Audit of the first caesarean section in a reference hospital in the African environment

Background The practice of a first caesarean section can condition the future obstetric prognosis. The aim of this work was to study the indications of the first caesarean sections at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou.Methods: This was a cross-sectional study with prospective collection. The data were collected from 1 March to 30 May 2018. The women who benefited from caesarean section for the first time were the study population. The review of the documents, the interview with the patients and the expert opinion were the techniques used. The expert opinion made it possible to determine whether or not the caesarean section was preventable.Results: The first caesarean sections accounted for 62.5% (280/448) of all caesarean sections and 34.6% (280/810) of all childbirths in the period. Caesarean section was urgently performed in 95% of cases. It was mostly an obstetrical indication. Probable fetal asphyxia was the first major indication (27.5%) followed by preeclampsia/eclampsia (15.7%) and uterine pre-rupture syndrome (8.9%). Caesarean section was found to be avoidable in 53 cases (18.9%). Probable fetal asphyxia was the most common indication (22.4%) of these preventable caesarean sections.Conclusions: The good management of preeclampsia, the strengthening of the birth room in fetal and maternal monitoring equipment, the close coaching of physicians in specialization and the periodic audits of practices would reduce the preventable caesarean sections.

Aspects cliniques et therapeutiques desviolences sexuelles reçues au centrehospitalier et universitaire (CHU)Yalgado Ouedraogo, Burkina Faso

Introduction:Les violences sexuelles constituent un problème de santé dont la prise en charge doitêtre adéquate et globale. Une stratégie préventive doit être menée afin de dissuader les potentielsagresseurs. Le but de l'étude étaitde décrire les cas de violences sexuelles reçus dans le Département de gynécoobstétrique du Centre Hospitalier Universitaire YalgadoOuédraogo (CHUYO).Patientes et méthode:Il s'est agi d'une étude rétrospective àvisée descriptive couvrant une période allant du 1er janvier 2009 au 31 décembre 2013.L'étude a concerné les présumées victimes de violences sexuelles reçues dans le département de gynécologie obstétrique du CHUYO et dont les dossiers étaient exploitables.Résultats: Lamoyenne d'âge des présumées victimes était de 16 ans avec des extrêmes allant de 03 ans à 32 ans. Le viol était le motif de consultation le plus fréquent (93,1%) et se déroulait nuitamment, généralement dans les domiciles.La lésion génitale la plus fréquente était les déchiruresvulvaires(17,8%). La lésion non gynécologique la plus fréquente était les égratignures (10,9%).La prise à charge des victimes était essentiellement médico chirurgicale.Le pronostic à court terme était favorable(100%). La prise en charge psychologique était marginale.Conclusion:Les violences sexuelles restent une préoccupation bien que sa fréquence soit faible. Ce fléau touche essentiellement les adolescentes

Maternal mortality by direct obstetric causes in an urban referral hospital: case of Boulmiougou District Hospital in Ouagadougou, Burkina Faso

Background: Complications during pregnancy and childbirth are the leading causes of death and disability for women of childbearing age. Objective of this study was to study maternal mortality of direct obstetric origin at the Boulmiougou district hospital from 2010 to 2014.Methods: This was a retrospective cross-sectional descriptive and analytical study of maternal deaths by direct obstetric cause at the maternity ward of Boulmiougou District Hospital during the period from January 1st 2010 to December 31st, 2014, i.e. 5 years.Results: The maternal mortality rate by direct obstetric cause of 147.68 maternal deaths per 100,000 live births. The average age of the patients was 27.09 years old. The direct causes of maternal death were hemorrhage (47.06%), hypertensive disorders (20.59%), infections (14.71%) and unsafe abortion (11.76%). Contributing factors to maternal deaths were delay in evacuation (47.06%) and delay in care (38.23%).Conclusions: Maternal mortality remains high in the Boulmiougou District Hospital. To effectively combat maternal mortality, it is important to focus on the continuous training of staff and the strengthening of the technical platform.

