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Volvulus of the Pelvic Colon in Pregnancy: A Case Report from the Surgical Department of the National Hospital of Ignace Deen, Teaching University of Conakry, Guinea
Naby Fofana,
Ansoumane Condé,
Massa Keïta,
Alseny Diallo,
Djiba Camara,
Sandaly Diakité,
Aminata Fofana,
Alpha Mohamed Youla,
Labile Togba Soumaoro,
Aboubacar Touré
Issue:
Volume 11, Issue 5, September 2023
Pages:
111-114
Received:
24 August 2023
Accepted:
12 September 2023
Published:
8 October 2023
Abstract: Introduction: Volvulus of the sigmoid colon in pregnancy is a rare and serious complication; prognosis depends on early diagnosis and appropriate surgical management. The high maternal-fetal morbidity is due to delayed diagnosis. Observation: We report a case of sigmoid colon volvulus in a 34-year-old multiparous woman. Her history includes chronic constipation; she has never undergone surgery and her pregnancy is currently being monitored. She was seen in emergency with abdominal pain, cessation of bowel movements and early gas, vomiting on a 26-week, 4-day amenorrhea, which had been evolving for 4 days. Obstetrical examination revealed an open cervix with endo uterine bleeding. The patient expelled a male fetus 2 hours after admission. An unprepared abdominal X-ray revealed a double-legged arch. The patient underwent surgery; the operative lesion being a 2-turn sigmoid volvulus with necrosis of the loop. The necrotic loop was resected and a Hartmann-type colostomy was performed; the peritoneal cavity was cleaned and drained. Results: Preoperative preparation of patients requires a collegial decision involving an obstetrician, a resuscitator-anesthetist and a surgeon, in order to discuss prophylactic tocolysis, corticosteroid therapy for fetal maturation and the surgical indication on a case-by-case basis. The standard surgical treatment is colectomy with restoration of colonic continuity, or colostomy if necrosis is present. Endoscopy is useful for emergency treatment of uncomplicated volvulus. Conclusion: diagnosis of sigmoid volvulus is difficult during pregnancy. It is a medical-surgical emergency requiring multidisciplinary management. The maternal-fetal prognosis depends on early diagnosis and rapid and adequate management. Standard surgical treatment is sigmoidectomy with immediate restoration of colonic continuity; in cases of necrosis, colostomy is indicated. Endoscopy is of vital importance in the emergency treatment of uncomplicated volvulus.
Abstract: Introduction: Volvulus of the sigmoid colon in pregnancy is a rare and serious complication; prognosis depends on early diagnosis and appropriate surgical management. The high maternal-fetal morbidity is due to delayed diagnosis. Observation: We report a case of sigmoid colon volvulus in a 34-year-old multiparous woman. Her history includes chronic...
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Determinants of Exclusive Breastfeeding Practice Among Recent Postpartum Women in a Level 3 Maternity Hospital (Abidjan, Côte d’Ivoire)
Diallo Sadio,
Ouattara Adama,
Dia Jean Marc,
Yao Ignace,
Okon Gerard,
Kume Stephane,
Tijani Fahimat,
Kehi Siaka,
Guie Privat
Issue:
Volume 11, Issue 5, September 2023
Pages:
115-119
Received:
4 September 2023
Accepted:
25 September 2023
Published:
8 October 2023
Abstract: Objective: To identify the obstacles to exclusive breastfeeding among recent postpartum women. Methods: A descriptive and analytical cohort study was conducted from December 5, 2021, to August 18, 2022, among recent mothers in a level 3 maternity hospital in Abidjan. This study involved 434 mothers and their newborns followed during their delivery period until 6 months postpartum. Results: The rate of exclusive breastfeeding was 18.4%. The rate of mothers with a satisfactory knowledge of exclusive breastfeeding was 27.6%. Protection against diseases and child growth were the most commonly cited benefits (84.6%). Healthcare personnel were the most represented source of information (68.3%), followed by the media (21.1%). The rate of initiating breastfeeding within 30 minutes after delivery was 21%. The reasons given by the mothers for introducing other foods were insufficient milk and the child’s thirst, which accounted for 64.6%. The factors influencing exclusive breastfeeding practice included age, marital status, profession, mode of delivery, and lack of awareness about exclusive breastfeeding. Conclusion: Our study found that the rate of exclusive breastfeeding is low (18.4%). It reflects the 12% national rate in Côte d’Ivoire. A large-scale awareness-raising policy directed toward all social strata and the creation of breastfeeding facilities in the workplace is necessary to improve this rate in our country.
Abstract: Objective: To identify the obstacles to exclusive breastfeeding among recent postpartum women. Methods: A descriptive and analytical cohort study was conducted from December 5, 2021, to August 18, 2022, among recent mothers in a level 3 maternity hospital in Abidjan. This study involved 434 mothers and their newborns followed during their delivery ...
