[Sexual abuse: epidemiological, clinical aspects and management at gynaecological and obstetrical department of Dakar University Hospital]. / Profil épidémioclinique et prise en charge des victimes d'abus sexuels à la clinique gynécologique et obstétricale du CHU de Dakar.

OBJECTIVES: To carry out the epidemiological and clinical characteristics of supposed victims of sexual abuse and to evaluate case management. PATIENTS AND METHODS: A prospective study was conducted about cases of presumed sexual abuse received at the gynaecological and obstetrical clinic department of Aristide-le-Dantec hospital from January 2003 to May 2005. RESULTS: A total of 55 cases were reported and represented 0.4% of admissions in the clinic during the period of study. Twenty percent of them (20%) were referred on judicial requisition. The mean time between sexual abuse and consultation was 15 days. Victims were 14 years old in average, nulligeste in 96.5% of cases and living in the suburban area of Dakar. The presumed "violenter" was a man of 32 years, belonging to the environment of the victim in 70% of cases (spiritual guide, joint-tenant, friend of the family...). The type of sexual assault was an unprotected genito-genital intercourse in 67.3% of cases. On the clinical plan, 70.9% of patients suffered recent genital traumatism, 54.5% genital examination showed hymeneal lesions. The HIV test was positive in two cases. During the follow-up of the patients, three pregnancies occurred and for only 9.1%, a psychological assistance was proposed. CONCLUSION: Sexual abuses represent a current sociocultural issue. Prevention required large information campaign. Early management is necessary in order to prevent the sexual transmitted diseases and psychological side effects.

[Threatened preterm labour: assessment of its management at the Dakar University Teaching Hospital]. / Evaluation de la prise en charge des menaces d'accouchement prématuré au CHU de Dakar.

The objective is to specify epidemiological profile of pre term labour birth and evaluate the efficiency of the tocolysis protocol of Dakar University Teaching Hospital. It's a retrospective study which included 155 cases of spontaneous premature birth registered from January 1st 2000 to December 31 2002 in obstetrician clinic. The incidence is 15 per 1000 childbirth. The epidemiological profiles on a pauciparous woman (mean age: 25 years), of low economic and social level (90%), admitted with a bad antenatal follow-up and a pathology associated with pregnancy dominated by arterial hypertension (25%). The mean age of gestation is 30 weeks; severe forms are prevalent and tocolysis score of Baumgarten is equal or higher than 4 in 71.6%. The three principal etiologists are toxaemia, premature rupture of membranes and infections. An association Salbutamol-Phloroglucinol is carried out in 28 cases (18%) or with Phloroglucinol in 25 cases (16.1%). In summary, 138 patients (89%) were finally confined by low way after 5 hours a median time. Perinatal mortality was 347.2 per 1000; it's related to the large premature ones particularly having a weight of birth less than or equal to 1300 grams (78%). The threats of pre term labour are often diagnosed tardily. The access to the tocolysis in emergency is limited and it's effectiveness practises very weak. Use of calcic inhibitors and the systematisation of corticotherapy should improve the forecast of prematurity.