Rising caesarean birth rates in recent decades are an issue of public health. Potential harms for mothers and newborns are associated with caesarean delivery. Determinants of caesarean birth rates in Benin are unknown. The objective was to assess changes in caesarean rate and compare its indications before and during the implementation of policy of caesarian section fee exemption (PCSFE) in an urban district hospital in Cotonou, Benin. This cross-sectional study conducted at Suru Léré hospital, Cotonou, in 2014. Data on caesarean section were collected from completed medical records of 2104 women who underwent caesarean section before and during the implementation of the PCSFE. Caesarean rates by quarter varied between 17% and 26% (p=0,133) before the PCSFE while the rate increased significantly from 28% to 48% (p<0,001) during the implementation PCSFE. During the period of implementation of PCSFE, frequencies of "placenta praevia" (p = 0.022) and excessive uterine height (p <0.001) were significantly higher while frequencies of "uterine pre-rupture syndromes" (p = 0.017) and generally contracted pelvis (P = 0.013) decreased compared to period prior the PCSFE. Caesarean section rate increased during the implementation PCSFE and some caesarean section indications increased during the PCSFE. Further prospective studies are needed to follow the evolution of indications of caesarean section to inform preventives measures in urban district hospital Suru Léré Cotonou.
Introduction: Breast cancer remains a global public health problem. In Benin, it is the first type of cancer developed by women and it causes an important morbidity and mortality. Objective: The purpose of this study is to assess women's knowledge, attitudes and practices regarding breast cancer screening in a hospital located in the southern side of Benin republic. Framework and study method: We conducted a descriptive cross-sectional study exploring the knowledge, attitudes, and practices of women regarding breast cancer screening. The population studied was made of women of 30 years old minimum admitted at the mother and child hospital (HOMEL) from July 1 st to September 30 th 2017. The data were collected using a structured questionnaire. Results: The participation rate to this survey was 67.1%. The average age of the respondents was 35.2 years old with extremes ranging from 30 to 48 years old. They were traders by profession (43%) with a level of education not exceeding the primary school in 42% of cases. They had heard about breast cancer in more than 9 out of 10 cases; by the media in half of the cases. Breast cancer risk factors were unknown in 51% of cases; Breast self-examination was practiced by 57% of the women, 6% of which conducted it properly. More than 8 out of 10 women (84%) had never been screened for breast cancer. Conclusion: Public awareness must be strengthened by all available means, including media, schools and social gatherings and waiting areas in primary health care centers.
Objective: Vertical transmission of HIV remains the second mode of infection in Benin. To study the epidemiological aspects of HIV infection during the pregnancy at University Hospital Centre for Mother and Child Lagoon (CHU-MEL). Patients and methods: We conducted a descriptive cross-sectional study at the Mother and Child Hospital in Benin from 1 January 2015 to 30 June 2017. The sampling was exhaustive. The selection criteria were: all pregnant or parturient seropositive who were taken care of during the study period at HOMEL. The data analysis was done with the Epi Info software, by calculating averages and standard deviations. Results and conclusion: The prevalence rate of HIV amongst pregnant women was 1.9% (188/9554). The average age was 30 years old ± 5 years. They were married (45.6%), crafts women (67.7%), lived in a monogamous family (60.3%) and gave birth at least once (73.8%). The prevalence rate varied depending on the level of education; it was lower among the unschooled (17.5%), around (7.4%) among those who went to high school and higher among those with an intermediate level of education. HIV prevalence remains stable in the population of pregnant women. The education of young girls and the increasing purchasing power of women must be taken into consideration when drafting HIV control strategies.
Objective: To evaluate the prognosis of unfollowed pregnancies at a referral hospital of the district. Patients and methods: This was a cross-sectional, retrospective, descriptive study over a period of six (6) months, from May 1 st to November 30 th , 2016. Results: The frequency of unfollowed pregnancies was 21.5%. The post-partum women were young (75.8% aged between 20 and 34 years old), uneducated (43.9%), and sellers (30.3%). The complications at admission were mostly pre-eclampsia (54%), placenta previa (21%), retroplacental hematoma (11%) and postpartum complications were anemia (74%), immediate postpartum hemorrhage (9%) and infection (6%). Cesarean section was performed in 38.9% of cases.The stillbirth rate was 8.5 per 1000 births and the early neonatal mortality rate was 36.5 per 1000 live births. Conclusion: unfollowed pregnancies still remain a global health problem in developing countries. They constitute a pejorative element for perinatal and maternal prognosis in terms of morbidity and mortality.
Objective: To evaluate factors related to the maternal and perinatal prognosis of gestational diabetes.
Patients and Methods:It was a prospective case-control study carried out from February 1 st , 2015 to July 31 st , 2017 at the maternity of the University Hospital Center (CHU) of Porto-Novo in Southern Benin. We screened gestational diabetes in all pregnant women admitted to antenatal care with a gestational age between 24 and 28 Weeks of Amenorrhea (WA), and who agreed to participate in the study.
Results:There was a high correlation between the delivery route and gestational diabetes, with a higher caesarean section rate [OR 2.51 95% CI (1.55-4.67)]. The maternal prognosis was more severe for women with diabetes than it was for women without diabetes. Maternal morbidity was marked by pre-eclampsia [OR 2.90 CI 95% (1.74-4.84)], urinary tract infection [OR 2.86 CI 95% (1.49-5.48)], fetal and pelvic disproportion [OR 2.67 CI 95% (1.55-4.67)] and immediate postpartum hemorrhage [OR 2.93 CI 95% (1.41-6, 07)]. Perinatal prognosis was also more severe with diabetic women than it was for non-diabetic women. Perinatal morbidity was marked by stillbirth [OR 2.77 CI 95% (1.11-6.92)], fetal asphyxia [OR 2.54 CI 95% (1.44-4.50)], immediate neonatal distress [OR 2.64 CI 95% (1.35-5.16)], secondary neonatal distress [OR 5.85 CI 95% (2.57-13.29)], macrosomia [OR 6.16 CI 95% (3.29-11.50)] and neonatal hypoglycemia [OR 5.12 CI 95% (1.57-16.76)]. The neonatal lethality rate was 5-times higher with diabetic women [OR 5.12 CI 95% (1.57-16.76)].
Conclusion:This study confirmed that gestational diabetes increases the risks of a pregnancy for the mother, the fetus, and the newborn.
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