Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X 2 or Fisher test, its 95% confidence interval (CI 95% ), p value was significant if <5%. Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009; RR = 3.04; CI 95% [2.80 -5.11]), prolonged labor (p = 0004; RR = 4.00; CI 95% [3.06 -10.02]), oxytocin/prostaglandin use (p = 0003; RR = 1.47; CI 95% [1.17 -3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

The aim was to describe aspects of students' knowledge of sexuality and contraception and their sexual behaviour in schools in Ségou, Mali. Materials and Methods: This was a one-pass cross-sectional survey with reasoned choice at the first level and random choice at the second level over a 3-month period from January 2013 to March 2013. Results: The majority of the students involved in our study reside in the commune of Ségou, 90.4%. The average age of our students was 18. The female sex was the most represented in our study with 59.7%. The majority of students had casual sex at 60.3% and 70.9% irregularly. The change of sexual partner affected 47.9% of schoolchildren. Of our sexually active students, 72.6% had sexual partners and 37.4% had more than 2 partners. The main sources of information are respectively the media with 72.1% followed by teachers with 12.9% and friends with 09.7%. Among the most well-known contraceptive methods, condoms rank first with 72.6%, followed by injectable with 72.0%. 70.6% of the population had not yet used a contraceptive method at first sexual intercourse and in 72.9% of cases was condoms. The most cited source of contraceptive supply is pharmacy with 49.5% followed by family planning centres and maternity wards at 16.2% and shops at 16.2%. Conclusion: The referral of young people to approved health facilities for contraception could prevent them from risky sexual behaviours.

Post cesarean infections are the main sources of fever in the postpartum. We have undertaken this study in an African health setting where conditions of working are different from those in developed countries. Objectives: The objectives of this survey were to appreciate incidences, risk factors and prognosis of post cesarean infections. Method: We conducted a randomized historical cohort study in the department of gynecology and obstetrics of Gabriel Touré teaching hospital from 2010 to 2015. Data have been analyzed using X 2 or Fisher test according their application conditions, p value < 1% has been considered significant. Results: From 2010 to 2015 we performed 15,963 deliveries within 5263 cesareans sections (32.97%). According to all the deliveries, the global frequency of infection fluctuates from 1.5% in 2010 to 2.1% in 2015. The main risks that influenced the occurrence of post cesarean infections were: the context of cesarean section (RR = 2.05; CI 95% (1.35 -3.11); p < 0.01), the prolonged labor (RR = 1.38; CI 95% (1.05 -1.81); p < 0.01), the length of cesarean (RR = 3.00; CI 95% (1.89 -4.90); p < 0.01), and genital bleeding (RR = 1.50; CI 95% (1.10 -1.90); p < 0.01). The complications reported were endometritis (43.55%), wound infection (18.11%), breast infection (32.05%), puerperal psychosis (9 cases). We recorded six cases of pelviperitonitis and three cases of sepsis. Four cases of maternal death due to septic shock have been recorded (1.43%). Conclusion: Post cesarean infections constitute a real problem of public health in developing countries. In our survey, the main factors of infections have been context of cesarean, prolonged labor and length of cesarean. Endometritis, breast infection and wound infection are the major complications after cesarean section. The respect of protocol of the management of patients should permit to prevent this deadly complication.

Introduction: Late pregnancies are a hot topic for both women and perinatal health workers because of their increasing increase. In the elderly primiparous pregnancy, pregnancy has always preoccupied birth attendants for a long time because high-risk pregnancy is the one that is associated with certain risk factors that can hinder its normal evolution. Objective: Study childbirth in the elderly primiparous at the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a retrospective and analytical case/control study (1 case for 2 controls), from 1January 2019 to 31 December 2021.It had covered all deliveries recorded in the ward. Results: The frequency of delivery in the elderly primiparous was 0.36%. The most educated elderly primiparous accounted for 73.3% (p=0,000; OR= 2.014; 95% CI = [0.006-0.31]). Dystocia was the most common obstetric complication (p=0.13; OR= 0.69; 95% CI = [0.42-1.12]). Caesarean delivery accounted for 77.1% in cases versus 49% in controls (p=0.000; OR= 0.28; 95% CI = [0.170.48]). Apgar's score was greater than or equal to 8 in 90.5% of cases versus 82.4% of controls. We have not recorded any maternal deaths. Conclusion: Pregnancy and childbirth in the elderly primiparous are risk situations in some cases. Childbirth in the elderly primipare requires a skill that can detect and prevent morbid situations and allow adequate care.

Introduction: A descriptive analysis of contraception discontinuation, based on Demographic and Health Survey data from six countries with high level of contraceptive use, fonds that approximately one-third of couples discontinuous their contraceptive use, method within 12 months and about half cease within 24 months. Aim: Was to study the reasons for abandoning contraception at the Reference Health Center of Commune V of District of Bamako. Material and Methods: We carried out a prospective, descriptive and cross-sectional study on the reasons for abandoning contraceptive methods from January 1, 2020 to December 31, 2020. Results: The frequency of abandonment of contraceptive methods in Commune V was 18.19%. The main reasons mentioned among the 200 former users of contraceptive methods interviewed were side effects with 35% of cases, husband's opposition (10 %), complications (20%), the desire to pregnancy (10%), reception of clients and occasional unavailability of inputs (5%). Conclusion: Inadequate management of side effects and complications related to contraception, the husband's reluctance and rumors had been the determining factors in the abandonment of contraception.