice. The most common histological forms were serous and mucinous cystadenomas. Conservative treatment has been practiced in the majority of cases

Results of the multicentric management of infertility couples in Abidjan (Cote d’Ivoire)

Background: The management of infertile couples has seen many advances characterized today by the different techniques of medically assisted procreation (MAP) that are increasingly practiced in the developed countries. The objective of present study is to describe our experience of multicentric management of infertile couples in our ivorian context.Methods: This is a retrospective and cohort study with descriptive purpose over 210 couples treated for infertility in the gynecology services of the University and Hospital Center of Treichville and a private clinic in Abidjan, from 1st February 2013 to 31st January 2017 (48 months).Results: The frequency of infertility was 14%, and the average age was 34.3 years for women and 43.2 years for men. The etiologies were found in 199 couples (94.8%), particularly in 136 women and 113 men. The main causes were uterine (58.1%), and hormonal (26.5%) in women and of infectious origin in men (79.7%). The majority of the patients (113 women and 97 men) received an etiologic treatment, dominated by myomectomia in women (67 patients) and targeted antiobitherapy in men (84.5%). Moreover 113 couples (53.8%) received a medically assisted procreation. After the management 110 couples (52.4%) got pregnant.Conclusions: The multicenter management has enabled infertile couples to have access to modern methods in their care

Outcome of surgical management of genital prolapse in the obstetric gynecology department of the Ignace Deen Hospital in Conakry, Guinea

Background: Each year several patients are operated on for genital prolapse in our department, but no study has yet been done to analyse the results. The objective of this study was to highlight the operating techniques used and to analyse the anatomical and functional outcomes.Methods: It was an observational, longitudinal, prospective and descriptive study which took place over a period of 2 years in the department of obstetrics and gynecology of the Ignace Deen hospital de Conakry in Guinea. This study focused on patients operated on in the department for genital prolapse.Results: During the study period, 67 patients underwent genital prolapse surgery in the department. The operating techniques used are the triple perineal operation or, associated with colposuspension and/or Richter or Mc Call, Richardson's operation, Rouhier's operation and promonto-fixation. This study recorded in the follow up a case of recurrence of hysterocele one year after a Richardson operation, a correction of all digestive and sexual functional disorders and a correction of 81.25% of functional urinary disorders. The intraoperative complications were a rectal wound, two bladder wounds and three cases of hemorrhage requiring blood transfusion. The post-operative results were good in 98.5% of the cases.Conclusions: The lower approach is the main route used for surgical treatment of prolapse. The anatomical and functional results obtained are encouraging

Aspects Epidémiologiques, Cliniques et Prise en Charge Chirurgicale des Fibromyomes Utérins au Service de Gynécologie-Obstétrique de l’Hôpital National Ignace Deen-CHU de Conakry 2022

Introduction: L’objectif était d’étudier les aspects épidémiologiques, cliniques et prise en charge chirurgicale des fibromyomes utérins au service de gynécologie-obstétrique de l’hôpital national Ignace Deen du CHU de Conakry en 2022. Méthodologie : Il s’agissait d’une étude descriptive transversale, allant du 1er Mai au 30 octobre 2022 soit une période de six (6) mois. Ont été étudié les variables épidémiologiques, cliniques et prise en charge, les données ont été collectées à l’aide de la fiche d’enquête préétablie et prétestée, le logiciel SPSS version 21 a été utilisé pour l’analyse des données. Résultats : les interventions chirurgicales pour fibromyome utérin ont occupé 48,90% des activités chirurgicales pour pathologie gynécologique. L’âge moyen de nos patientes était de 38,38 ±9 ans avec les extrêmes 22 et 70 ans, les nullipares étaient les plus représentées (48,70%), il s’agissait des femmes non scolarisées (42,10%), en foyer (73,30%), exerçant une profession libérale (40,80%), cliniquement, l’indice de masse corporelle (IMC) de nos malades se situait entre 18,5-24,99 soit 52,6%, la ménorragie était le motif de consultation le plus fréquent (28,53%),  le volume utérin simulant une grossesse de 12- 20 SA (72,40%) était plus représenté, la classification de FIGO  à l’échographie a été utilisée (9,20%), utérus polymyomateux était l’indication opératoire la  plus rependue (65,79%), le traitement était conservateur (myomectomie) dans 64,50% des cas, toutes nos pièces opératoires ont été examinées avec une confirmation de léiomyome utérin. La complication post opératoire immédiate la plus fréquemment rencontrée était l’anémie (5,26%). Nous avons utilisé le logiciel SPSS version 21 pour l’analyse des données. Conclusion : le traitement conservateur pour la prise en charge du fibromyome utérin constitue une option salutaire pour les femmes en âge de procréer.   Introduction: The aim was to study the epidemiological, clinical aspects and surgical management of uterine fibromyomas in the gynecology-obstetrics department of the Ignace Deen National Hospital of Conakry University Hospital in 2022. Methodology : This was a descriptive cross-sectional study, running from May 1 to October 30, 2022, a period of six (6) months. Epidemiological, clinical and management variables were studied. Data were collected using a pre-established and pre-tested survey form, and SPSS version 21 software was used for data analysis. Results : Uterine fibromyoma surgery accounted for 55.64% of surgical activity for gynaecological pathology. The mean age of our patients was 38.38 ±9 years, with extremes of 22 and 70 years; nulliparous women were the most common (48.70%), with no schooling (42.10%), living at home (73.30%) and self-employed (40.80%); clinically, the body mass index (BMI) of our patients ranged from 18.5-24.99 (52.6%); menorrhagia was the most frequent reason for consultation (28, 53%), uterine volume simulating a pregnancy of 12-20 SA (72.40%) was the most common, FIGO ultrasound classification was used (9.20%), polymyomatous uterus was the most common operative indication (65.79%), treatment was conservative (myomectomy) in 64.50% of cases, all our surgical specimens were examined with confirmation of uterine leiomyoma. The most frequent immediate postoperative complication was anemia (5.26%).  Conclusion : conservative treatment for uterine fibromyoma is a beneficial option for women of childbearing age

