[Etiologic factors of prematurity in Ziguinchor maternity hospital center (Senegal)]. / Facteurs étiologiques de la prématurité au centre hospitalier régional de Ziguinchor, Sénégal.

A case-control study was conducted between September 2003 and January 2004. Fifty four newborn babies born before 37 weeks of gestation resulting from 47 pregnancies including 7 multiple pregnancies were compared to 105 newborn babies born between 37 and the 42 weeks of gestation. Parturient geographical origin, marital status, age, alcohol or tea consumption and height were not significantly associated to premature birth (p > 0.05). On the other hand, a higher parity or equal to 3, a number of antenatal care lower than 3 were significantly associated with the risk of premature birth (p < 0.05). But a gestity and a parity lower than 3 and a number of antenatal consultations higher or equal to 3 had a protective effect (OR < 1; p < 0.05). We recommend a reinforcement of malarial prevention during pregnancy according to WHO recommendations and the improvement of the quality of the antenatal care in the Ziguinchor medical district.

[Tubal sterilization by minilaparotomy under local anesthesia]. / Stérilisation tubaire par minilaparotomie sous anesthésie locale.

Minilaparotomy under local anesthesia (ML/LA) is the most widely used technique of tubal sterilization in the world. Since 1993, the University Hospital Center of Dakar, Senegal has been the reference center performing 20 ML/LA a month. Most procedures (72%) are carried out for non-medical personal reasons. The remaining cases (28%) involve physical conditions incompatible with completion of normal pregnancy. In all cases, voluntary, informed consent is obtained from the couple and is documented in writing. Preoperative evaluation is performed to detect contraindications. The procedure consists of five steps: the vaginal phase, local anesthesia, abdomen incision, tubal ligation, and closure. Morbidity is less than 1%. The most common complications involve damage to visceral organs (intestine, bladder). These injuries are accessible to immediate repair and thus have a good prognosis. Failure rate due to technical error is low (average: 5.8/10,000). Current experience shows that ML/AL is a safe, effective, low-cost technique well suited to use in developing countries.