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Article | IMSEAR | ID: sea-207735


Background: In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.Methods: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.Results: Authors collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e. a frequency of 51.92%. Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%) The surgical treatment was conservative in 92.60%. The total hysterectomy was performed in 7.40. Lethality was 1.4%.Conclusions: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In this context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment are necessary for less invasive surgery.

Article | IMSEAR | ID: sea-207707


Background: Each year several patients are operated on for genital prolapse in our department, but no study has yet been done to analyse the results. The objective of this study was to highlight the operating techniques used and to analyse the anatomical and functional outcomes.Methods: It was an observational, longitudinal, prospective and descriptive study which took place over a period of 2 years in the department of obstetrics and gynecology of the Ignace Deen hospital de Conakry in Guinea. This study focused on patients operated on in the department for genital prolapse.Results: During the study period, 67 patients underwent genital prolapse surgery in the department. The operating techniques used are the triple perineal operation or, associated with colposuspension and/or Richter or Mc Call, Richardson's operation, Rouhier's operation and promonto-fixation. This study recorded in the follow up a case of recurrence of hysterocele one year after a Richardson operation, a correction of all digestive and sexual functional disorders and a correction of 81.25% of functional urinary disorders. The intraoperative complications were a rectal wound, two bladder wounds and three cases of hemorrhage requiring blood transfusion. The post-operative results were good in 98.5% of the cases.Conclusions: The lower approach is the main route used for surgical treatment of prolapse. The anatomical and functional results obtained are encouraging.

Article | IMSEAR | ID: sea-207654


Background: Vascular-renal syndrome, also known as pre-eclampsia, is a condition specific to pregnancy, usually occurring in the last trimester of pregnancy. Pregnant women are sometimes at risk of unpredictable obstetrical complications such as: hemorrhage, kidney failure, HELLP syndrome, sometimes even brain damage requiring prompt care and multidisciplinary collaboration. Vascular-renal syndromes are the third leading cause of maternal death and also the world's leading cause of perinatal death. Objectives of this study were to analyse the management of vascular-renal syndromes. Calculate their frequency, describe the sociodemographic characteristics of patients, describe the clinical and biological signs of patients, evaluate the maternal-fetal prognosis.Methods: The study was conducted in the department of obstetrics and gynecology of Donka National Hospital. It was a prospective, descriptive, cross-sectional, 6-month study from March 1st to August 31st, 2015, of pregnant women with pre-eclampsia.Results: The study included 217 cases of pre-eclampsia out of a total of 3054 patients, i.e. a proportion of 7.10%. The proportion of pre-eclampsia was high in patients aged between 15 and 19 years, housewife, married, primary. The predisposing factors were primigestitis, obesity and twinkling. The clinic was dominated by headaches and visual disturbances. Severe preeclampsia in 78.49%, eclampsia in 21.65% or simple hypertension in 1.75%. Maternal and fetal complications were dominated by eclampsia 26.26%, PPH (2.63%), eclamptic coma (0.46%), acute fetal distress 27.19%, and fetal death in utero (11.40%). In order to improve maternal and fetal prognosis it is necessary to provide multidisciplinary care, which unfortunately is not always available in our context.Conclusions: Obstetric emergency is a frequent situation for which a better management would improve the maternal-fetal prognosis.