Objective: Analyze the maternal mortality in the two departments of CHU Point "G" in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point "G". All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of Chi 2 , the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20-24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%; the evacuation without any evacuation sheet: 259/389 making 66.6%), poor CPN (Prenatal consultation) quality (undone CPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389
Infertility is a socio-cultural drama in Africa, especially in Mali and remains difficult for couples to overcome. Laparoscopy, also called minimally invasive surgery or keyhole surgery, is an operative technique that permits to explore the pelvis and perform an appropriate therapeutic procedure. The objective of our work was to assess the role of laparoscopic surgery in the treatment of female infertility at Hôpital du Mali. It was a retrospective descriptive study that was conducted over a period of 5 years (January 2013 to December 2018). Any patients followed for infertility and who underwent laparoscopic surgery in the gynecology department over a period of two (2) years were included. The outcome of laparoscopic surgery was evaluated in terms of conception of pregnancy. We had collected 103 infertile patients out of 2984, with a frequency of 3.45%. The mean age of our patients was 30.2 years. Housewives and out-of-school women accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%. Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with an average duration of 6.2 years. Systematic chlamydial serology was positive in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of cases. Adhesiolysis was the main procedure performed with 84.47% bilateral tubal patency achieved in the methylene blue test. Among our patients who had contracted a pregnancy (22.99%), 85% had carried their pregnancies to term. Tubal damage was the main cause of infertility. Adhesiolysis remains the main laparoscopic procedure for treatment.
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