Hysterectomy following severe primary postpartum hemorrhage: A five year review in Abidjan University Hospitals.

Hemostasis hysterectomy is a mutilating technique responsible for definitive side effect on the woman's fertility. The aim was to document to document hemostasis hysterectomies performed in obstetrics units of university hospitals in Côte d'Ivoire. This was a retrospective, cross-sectional, and descriptive study from January 2013 to January 2018 in the three university hospital centers of Abidjan. It involved all parturients of the said university hospital centers who presented a severe postpartum hemorrhage and in whom a hemostasis hysterectomy was performed. The overall frequency of hemostasis hysterectomy in the three university hospitals was 0.32%. The most common etiologies were atony and uterine rupture. Hemostasis hysterectomy was indicated immediately. The deaths recorded were most often intraoperative and in the immediate postoperative period. The reduction of its incidence requires a good surveillance of the third period of delivery.

Overall survival and current management of breast cancer in elderly Ivoirian's women / Supervivencia general y tratamiento actual del cáncer de mama en mujeres ancianas de Costa de Marfil

Objective: To present the epidemioclinical features, the immunohistochemical profile and the overall survival rate of women over 65 with breast cancer.Materials and methods: In a retrospective study, we recruited women over 65 years old with breast cancer who were treated in the district of Abidjan. Our study took place in a period of 60 months, from 2014 until 2018. The patients were selected from several sources; namely the consultation's registers, the hospitalization's units, the operating theater and the archive files of all the above. The data were collected using a survey sheet, processed then analyzed from the Epi info7 software. The Kaplan–Méier test helped us appreciate the survival.Results: From a total of 2233 breast cancers, we got 52 patients over the age of 65, i.e. a proportion of 9.53%. These patients’ age range was between 65 and 86 years old with an average age of 72 years old. The non-specific invasive carcinoma represented the most frequent histological type with 94.23% of the cases. 1 out of 2 women (56.41%) received a neoadjuvant chemotherapy. The overall survival rate for 5 years were 9.62%. The median survival of the patients was 15.50 months. The immunohistochemical profile was determined for 21 patients and among them there was no Luminal B Her 2- and the Luminal A (43%) was the dominant profile.Conclusion: The management of elderly Ivoirian breast cancer was essentially non-surgical with a low survival. (AU)

Objetivo: Presentar las características epidemiológicas, el perfil inmunohistoquímico y la tasa de supervivencia global de mujeres mayores de 65 años con cáncer de mama.Materiales y métodosEn un estudio retrospectivo, reclutamos mujeres mayores de 65 años con cáncer de mama que fueron tratadas en el distrito de Abiyán, Costa de Marfil. Nuestro estudio se llevó a cabo en un periodo de 60 meses, desde 2014 hasta 2018. Las pacientes fueron seleccionadas de varias fuentes; a saber, los registros de consulta, las unidades de hospitalización, el quirófano y los archivos de todos los anteriores. Los datos se recopilaron mediante una hoja de encuesta, se procesaron y luego se analizaron desde el software Epi Info 7 (version 7.2.1.0). La prueba de Kaplan-Meier nos ayudó a apreciar la supervivencia.ResultadosDe un total de 2.233 cánceres de mama, obtuvimos 52 pacientes mayores de 65 años, es decir, una proporción del 9,53%. El rango de edad de estas pacientes estaba entre los 65 y los 86 años, con una edad promedio de 72 años. El carcinoma invasivo inespecífico representó el tipo histológico más frecuente, con el 94,23% de los casos. Una de cada dos mujeres (56,41%) recibió quimioterapia neoadyuvante. La tasa de supervivencia global durante cinco años fue del 9,62%. La mediana de supervivencia de las pacientes fue de 15,50 meses. Se determinó el perfil inmunohistoquímico para 21 pacientes, y entre ellas no hubo Luminal B Her2− y el Luminal A (43%) fue el perfil dominante.ConclusiónEl tratamiento del cáncer de mama de Costa de Marfil de edad avanzada fue esencialmente no quirúrgico, con una baja supervivencia. (AU)

[Opinion survey on postpartum pelvic floor rehabilitation among Ivorian practitioners]. / Enquête d'opinion des praticiens ivoiriens sur la pratique de la rééducation périnéale dans le post-partum.

INTRODUCTION: the purpose of this study was to report health care providers' experience of perineal rehabilitation in the Maternity Hospital of Abidjan by assessing their level of knowledge and their practical attitudes. METHODS: we performed a survey among obstetricians and midwives working in a Maternity Hospital in Abidjan over a period of at least two years. The information were collected using a questionnaire including direct, open and semi-open questions. RESULTS: the study included 120 practitioners, 66 midwives and 54 obstetricians. Seventy-nine point six percent of obstetricians and 37.9% of midwives worked in a university hospital. Midwifery knowledge was good or average in 25% of cases (interquartile range [IIQ] 16.8-48.3); 65% of obstetricians had a good or medium level of knowledge (IIQ 41.1 -48.3). The majority of providers summoned women in the postpartum period, but only 7 out of 10 caregivers performed perineal assessment and 2 out of 10 obstetricians suggested the need for rehabilitation. CONCLUSION: the low level of knowledge of Ivorian midwives and obstetricians regarding postpartum pelvic floor rehabilitation and the lack of practice suggest the need for ongoing training.