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Article | IMSEAR | ID: sea-208038


Background: The objective of this study was to determine the frequency, skills level of health care service providers; to identify complications and difficulties related to the implementation of AMTPC/GATPA.Methods: It was about prospective study, descriptive of 6 months (1st March to 31st August 2014) carried out in the maternity hospitals of Faranah, Kindia, Mamou and Nzérékoré. It concerned the parturient women who had recently given birth and the personnel that carried out AMTPC/GATPA in these hospitals.Results: During the study period of 1,254 out of 1,305 births had benefited of AMTPC/GATPA, a frequency of 96.1%. The midwives were the most represented personnel in the implementation of GATPA (44.1%). In 46.4% of the cases, the health care service providers acquired this competence from the initial training. The release was obtained in the first trial in 64.9% cases. The duration of implementation of GATPA was less than 5 minutes in 72.6% cases. The different stages were respected in 91.5% cases. Complications were dominated by retention of placental fragments (10.2%). Lack of oxytocin was the main difficulty (36.6%).Conclusions: The sustainability of this achievement would depend on the systematic and correct implementation of AMTPC/GATPA at all childbirth attendants and the effective management of oxytocin.

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.