[Abdominal pregnancy in Libreville from 1999 to 2009]. / Grossesse abdominale à Libreville de 1999 à 2009.

INTRODUCTION: Abdominal pregnancy (AP) is defined as the implantation and development of the fertilised egg in the cavity of peritoneum. It causes severe perinatal morbity and mortality. OBJECTIVE: Underline the epidemiologic, diagnostic, therapeutic and prognostic aspects of the AP. METHODOLOGY: Retrospective study conducted at Maternité Joséphine Bongo (maternity hospital) and at the Centre Hospitalier de Libreville (hospital centre) from January 1999 to December 2009 on 19 cases of abdominal pregnancies. RESULTS: The frequency of AP in Libreville is one per 4447 deliveries (0.2 ‰) and one per 141 tubal ectopic pregnancies (0.7%). The mean age was 30.5 ± 7.2 years old and the mean parity 2.7 ± 1.7. The mean term of occurrence was 24.3 weeks of amenorrhoea (WA) with extremes at 14 and 39 WA. The diagnosis was made in the face of abdominal and pelvic pains in all the patients and an amenorrhoea in 11 cases (57%). It was confirmed by ultrasound scan in 14 cases (73.7%) and further to a laparotomy in five (26.3%) patients. We had two live births at 39 and 38 WA with respective birth weights of 2,380 and 2,550 g. Expulsion of the placenta was complete in seven (36.8%) cases. Five (26.3%) patients experienced hemorrhagic complications. CONCLUSION: AP is a rare pathology. Its diagnosis beyond of the second quarter is difficult with an often-pejorative foetal forecast.

[Serological study on toxoplasmosis among pregnant women from Franceville, Gabon]. / Etude sérologique de la toxoplasmosechez les femmes enceintes de Franceville, Gabon.

The serological prevalence of Toxoplasma gondii was studied among 839 pregnant women in two hospitals from Franceville (Gabon), between May 2007 and December 2007. Specific T gondii IgG and IgM were measured by Enzyme Linked Fluorescent Assay (ELFA). Datation of the infection was carried out by avidity test. Fifty-six percent of women in this study were immunised compare to the 71% who were found as immunised in a previous study carried out fifteen years ago. 2.6% were found to be IgM positive. However, from the avidity test it was found that these infections occurred before pregnancy contact with cats and age increase this prevalence. The lack of information for pregnant women, the lack of continuous training for health personnel and lack of awareness about interpretation of laboratory diagnostic tests like avidity test in these hospitals reduce the level of counselling for women about T gondii.

[Prevalence of illegal abortions in Libreville Hospital, Gabon]. / Prévalence des avortements clandestins au centre hospitalier de Libreville, Gabon.

The objectives of this study were to determine the prevalence of illegal abortion in Libreville and to describe abortive methods used. It is a cross sectional and descriptive survey carried out at the maternity hospital of Libreville (MHL) during one year, from 1 January 2008 to 31 December 2008. 750 abortions were performed during this period and 651 cases were illegal abortions. Prevalence was of 86.7%. The women undergoing illegal abortion were most often pupils (67.1%), with an average age of 22.4 +/- 5.3 years old and a mean parity of 1.2 +/- 1.50. The average gestational term was of 7.4 +/- 1.9 weeks. Misoprostol (63.1%) was the most frequent abortive product used. 2 maternal deaths were notified. Prevalence of illegal abortions is increasing at the MHL. Up to now, misoprostol is the most frequent abortive product used.

[Dermatomyositis and pregnancy: a case in Gabon]. / Dermatomyosite et grossesse: une observation au Gabon.

The purpose of this report is to describe a case of successful pregnancy involving a 30-year-old Afican woman presenting dermatomyositis, without use of immunosuppressive treatment. The child was delivered prematurely by caesarean section at 32 weeks of gestation.

[Risk factors of bilateralization of breast cancer: description of five cases in Libreville (Gabon) and review of the literature]. / Facteurs de risque de bilatéralisation du cancer mammaire: cinq observations à Libreville (Gabon).

Approximately 10% of patients diagnosed with breast cancer will develop cancer in the contralateral breast within 10 years. The risk factors for bilateralization are now better understood thanks to advances in molecular biology. Based on reports in the literature the main risk factors are presence of brca 1 or 2 gene mutations and family history. Despite the increasing incidence of breast cancer, this special aspect of the disease remains poorly studied in Gabon as well as in Black Africa in general. Incidence is increasing. This report describes 5 patients and discusses their profiles in relation to the literature. This study provides on update on current knowledge.