Management of Non-Traumatic Urological Emergencies at Souro Sanou University Teaching Hospital of Bobo-Dioulasso (Burkina Faso)

Background: Generally, urological emergencies are assumed not to be very common, however, recent reports showed that they constitute an important aspect of the day-to-day urological practice. If not well and promptly managed, they may lead to serious morbidity or mortality. Objectives: To study the pattern of presentation, diagnosis and outcome of management of non-traumatic urological emergencies seen at the Emergency Department of Souro Sanou University Hospital in Bobo-Dioulasso. Patients and Methods: This was a retrospective and descriptive study over four years. It included patients of all ages and both sexes, admitted for non-traumatic urological emergencies in the surgical emergency department of Souro Sanou University Hospital. It took place from January 1, 2017 to December 31, 2020. Results: A total of 584 patients were reviewed in our study. Non-traumatic urological emergencies account for 6.3% of all surgical emergencies seen during the study period. The male-to-female ratio was 9.2 to 1. The mean age of the patients was 51.9 ± 23.9 years. Forty-five per cent of the patients presented within 48 hours of symptoms. The vast majority of the patients presented with difficulties with passing urine (41.6%), followed by cases of hematuria (18.4%). On admission, 154 patients (26.4%) presented with severe conditions such as anemia as seen in 40.9% of the cases and deterioration in the general health condition as seen in 34.4% of the patients. Leukocytosis was noted in 18.7% of the patients and anemia in 17.9%. Urine culture was positive in 15.4% of the patients and Escherichia coli was the most common pathogen found (40.6%). Ultrasound was the most requested examination (81.2%), followed by a computerized tomography (CT) scan (22%). The most frequent diagnoses were urine retention (42.9%), hematuria (16.9%) and renal colic (10.1%). Emergency interventions were carried out in 525 patients (89.9%) who include bladder catheterization (46.1%), bladder lavage and/or bladder irrigation (20.9%) and suprapubic cystocatheterization (10.1%). Most of the patients (61.3%) were discharged after a mean stay in the hospital of about 5.1 ± 7.5 days. A mortality rate of 3.8% was also recorded among the patients studied. Conclusion: Non-traumatic urological emergencies are common and are an important aspect of daily urological practice. The majority of the patient presents late with usually a severe form of the disease, which adversely affects the outcome even after treatment.

Sexual Assault in the Department of Obstetrics and Gynaecology of the Bamako’s 5th Municipality Medical Center

Background: The authors report cases of sexual assault reported to the obstetrics and gynecology department of the Bamako’s 5th municipality medical center during a prospective study of eight months from 1st January to 31st August 31st, 2012. Results: Twenty-one cases of assault were reported out of a total of 13,482 consultations, representing a frequency of 0%, 15%. Most victims were represented by students and accounted 43% of the study population. In 76% of cases the victims knew their assailant. The type of sexual contact was genito-genital vaginal penetration in 67% of cases and the condom was used in only one case. The average time before consultation was 3 days. The preventive ARV treatment was administered in 24% of cases and emergency contraception in 43% of cases. Conclusion: Sexual assault is common in Bamako. The reality is probably underestimated because many cases are not reported. The victims are mostly children and adolescents. The risk of transmission of STIs and HIV is very high during the sexual assault. Education and awareness of the population are essential for early consultation. Training of health workers to care for victims of sexual assault is needed.

Tuberculosis of the Uterine Cervix: About a Case and Literature Review

The authors report a case of tuberculosis of the uterine cervix observed at the maternity unit of the Souro Sanon Teaching Hospital (CHUSS) of Bobo-Dioulasso. This is a rare localization of genital tuberculosis and can take the appearance of a cervical cancer. Biopsy with histological study of the lesion confirms the diagnosis. The frequency of this pathology can reach up to 8%. The extension to the endometrium and/or tubes in a young woman may compromise future fertility. Early and well conducted TB treatment allows the ad integrum restitution cervix.

Place of Autologous Intraoperative Blood Transfusion in the Treatment of Broken Ectopic Pregnancy (EP) at the Chiphra Hospital of Ouagadougou, Burkina Faso

Objective: To describe the role of autologous regenerative intraoperative bleeding of recent intra-cavity losses over the ectopic pregnancy ruptured at the Schiphra Hospital of Ouagadougou. Methodology: It has been a cross-sectional descriptive study over a period of 18 months from January 1st 2014 to June 30th 2015 in the obstetrics and gynecology department at the schiphra hospital of Ouagadougou. In our study, we included all pregnant women having received emergency with a diagnosis of broken ectopic pregnancy complicated by a significant array of clinical haemoperitoneum and who have consented to participate in the survey. Results: During the study period, we recorded 322 cases of ectopic pregnancy, among which 106 were broken. Autotransfusion was performed in 59 patients, that is to say 18.3%. The average age of patients was 27 years (18 - 40). The average rate of childbirth was 5.25 (0 - 11). The general condition of the patients was pretty good at 8.5% and poor in 91.5% of cases. The average amount of blood transfused per patient was 935 ml with a range of 400 and 1600 ml. After autotransfusion, 62% of patients had greater improvement in hemoglobin 10 g/dl. Maternal prognosis was marked by a case of fever with a morbidity rate of 1.9% and a death post autotransfusion case fatality rate of 1.9%. Conclusion: In the context of shortage of blood products, autologous transfusion could be an alternative in the treatment of ruptured ectopic pregnancy in developing countries.