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Acute Tocolysis Using a Single Bolus Dose of Atosiban for Preterm Labor Management: A Prospective Study
Bhupesh Dewan,
Siddheshwar Shinde
Issue:
Volume 11, Issue 5, September 2023
Pages:
120-124
Received:
15 September 2023
Accepted:
4 October 2023
Published:
14 October 2023
Abstract: Background: Preterm labor poses a significant challenge within obstetrics, carrying the potential for diverse complications for both maternal and neonatal well-being. Extensive clinical data indicates that atosiban stands as a secure and well-tolerated therapeutic alternative, exhibiting fewer adverse effects on both the mother and fetus compared to other tocolytic treatments. The investigation aimed to assess the feasibility of achieving optimal medical care by employing a solitary atosiban bolus dose. This approach holds the promise of mitigating the necessity for hospitalization, potentially enabling outpatient management of the condition. Aim: The purpose of the study was to assess the efficacy and safety of using a single bolus dose of atosiban to delay premature delivery. Material and Methods: The study included 75 patients experiencing symptoms of preterm labor. These patients were administered a single bolus dose of atosiban (6.5 mg/0.9mL). The study was conducted between August 2019 and July 2023. Results: The study successfully used a single bolus dose of atosiban to delay delivery by up to 48 hours, enabling corticosteroid prophylaxis. The participants' average gestational age was 32.1 weeks. Atosiban effectively delayed delivery in 68% of patients for an average of 13.3 days, with a range of 0-62 days. No adverse effects were reported by either mothers or fetuses during the study period. Conclusion: The study findings suggest that a single bolus dose of atosiban is an effective and safe treatment option for delaying preterm labor. The treatment provides short-term relief for an average of 13 days, with potential benefits over other tocolytics like isoxsuprine, ritodrine, and nifedipine due to fewer side effects. The intravenous bolus dose of atosiban has a quick onset and long-lasting effects, making it convenient for both patients and physicians. The approach is cost-effective and could be repeated after a few days if necessary. Overall, the study demonstrates the potential of using a single bolus dose of atosiban as an outpatient treatment to manage preterm labor effectively, offering benefits in terms of safety, convenience, and cost.
Abstract: Background: Preterm labor poses a significant challenge within obstetrics, carrying the potential for diverse complications for both maternal and neonatal well-being. Extensive clinical data indicates that atosiban stands as a secure and well-tolerated therapeutic alternative, exhibiting fewer adverse effects on both the mother and fetus compared t...
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Research Article
Obstetrical Emergencies: Clinic and Management at the Ignace Deen Maternity Hospital of the Conakry University Hospital Centre (Guinea)
Conté Ibrahima,
Diallo Abdourahamane,
Diallo Boubacar Siddi,
Sylla Ibrahima,
Yansané Fatoumata,
Bah Ibrahima Koussy,
Baldé Ibrahima Sory,
Sy Telly
Issue:
Volume 11, Issue 5, September 2023
Pages:
125-129
Received:
21 September 2023
Accepted:
10 October 2023
Published:
28 October 2023
Abstract: Introduction: the objectives of this study were to calculate the frequency, describe the clinic and management of obstetric emergencies in the maternity ward of the Ignace Deen national hospital. Methods: this was a prospective cross-sectional descriptive study lasting 6 months, from 1 January to 30 June 2019, covering all patients treated for obstetric emergencies in the maternity ward of the Ignace Deen National Hospital during the study period. Results: Obstetric emergencies accounted for 30.48% of consultations during the study period. The average age of patients was 26.30 years, with extremes of 15 and 45 years. Nulliparous women were the most represented with a rate of 34.73%. Emergencies occurred in full-term pregnancies in 71.29% of cases. Acute foetal distress and arterial hypertension and its complications were the main obstetric emergencies encountered, with proportions of 22.65% and 21.36% respectively. Treatment was surgical in 82.73% of cases. Maternal mortality was 5% and foetal mortality 30%. Conclusion: Obstetric emergencies are frequent in our working environment and are the cause of several maternal and perinatal deaths. Measures must be taken to improve monitoring of pregnancies and childbirth, which would make it possible to avoid most obstetric complications.
Abstract: Introduction: the objectives of this study were to calculate the frequency, describe the clinic and management of obstetric emergencies in the maternity ward of the Ignace Deen national hospital. Methods: this was a prospective cross-sectional descriptive study lasting 6 months, from 1 January to 30 June 2019, covering all patients treated for obst...
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Case Report
Chronic Non-Puerperal Uterine Inversion About a Case
Diakite Sandaly,
Conte Ibrahima,
Camara Fode Lansana,
Camara Soriba Naby,
Soumaoro Labile Togba,
Diakite Saikou Yaya,
Camara Ibrahima Sokhona,
Toure Aboubacar
Issue:
Volume 11, Issue 5, September 2023
Pages:
130-132
Received:
18 September 2023
Accepted:
14 October 2023
Published:
31 October 2023
Abstract: Chronic non-puerperal uterine inversion is an extremely rare complication. Puerperal inversions are reported in 85% of uterine inversion cases. Puerperal uterine inversions are life-threatening due to the cataclysmic delivery hemorrhage they cause. Most reported cases of non-puerperal uterine inversion are due to benign tumors, including leiomyomas. Rarely, a malignant uterine tumor presents as a uterine inversion. Clinical diagnosis is often difficult due to the distorted anatomy. Four anatomical stages are classically described Radical treatment is preferred in the absence of a desire for pregnancy, and is virtually indispensable in the case of 3rd and 4th degree uterine inversion. We report the case of a 42-year-old patient who presented urgently with a stage 3 non-puerperal uterine inversions and cyanosis of the external mass. We indicated sub hysterectomy by vaginal approach. This technique was decided upon intraoperatively in view of the lesion assessment. The authors agree that due to the rarity of this pathology, most cases are operated on without any surgical experience. A rare complication that is difficult to diagnose, acute non puerperal uterine inversion is a medical-surgical emergency that must be considered when a mass is externalized through the vaginal vulva, although in our context, delivery through the uterine cervix is often the hypothesis evoked.
Abstract: Chronic non-puerperal uterine inversion is an extremely rare complication. Puerperal inversions are reported in 85% of uterine inversion cases. Puerperal uterine inversions are life-threatening due to the cataclysmic delivery hemorrhage they cause. Most reported cases of non-puerperal uterine inversion are due to benign tumors, including leiomyomas...
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