Dengue infection during pregnancy in Burkina Faso: a cross-sectional study.

BACKGROUND: Dengue fever is prevalent in the world; in recent years, several outbreaks occurred in West Africa. It affects pregnant women. We aimed to assess the consequences of dengue fever on pregnant women and their fetuses during dengue epidemic in Burkina Faso. METHODS: We conducted a cross-sectional study from November 1, 2015 to January 31, 2017 in 15 public and private health facilities in Ouagadougou, using secondary data. Immunochromatographic rapid test Duo detecting specific antibodies, immunoglobin M/G and /or dengue non structural antigen1 virus was used to diagnose dengue cases. RESULTS: Out of 399 (48%) women registered during the study period, 25 (6%) were pregnant. The average age of pregnant women was 30 years, with 18 and 45 years as extremes. The main symptoms were fever (92%) and headache (92%). Nine patients (36%) had severe dengue characterized by bleeding (16%), neurological symptoms (16%) and acute respiratory distress (8%). Eight (32%) of the 25 women had early miscarriage and 8 (32%) women gave birth to viable fetuses. Among those with viable babies, 5 (20%) presented post-partum hemorrhage and 3 (12%) presented early delivery. The main fetal complications included 3 cases of acute fetal distress (12%). One case of maternal death (4%) and 4 cases of neonatal mortality (44.5%) were notified. CONCLUSION: Dengue fever occurring during pregnancy increases maternal and neonatal mortality. Its severe complications require specific monitoring of pregnant women until delivery.

Diagnosis and management of a giant ovarian cyst in the gravid-puerperium period: a case report.

BACKGROUND: Giant ovarian cyst is very rare in gravid-puerperium period. It is a cause of a maternal-fetal morbidity. We report a case of a giant benign ovarian cyst in gravid-puerperium period which was diagnosed and managed in a hospital of a low-resource country. CASE PRESENTATION: Data were collected by historical review, clinical examination, laboratory investigations, imaging examination, and by histopathological study of the excised surgical specimen. It is the case of a 25-year-old woman who was third gravida and third para with unknown pathological history. After she had given birth through vagina, a giant ovarian cyst, unknown during pregnancy, was diagnosed. A left oophorectomy carrying the cyst was performed after laparotomy in Yalgado Ouedraogo University Hospital Center of Ouagadougou (Burkina Faso). The cyst was 42 cm long and weighed 19.7 kg. The histology of the operative specimen revealed serous cystadenoma of the ovary. The postoperative course was uneventful. CONCLUSION: This case reports that vaginal delivery is possible with a giant ovarian cyst associated with pregnancy. Surgical management of the cyst can be performed in the postpartum with satisfaction.

A full term abdominal pregnancy with an isthmic tubal implantation of the placenta.

BACKGROUND: Abdominal pregnancy is defined as the partial or total insertion of the embryo into the abdominal cavity. It is rare, and can evolve towards the full term if it is not recognized in the early pregnancy. It carries a high risk of maternal-fetal morbidity and mortality. CASE PRESENTATION: We report a case of a 22 year-old gravida IV, para II with an asymptomatic and undiagnosed abdominal pregnancy presumed full term, in a context of health centers under-equipment. She had attended 5 routine antenatal care, but had not performed any ultrasound scan. She had been transferred from a medical center to the Hospital of Ouahigouya (Burkina Faso) for bowel sub-obstruction and intrauterine fetal death, with failure of labor induction. On admission, the hypothesis of uterine rupture or abdominal pregnancy with antepartum fetal demise was considered. A laparotomy was then performed, where an abdominal pregnancy was discovered, and a dead term baby weighing 3300 g delivered. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. Postoperative follow-up was uneventful. CONCLUSION: This case report exposes the necessity for the practitioner to think about the possibility of abdominal pregnancy in his clinical and sonographic practice, irrespective of the gestational age, mainly in contexts where there is under-equipment of the health centers.

[A case of large Mucinous Cystadenoma of the Ovary at the Regional Teaching Hospital of Ouahigouya (Burkina Faso)]. / Un cas de volumineux Cystadénome Mucineux de l'ovaire au Centre Hospitalier Universitaire Régional De Ouahigouya (Burkina Faso).

Introduction: A benign tumor of middle-aged women, mucinous cystadenoma accounts for about 20% of tumors of the ovary. It can reach very large sizes. Clinical observation: We report the case of a 42-year-old patient received for a voluminous abdomino-pelvic mass. The examination found a soft, rounded, fairly mobile abdomino-pelvic mass going up to the level of the xiphoid appendix with a light skin and collateral venous circulation. Imaging showed a circumscribed fluid formation occupying the abdomino-pelvic cavity of 40.1 x 29 x 25.7 cm developed at the expense of the ovary. A laparotomy brought to light a voluminous cyst at the expense of the left ovary with fluid content cowardly adhering to the abdominal wall and intimately to the left proboscis. The uterus and right adnexa were unremarkable. We performed a left adnexectomy with satisfactory hemostasis taking away the cyst. The adnexectomy piece weighed 13.5 kg. The surgical follow-ups were simple. Anatomo-pathological examination confirmed a mucinous cystadenoma of the ovary. Conclusion: Mucinous cystadenoma of the ovary is a benign tumor which can reach very large volumes. Its treatment is surgical and the follow-ups are usually simple.

