ABSTRACT
Background: Urinary tract infection is a common pathology during pregnancy due to hormonal and morphological changes. Objective of this study was to improve management of urinary tract infection during prenatal care.Methods: A total of 987 pregnant women who have been in prenatal care have freely accepted to participate in cross-sectional study carried out from 1st May 2016 to 30th April 2017 at Yopougon University Hospital (Abidjan Côte d’Ivoire) were included. Patients were submitted to questionnaire by one of investigators for epidemiological component and then physical examination was carried out by her attending physician for clinical component. Then at laboratory urine was taken for culture after dipstick test.Results: Of the 987 patients included 9.4% had a urinary tract infection of which 81.7% were asymptomatic. Significant risk factors retained were existence of a history of urinary tract infection (OR=0.46; p=0,038) and gestational age of pregnancy (OR=0.44; p=0.05). Urine culture isolated germs were mainly Escherichia Coli (51.6%) and Klebsiella pneumoniaie (23.6%). These germs were all susceptible to cephalosporins. They had resistances of more than 50% to penicillins.Conclusions: Escherichia coli and Klebsiella pneumoniae are most common germs of urinary tract infections in pregnant women. Escherichia coli is not susceptible to penicillins with a resistance of 70% for penicillins except for clavulanic acid amoxicillin. It appears as first choice antibiotic for our prescriptions in case of probabilistic antibiotic therapy.
ABSTRACT
Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.Results: The average age was 33 years old. 30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.