Evaluation of Insertion with the New Inserter of the Intra-Uterine Device of the Postpartum at the Referral Health Center of Commune II of Bamako, Mali

Abstract

Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1 st 2016 to August 31 st , 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization's criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn't notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn't have any side effects in 98% of cases. Conclusion: The

Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

“…Spontaneous miscarriage: the frequency of abortion is 8.28% in our study. This rate is much lower than the results of other studies; Dao SZ, a Danish study [5] [9] [10], which respectively found L 15% and 54% miscarriage, while the overall risk is 8% at 22 years [3]. In our study, there is no associative link between the occurrence of ectopic pregnancy and maternal age, i.e.…”

“…This high rate corresponds to the results of many other series, Jo-Ann Johnson et al, AUDIPOG, Audrey Meyer respectively, Panel A et al[1] [18][21] [22] 50%, 43%, 40%, 43, 5%. In their study Dao SZ[5] et al found a lower cesarean section rate; its cesarean rate is 16.7%, three times higher in exposed patients than in unexposed patients, i.e. 5.8%.…”

“…Dao SZ [5], Loué V et al [6], ZONGO Georges Fructueux [7], Cyrielle Cuvillier [8] had respectively found a frequency of 1.68%; 2.8%; 2.81%; and 3.17%. This low rate can be explained by a natural drop in fertility at this period of genital life probably linked to ovulation disorders [2].…”

Emergency C-Section on Multi-Scar Uterus: Maternal and Fetal Prognosis at the Nianankoro Fomba Hospital in Segou, Mali

“…The same postoperative complications were reported in lower proportions than ours by: Dao S.Z. et al [13] with 1.81% of parietal suppuration, 1.44% of endometritis; Traoré S. et al [6] with 1.9% of parietal suppuration and 1.3% of anemia; 2.6% of endometritis.…”

Maternal Deaths in Patients Evacuated to the Fousseyni Daou Hospital in Kayes over a Decade

“…Of these, 284 cases died, a frequency of 4.2%. This frequency is higher than: from Thiam O [6] in Senegal in 2013, Seydou Z et al [7] in 2018 to CS Ref Commune II in Bamako, Mali, Touré S in 2019 in Banamba [8] which reported respectively 2%; 0.4% and 0.7%. The frequency of maternal deaths among evacuees is variously assessed, depending on the method of recruitment, the area and the duration of study.…”