Interventions to improve the use of long-acting reversible contraceptive methods at primary health centers in Burkina Faso.

OBJECTIVE: To assess the effects of strengthening family planning capacity on the uptake of long acting reversible contraceptive (LARC) methods at two primary health centers. METHODS: Between April 2016 and March 2017, the Society of Gynecologists and Obstetricians of Burkina Faso (SOGOB) increased the capacity of two primary health centers in Ouagadougou, Burkina Faso, to offer LARC methods by training staff and providing family planning equipment and commodities. Uptake of LARC methods was compared between the year preceding the intervention and the year during the intervention. RESULTS: Within a year, the number of new users of family planning increased 2.8-fold from 2936 new users before the intervention to 8267 during it. The rate of new users of contraception increased 1.9-fold (14.9% vs 28.1%; P<0.001) for all LARC methods, 2.4-fold for intrauterine contraceptive devices (IUCDs), and 1.7-fold for subdermal contraceptive implants. The proportion of new users of the copper IUCD younger than 25 years was higher during the intervention than before it (57.2% vs 46.9%; P=0.026). CONCLUSION: The SOGOB's family planning intervention resulted in an increase in the use of LARC methods at the two primary health centers.

[A 36 weeks heterotopic pregnancy discovered incidentally at the Regional University Hospital of Ouahigouya]. / Une grossesse heterotopique de 36 semaines de decouverte fortuite au centre hospitalier Universitaire Regional de Ouahigouya (Burkina Faso).

Heterotopic pregnancy is a rare entity, its development up to term is exceptional. We report a case of heterotopic pregnancy of fortuitous discovery during a caesarean section performed in a 26-year-old female patient received for abdomino-pelvic pain on suspected twin pregnancy of 33 SA. No obstetric ultrasound had been performed before admission. Two ultrasound ultrasounds have objectified an intrauterine twin pregnancy with hydramnios. A caesarean section at 36 weeks indicated for twin pregnancy with hydramnios and severe anemia was performed during which we discovered an intrauterine pregnancy and an abdominal pregnancy with insertion of the placenta at the level of the broad left ligament with adhesion on the left annex, Omentum and small handles. Newborns did not require any special care outside the classical essential care. The first intrauterine had a weight of 2650 g and the second abdominal of 2000 g. The postoperative sequences were simple.

La grossesse hétérotopique est une entité rare, son développement jusqu'à terme est exceptionnel. Nous rapportons un cas de découverte fortuite chez une patiente de 26 ans, reçue pour douleurs abdomino-pelviennes sur grossesse présumée gémellaire de 33 SA. Aucune échographie obstétricale n'avait été réalisée avant son admission. Deux échographies tardives ont objectivé une grossesse gémellaire intra utérine avec hydramnios. Une césarienne à 36 semaines indiquée pour grossesse gémellaire avec hydramnios et anémie sévère a été réalisée au cours de laquelle nous avons découvert une grossesse intra-utérine et une grossesse abdominale avec insertion du placenta au niveau du ligament large gauche avec adhérence sur l'annexe gauche, l'épiploon et les anses grêles.Les nouveaunés étaient bien portant. J1 intra utérin avait un poids de 2650 g et J2 abdominal de 2000g. Les suites ont été simples.

Respectful maternity care in three health facilities in Burkina Faso: the experience of the Society of Gynaecologists and Obstetricians of Burkina Faso.

The Society of Gynaecologists and Obstetricians of Burkina Faso (SOGOB) conducted a project to reinforce skills in respectful maternity care among its members and health workers at three facilities. The participatory process allowed health workers to self-diagnose quality of care, recognize their own responsibility, propose solutions, and pledge respectful care commitments that were specific for each unit. Key commitments included good reception; humanistic clinical examination; attentive listening and responsiveness to patient needs; privacy, discretion, and confidentiality; availability; and comfort. These commitments can potentially be modified after each evaluation by SOGOB. Poor working conditions were found to negatively impact on quality of care. High staff turnover, frequent technical malfunctions, and inadequate infrastructure were identified as issues that require future focus to ensure improvements in quality of care are sustainable. Programs that aim to improve the maternity experience by linking good practice with humanistic care merit rollout to all healthcare facilities in Burkina Faso.