Introduction: Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. Objective: To assess the practice of AMTSL in four maternity in the commune of Kara (
Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.
Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.
Introduction : Le but de cette étude est de déterminer les principales complications des suites de couches à la maternité du CHU-Kara. Patientes et Méthodes : il s’est agi d’une étude rétrospective et descriptive menée du 1er janvier 2017 au 31 décembre 2020 portant sur les complications des suites de couches au CHU Kara. Résultats : 300 cas de complications du post partum soit une fréquence de 3,13% ont été enregistrées dans le service de gynécologie-obstétrique du CHU Kara. La majorité des patientes était référée (59,33%) avec une tranche d’âge comprise entre 18 et 30 ans (49%). Les complications des suites de couches majoritaires étaient les complications hémorragiques 59,31%, l’anémie du post partum 17%, l’endométrite 9,33% et l’éclampsie du Post partum 6,30 %. Toutes ces complications ont nécessité une prise en charge médicale et obstétricale. L’hystérectomie et la triple ligature vasculaire ont été effectuées respectivement dans 1,69% et 3% des cas. Nous avons enregistré 17 décès maternels soit 6%. Conclusion : Il ressort de cette étude que les complications hémorragiques étaient les plus fréquentes en suites de couche au CHU Kara. La meilleure prise en charge de ces complications du post partum passerait par une meilleure réorganisation du système de prise en charge et un renforcement du plateau technique de toutes les structures sanitaires.
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