Satisfaction of patients received in emergencies in the department of obstetrics and gynecology at the Yalgado Ouedraogo teaching hospital: comparative study before and after the introduction of free care

Background: The quality of care perceived by the users of health care services is an important indicator of the quality of care. The aim of this study was to assess the satisfaction of patients received in obstetric and gynecological emergencies department of Yalgado Ouedraogo Teaching Hospital before and after the introduction of free care.Methods: This was a cross-sectional investigation. Data collection was carried out from February to July 2016, covering the last three months before the start of free care and the first three months of implementation of this free policy in Burkina Faso.Results: A total of 620 patients formed the sample. The reception (p=0.0001), the waiting period (p=0.0001), respect for treatment schedules (p=0.0001), respect for intimacy (p=0.0001), communication between providers and patients (p=0.007), the comfort of the delivery room (p=0.003) and the comfort of the ward room (p=0.002) were more favorably appreciated by patients before the free treatment than during that period. Overall patient satisfaction was better before the effectiveness of free care (p=0.003).Conclusions: The realization of free care process was followed by a lower patient’s satisfaction reflecting an alteration in the quality of health care services. A situational analysis of this free health care process is necessary in order to make corrective measures. Also adequate preventive measures should be adopted before any implementation to a larger scale of this free policy.

Congenital cystic adenomatoid malformation, antenatal diagnosis: about one case

Antenatal ultrasound screening of fetal malformations requires for management, the immediate nature of which at certain birth, conditions the survival of the newborn. The Objectives Describe a case of pulmonary cystic adenomatoid malformation discover during antenatal ultrasonography. It was a 36 years old primary patient, referred to the maternity of Lafontaine hospital (France) for the presence, on obstetrical ultrasound screening, of suspected lesions on the foetal right lung’s field in a 21 weeks gestation pregnancy. After successive obstetric ultrasound scan, it was discovered that the left lungs were big with some parenchymal cysts of different sizes more than 3 mm in diameter. We made a diagnosis of type I left pulmonary cyst adenoma with excess amniotic fluid, without associated anomalies. The pregnancy progressed to 40 weeks gestation and a caesarean section was done with extraction of a live female new born weighing 2730 gr. The new born had 40 days later a successful surgical lobectomy for a cystic adenomatoid dysplasia. Histological examination revealed type I Stocker congenital pulmonary cystic adenomatoid malformation. During obstetrical ultrasound screening, we paid more attention to the brain, the heart, the face. Through this study we realised that during routine antenatal ultrasound for morphology, we should also pay more attention to the lungs.

Knowledge and practice of emergency contraception among female students of public university of Ouagadougou, Burkina Faso, West Africa

Background: Female students are exposed to unsafe sex, sources of unwanted pregnancy and abortions. It is recognized that emergency contraception can effectively prevent pregnancy. The purpose of this study was to evaluate the knowledge and practices of Ouagadougou public university students in relation to emergency contraception in order to propose solutions to reduce the proportion of unwanted pregnancies among female students.Methods: This was a cross-sectional study conducted between May 1st and October 31st, 2016 in the public universities of Ouagadougou. A questionnaire was administered to a sample of 732 students randomly selected.Results: The average age of female students was 22.7 years old. The age group 19 to 24 was the most represented (68.03%). Of the students surveyed, 87% knew or had heard of emergency contraception. The students only used the emergency contraceptive pill. The emergency contraceptive use rate was 44.42%. Approximately, 83% of users were aware of the delay in using emergency contraception. The reasons for using emergency contraception were condom breakage (25.10%) and unprotected sex (74.9%). Female students purchased the contraceptive directly in pharmacies (93.61%).Conclusions: Emergency contraception gives women a last chance to avoid an unwanted pregnancy after unprotected sex.  Awareness and free availability of emergency contraception (EC) could improve the reproductive health of female students.

Une grossesse hétérotopique de 36 semaines de découverte fortuite au centre hospitalier universitaire régional de Ouahigouya (Burkina Faso)

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 nouveau-nés étaient bien portant. J1 intra utérin avait un poids de 2650 g et J2 abdominal de 2000g. Les suites ont été simples