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.

[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.

A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature.

The cavernous hemangioma is a rare benign vascular tumor. About 50 cases of this disease were found in the literature over the last century and only 9 cases of cavernous hemangioma on the pregnant uterus were published it comes into cavernous or capillary form. The symptomatology is not unequivocal and when it occurs during pregnancy or postpartum, it causes life-threatening cataclysmic hemorrhage. Antenatal diagnosis is difficult and requires a multidisciplinary approach with pathologists, radiologists and gynecologists to avoid these complications or unnecessary hysterectomies. The diagnosis is histological. Hysterectomy is possible after failure of conservative treatment means. We report a rare case, a novel mixed cavernous hemangioma of the body associated with a capillary hemangioma of the cervix in a patient of 28 years 5th visors with recurrent genital bleeding in the postpartum period leading to a hysterectomy.

Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies.

Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol's iodine (VILI). Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.