The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with ...The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with a high risk of uterine rupture and to classic abdominal cesarean section with risk of significant surgical trauma, particularly adhesions. However, this surgical technique, described since the 19th century, remains unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of expulsion of fetal death on a tri-scarred uterus performed by vaginal cesarean section at the Health District Reference Health Center (District Hospital) of Commune I in Bamako, Mali in a 37-year-old patient with a pregnancy of 27 weeks of amenorrhea.展开更多
Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-section...Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.展开更多
The aim was to assess transfusion needs in the management of immediate postpartum haemorrhage. Materials and Methods: this was a prospective, descriptive, analytical study from 01 January 2018 to 31 October 2018 in th...The aim was to assess transfusion needs in the management of immediate postpartum haemorrhage. Materials and Methods: this was a prospective, descriptive, analytical study from 01 January 2018 to 31 October 2018 in the gynecology and obstetrics department of the reference health center of Kalaban-Coro (Mali). Results: During the study period we recorded 32 cases of transfusion of the immediate postpartum out of 109 cases of hemorrhage or 29.35%;for a total of 2425 deliveries or a frequency of 1.31%. The main indications for blood transfusion were: postpartum haemorrhage due to tearing of the soft parts in 21.9%;retroplacental hematoma in 18.6%;uterine rupture in 12.5%;and placenta previa covering hemorrhagic in 12.5%. More than half of the transfused were evacuees, or 62.5%. Unmet transfusion requirements were 59.4%. The blood products requested were: whole blood in 99% of cases and fresh frozen plasma in only 1% of cases. Conclusion: the need for labile blood products remains a reality in obstetrics. The permanent availability of labile blood products improves the prognosis of immediate postpartum haemorrhages.展开更多
文摘The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with a high risk of uterine rupture and to classic abdominal cesarean section with risk of significant surgical trauma, particularly adhesions. However, this surgical technique, described since the 19th century, remains unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of expulsion of fetal death on a tri-scarred uterus performed by vaginal cesarean section at the Health District Reference Health Center (District Hospital) of Commune I in Bamako, Mali in a 37-year-old patient with a pregnancy of 27 weeks of amenorrhea.
文摘Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.
文摘The aim was to assess transfusion needs in the management of immediate postpartum haemorrhage. Materials and Methods: this was a prospective, descriptive, analytical study from 01 January 2018 to 31 October 2018 in the gynecology and obstetrics department of the reference health center of Kalaban-Coro (Mali). Results: During the study period we recorded 32 cases of transfusion of the immediate postpartum out of 109 cases of hemorrhage or 29.35%;for a total of 2425 deliveries or a frequency of 1.31%. The main indications for blood transfusion were: postpartum haemorrhage due to tearing of the soft parts in 21.9%;retroplacental hematoma in 18.6%;uterine rupture in 12.5%;and placenta previa covering hemorrhagic in 12.5%. More than half of the transfused were evacuees, or 62.5%. Unmet transfusion requirements were 59.4%. The blood products requested were: whole blood in 99% of cases and fresh frozen plasma in only 1% of cases. Conclusion: the need for labile blood products remains a reality in obstetrics. The permanent availability of labile blood products improves the prognosis of immediate postpartum haemorrhages.