Aspects Epidémiologiques, Cliniques et Prise en Charge Chirurgicale des Fibromyomes Utérins au Service de Gynécologie-Obstétrique de l’Hôpital National Ignace Deen-CHU de Conakry 2022

Introduction: L’objectif était d’étudier les aspects épidémiologiques, cliniques et prise en charge chirurgicale des fibromyomes utérins au service de gynécologie-obstétrique de l’hôpital national Ignace Deen du CHU de Conakry en 2022. Méthodologie : Il s’agissait d’une étude descriptive transversale, allant du 1er Mai au 30 octobre 2022 soit une période de six (6) mois. Ont été étudié les variables épidémiologiques, cliniques et prise en charge, les données ont été collectées à l’aide de la fiche d’enquête préétablie et prétestée, le logiciel SPSS version 21 a été utilisé pour l’analyse des données. Résultats : les interventions chirurgicales pour fibromyome utérin ont occupé 48,90% des activités chirurgicales pour pathologie gynécologique. L’âge moyen de nos patientes était de 38,38 ±9 ans avec les extrêmes 22 et 70 ans, les nullipares étaient les plus représentées (48,70%), il s’agissait des femmes non scolarisées (42,10%), en foyer (73,30%), exerçant une profession libérale (40,80%), cliniquement, l’indice de masse corporelle (IMC) de nos malades se situait entre 18,5-24,99 soit 52,6%, la ménorragie était le motif de consultation le plus fréquent (28,53%),  le volume utérin simulant une grossesse de 12- 20 SA (72,40%) était plus représenté, la classification de FIGO  à l’échographie a été utilisée (9,20%), utérus polymyomateux était l’indication opératoire la  plus rependue (65,79%), le traitement était conservateur (myomectomie) dans 64,50% des cas, toutes nos pièces opératoires ont été examinées avec une confirmation de léiomyome utérin. La complication post opératoire immédiate la plus fréquemment rencontrée était l’anémie (5,26%). Nous avons utilisé le logiciel SPSS version 21 pour l’analyse des données. Conclusion : le traitement conservateur pour la prise en charge du fibromyome utérin constitue une option salutaire pour les femmes en âge de procréer.   Introduction: The aim was to study the epidemiological, clinical aspects and surgical management of uterine fibromyomas in the gynecology-obstetrics department of the Ignace Deen National Hospital of Conakry University Hospital in 2022. Methodology : This was a descriptive cross-sectional study, running from May 1 to October 30, 2022, a period of six (6) months. Epidemiological, clinical and management variables were studied. Data were collected using a pre-established and pre-tested survey form, and SPSS version 21 software was used for data analysis. Results : Uterine fibromyoma surgery accounted for 55.64% of surgical activity for gynaecological pathology. The mean age of our patients was 38.38 ±9 years, with extremes of 22 and 70 years; nulliparous women were the most common (48.70%), with no schooling (42.10%), living at home (73.30%) and self-employed (40.80%); clinically, the body mass index (BMI) of our patients ranged from 18.5-24.99 (52.6%); menorrhagia was the most frequent reason for consultation (28, 53%), uterine volume simulating a pregnancy of 12-20 SA (72.40%) was the most common, FIGO ultrasound classification was used (9.20%), polymyomatous uterus was the most common operative indication (65.79%), treatment was conservative (myomectomy) in 64.50% of cases, all our surgical specimens were examined with confirmation of uterine leiomyoma. The most frequent immediate postoperative complication was anemia (5.26%).  Conclusion : conservative treatment for uterine fibromyoma is a beneficial option for women of childbearing age

Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea

Acceptability of contraceptive implants at the maternity ward of the Matam Communal Medical Center

Background: World Health Organization (WHO), defines contraception as "the use of agents, devices, methods or procedures to decrease the likelihood of conception or avoid it". In Africa, only 24% of women of childbearing age have access to a modern contraceptive method. The objective of the study was to determine the frequency of use of the contraceptive implant, to describe the socio-demographic characteristics of the users, to identify the reasons for the choice of the method and to assess the degree of satisfaction of the clients.Methods: The study was conducted at the Matam Communal Medical Center on level 2 of the health pyramid in Guinea. This was a 12-month cross-sectional, descriptive and analytical study (June 2017 to May 2018), including all women admitted for desire for contraception and who agreed to choose the implant as a contraceptive method.Results: The study involved 512 clients. The proportion of female users was 26.21%. The average age was 27.8 years, the main users were women of liberal trade, married, multiparous. The main reasons for choice cited by clients were the effectiveness and long duration of action of the method, i.e. 35.2% and 30.9% respectively. The majority of providers of the method were represented by midwives (73.3%) and the degree of client satisfaction with the method was 97%.Conclusions: The implant is a long-acting method of contraction. It is frequently used at the Communal Medical Center of Matam. Its efficient use would involve effective counselling

Aspects Epidemiologiques, Cliniques, et Prise en Charge Chiryrgivale des Fibromyomes Uterins au Service de Gynecologie -Obstetrique de l’Hopital National Ignace Deenchu de Conakry 2022

Introduction : L’objectif était d’étudier les aspects épidémiologiques, cliniques, et la prise en charge chirurgicale des fibromyomes utérins au service de gynécologie-obstétrique de l’hôpital national Ignace Deen du CHU de Conakry en 2022. Méthodologie: Il s’agissait d’une étude descriptive transversale, allant du 1er Mai au 30 octobre 2022 soit une période de six (6) mois. Ont été étudié les variables épidémiologiques, cliniques et la prise en charge. Les données ont été collectées à l’aide de la fiche d’enquête préétablie et prétestée. Le logiciel SPSS version 21 a été utilisé pour l’analyse des données. Résultats : les interventions chirurgicales pour fibromyome utérin ont occupé 55,47% (76/137) des activités chirurgicales pour pathologie gynécologique. L’âge moyen de nos patientes était de 38,38 ±9 ans avec les extrêmes 22 et 70 ans, la tranche d’âge la plus représenté était celle de 31-39 ans avec la proportion de 43,40%. Les nullipares étaient les plus représentées 48,68% (37/76). Il s’agissait des femmes non scolarisées 42,10% (32/76), en foyer 73,30% (56/76), exerçant une profession libérale 40,80% (31/76). Cliniquement, le volume utérin simulant une grossesse de 12- 20 SA était le motif de consultation le plus représenté 72,40% (55/76), puis la ménorragie 28,53% (55/76), la classification de FIGO à l’échographie a été réalisée dans 9,21% (7/76). Utérus polymyomateux était l’indication opératoire la plus rependue 65,79% (50/76), le traitement conservateur (myomectomie) a été dans 64,47% (49/76) des cas, par contre le taux d’hystérectomie n’était pas négligeable 35,52% (27/76) et les complications per opératoires ont été marquées par l’hémorragie (23,15%). Le nombre moyen de noyaux myomateux énucléés était de 7.  Il y a une effraction accidentelle de la cavité utérine chez 15 patientes (15,78%). L’anémie était la complication post opératoire immédiate la plus fréquente dans 5,26% (4/76) des cas et la transfusion sanguine a été réalisée chez 43,40% de nos malades. Aucun décès n’a été enregistré.  Conclusion : Le traitement conservateur pour la prise en charge du fibromyome utérin constitue une option salutaire pour les femmes en âge de procréer.   Introduction: This paper focuses on studying the epidemiological, clinical aspects, and surgical management of uterine fibromyomas in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital of the Conakry University in 2022. Methodology: This was a cross-sectional descriptive study, running from May 1 to October 30, 2022, within a period of six (6) months. Epidemiological, clinical, and management variables were studied. The data was collected using the pre-established and pre-tested survey form. SPSS version 21 software was used for data analysis. Results: Surgical interventions for uterine fibromyoma occupied 55.47% (76/137) of surgical activities for gynecological pathology. The average age of our patients was 38.38 ±9 years with the extremes of 22 and 70 years. The most represented age group was that of 31-39 years with the proportion of 43.40%. Nulliparous women were the most represented (48.68% (37/76)). These women were not in school (42.10% (32/76)), in households (73.30% (56/76)), and exercising a liberal profession (40.80% (31/76)). Clinically, the uterine volume simulating a pregnancy of 12-20 weeks was the most represented reason for consultation (72.40% (55/76)), which is followed by menorrhagia (28.53% (55/76)). The FIGO classification at Ultrasound was performed in 9.21% (7/76). Polymyomatous uterus was the most common operative indication (65.79% (50/76)), while conservative treatment (myomectomy) was in 64.47% (49/76) of cases. On the other hand, the rate of hysterectomy was not negligible (35.52% (27/76)) and intraoperative complications were marked by hemorrhage (23.15%). The average number of enucleated myomatous nuclei was 7. There was an accidental break-in of the uterine cavity in 15 patients (15.78%). Anemia was the most frequent immediate postoperative complication in 5.26% (4/76) of cases, and blood transfusion was performed in 43.40% of our patients. No deaths were recorded. Conclusion: Conservative treatment for the management of uterine fibromyoma constitutes a beneficial option for women of childbearing age

