ABSTRACT
Objectives To study maternal morbidity related to abruptiio placentae (HRP) and its management during delivery. Methodology It was a retrospective study held during one year in the Obstetrics and Gynecology Clinic at the University Teaching Hospital le Dantec of Dakar. From the 69 records of patients who had been faced abruptio placentae, the sociodemograhical and clinical characteristics were studied as well as the treatment applied Results The mean age of the patients was 28.82_+ 6.63 years and the mean parity was 4 _+3 children. At all, 59.4% of the patients were received in emergency care coming from the suburbs and 28.8% had done 3 prenatal consultations. Hypertension prior to pregnancy was seen in 17.1% cases and 20% of the patients presented toxemia. Caesarean section was performed in 11.6% and 88.4% of the patients had vagina delivery. Maternal morbidity was mainly related to haemorrhage and anaemia in 83.3%. Blood transfusion was performed in 56.62%. One hysterectomy due to haemorrhage was done and one patient had hemodialyse for kidney weakness. Lethality linked to abruptiio placentae was 8 maternal deaths leading to o proportion of 11.5%. The leading causes of death were haemorrhage (5 cases) and coagulopathy (3 cases). Conclusion Abruptio placentae is an obstetrical pathology which compromises maternal and foetal prognosis. Appropriate therapies of which caesarean section even if foetal death is diagnosed could improve the prognosis.
ABSTRACT
OBJECTIVES: Norplant implants have been used for long-lasting contraception in Senegal since 1986. The purpose of this work was to assess tolerance and acceptability of the method among Senegalese women. MATERIAL AND METHODS: A prospective non-comparative study including 300 women was undertaken in the Obstetrics and Gynecology Clinic at the University Teaching Hospital A Le Dantec of Dakar between December 1986 and July 1991. Women meeting inclusion criteria were seen at 1 month, 3 months, and 6 months after insertion then every 6-month until device removal. RESULTS: The mean age of women was 31.3+/-5.45 years and mean parity was 4.7+/-2.45. Almost half of the women no longer desired pregnancy and 67.6% of the women who had not used contraceptive method the month before admission decided to use Norplant. During follow-up visits, 45.2% had menstrual side effects mainly amenorrhea 23.4% and irregular bleeding 12.5%. Non-menstrual side effects were local reactions at the implant site (19.9%). The other side effects were dizziness, asthenia, insomnia, anemia, and high blood pressure and weight change. Overall, 58.8% of the women kept their implants and had them removed after 5 years of use. The failure rate was 3.3+/-1.25. At the end of five years of use, satisfaction was 84.8% and nearly two-thirds of the women decided to recommend Norplant to a friend or relative or to use it again. CONCLUSION: Norplant is a method of choice among the range of contraceptive methods available in Senegal. Because of its advantages and its ease of use, Norplant could be a widely used method in Senegal.