Facteurs de risque, épidémiologie et prise en charge de la grossesse extra-utérine rompue (GEUR) au service de gynécologie et d’obstétrique de l’hôpital national Ignace Deen du CHU de Conakry en 2022

Introduction : urgence gynécologique fréquente, découverte fortuite aux urgences médicales et ou chirurgicales dans un tableau d’anémie. L’objectif de cette étude était d’étudier les facteurs de risque, épidémiologie, et prise en charge de la grossesse extra-utérine rompue au service de gynécologie et d’obstétrique de l’hôpital national Ignace Deen du CHU de Conakry en 2022. Méthodes : il s’agissait d’une étude descriptive transversale à recrutement rétrospectif. Elle a été menée au service de gynécologie et d’obstétrique de l’hôpital national Ignace Deen du CHU de Conakry du 1er janvier  2019 au 31 Décembre 2022 soit une période de trois ans. Ont été étudiées les variables se rapportant aux facteurs de risque, épidémiologie, et la prise en charge de la GEUR dans notre contexte de travail. Nous avons utilisé le logiciel Excel pour l’analyse des données.    Résultats : fréquence de la GEUR dans notre étude était 1,26 % sur l’ensemble des interventions gynécologiques, les tranches d’âge les plus représentées étaient celles de 20-24 ans et 30-34 ans de 32,69%, plus de la moitié était célibataire 69,23%, sans profession, non scolarisé respectivement 64,23% et 42,31%, primipares dans 49,04%.  Parmi les facteurs de risque (FDR) retrouvés dans notre série, figuraient antécédent de :  l’infection génitale 46,15%, fausses couches spontanées 10,58%, la contraception par microprogestatif 16,34%. La prise en charge a été exclusivement chirurgicale (100%), associée à la transfusion sanguine comme moyen de réanimation dans 95,16%. Conclusion : la grossesse extra-utérine rompue est une urgence médicochirurgicale fréquente, le diagnostic précoce traine les pas dans les pays à faibles ressources.    Introduction : a frequent gynecological emergency, discovered incidentally in medical and/or surgical emergencies in the setting of anemia. The aim of this study was to investigate the risk factors and management of ectopic pregnancy in the gynecology and obstetrics department of the Ignace Deen National Hospital of Conakry University Hospital in 2022. Methods : This was a descriptive study with retrospective recruitment. It was conducted at the gynecology and obstetrics department of the CHU Ignace Deen national hospital in Conakry from January 1, 2019 to December 31, 2022, a three-year period. Variables relating to risk factors, epidemiology and management of GEUR in our working context were studied. We used Excel software for data analysis. Results : The frequency of GEUR in our study was 1.26% of all gynaecological procedures, the most represented age groups were 20-24 and 30-34 years with 32.69%, more than half were single 69.23%, without profession, not in school respectively 64.23% and 42.31%, primiparous in 49.04%.  Among the risk factors found in our series were a history of : genital infection 46,15%, spontaneous miscarriage 10.58%, microprogestogen contraception 16.34%. Management was exclusively surgical (100%), associated with blood transfusion as a means of resuscitation in 95.16% Conclusion : Ruptured ectopic pregnancy is a frequent medico-surgical emergency, early diagnosis is lagging behind in low-resource countries