Urologic Complications after Gynaecologic and Obstetric Surgery at the Urology-Andrology Teaching Clinic of Teaching Hospital of Cotonou

Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of Urology Andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: Urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to the lack of endo-urological facilities. The most important factor in prevention is good knowledge of pelvicanatomy and good knowledge of the surgical techniques of caesarean operation section and trans-abdominal hysterectomy.

Quality Control of First Trimester Ultrasound Examinations in the Gynecology and Obstetrics Department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou, Burkina Faso

Objective: To evaluate the quality of first trimester ultrasound examinations in patients consulting in the gynecology and obstetrics department at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Method: Our study took place from January 1st to March 31st 2017, in the department of Obstetrics and Gynecology of the University Teaching Hospital Yalgado Ouedraogo of Ouagadougou. This was a descriptive study on the records of the first trimester ultrasound of pregnancy, with analysis of the iconography. We used the criteria of the Technical Committee of Fetal Echography (TCFE) of France to analyse all the ultrasound reports brought by the patients. Results: Two hundred reports were collected in three months. In terms of ultrasound identification, only 2 reports out of 200 mentioned the brand and date of first circulation and 4 specified the type of device. The study of the quality of the appointment showed that only 52% of the ultrasounds had been performed at the right time, between 11SA - 14SA of amenorrhea. For the nuchal translucency quality, we rated by the Herman score, 41.67% of the scores were of “unacceptable” quality and only 58.33% were of “acceptable” quality we did not achieve “excellent” quality. The analysis of the biparietal diameter (BIP) cuts revealed that 1/4 only anatomical cuts had been well made. Analysis of the cranio caudal length (CCL) cuts showed that only 14.58% of the CCLs had been well done. Elements of early morphology had been explored to less than 5%. Conclusion: The results revealed the acceptable quality of the NC measurements, but a small proportion of NC achieved. The quality of the ultrasound, morphological analysis and biometrics period is not very acceptable.

The Role of Ultrasound in the Diagnosis and Management of Trophoblastic Diseases (TMD) at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou

Objective: To describe the place of ultrasound in the diagnosis and management of Gestational Trophoblastic Diseases (GTD) at the Ouagadougou UTH-YO, Ouagadougou, Burkina Faso. Materials and Patients: It was a prospective and descriptive study over a 3-year period from 1 January 2015 to 31 December 2017. It took place in the gynecology and obstetrics department of at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Monitoring was based on clinical examination data, ultrasound and kinetics of β-gestational chorionic hormone (GCH) levels. Results: During the study period, we recorded 34 cases of trophoblastic diseases. The average age of the patients was 35 years with extremes of 22 and 52 years. Physical examination revealed a uterus larger than gestational age in 17 patients (56.67%) of cases. Eight (26.67%) patients were asymptomatic. The initial mean β-GCH was 453,747.8 IU/l with extremes of 5903 IU/l and 1,890,000 IU/l. Ultrasound was used to evoke the diagnosis in 23 patients, that to say 76.67% of the cases. Ultrasound identified 10 complete mole cases, 20 partial mole cases. For the 3 cases of invasive mole, pelvic ultrasound revealed heterogeneous intrauterine multi-vesicular images. In a case of choriocarcinoma, ultrasound found an enlarged uterus with a poorly limited intracavitary heterogeneous fundic image. Conclusion: This short series shows the central role of ultrasound in the diagnosis and follow-up of gestational trophoblastic diseases. Indeed, the sensitivity of ultrasound is excellent in the early diagnosis of complete moles. Ultrasonography remains a good examination choice for the diagnosis of gestational trophoblastic tumors despite their great polymorphism. The place of ultrasound in prognostic evaluation and treatment monitoring deserves to be studied by more important series.

Causes of Maternal Mortality According to Reports of Maternal Death Audits in the University Teaching Hospital Bogodogo (UTH-B) from January to December 2017

Objective: To study causes of maternal mortality according to reports of maternal death audits in the University Teaching Hospital Bogodogo (UTH-B) of Ouagadougou, Burkina Faso. Materials and Method: This was a prospective study that took place over a year from 1 January to 31 December 2017.? It concerned maternal deaths that occurred during this period in the obstetrics and gynecology department of the University Teaching Hospital Bogodogo (UTH-B). All maternal deaths were systematically audited by the audit committee;interviews with providers and families were sometimes conducted. The record books of all patients were analyzed by the audit committee;if necessary, interviews were conducted with care providers and families. The main information collected were recorded on individual files, entered and analyzed using the software Epi-info 7. Result: During the study period, we recorded 32 maternal deaths i.e., 587 per 100,000 live births. Deceased women under age 20 were the most numerous, followed by women aged 20 to 24. The death occurred in most cases in the puerperium in 69.80% of cases. Complications of pregnancy were the most incriminated causes in maternal deaths. Bleeding was the leading cause, accounting for 34.3%. They are followed by hypertensive disorders of pregnancy (21.8%) and infections (18.8%). In the contributing factors, resource factors were incriminated in 56.2% of cases, social factors in 43.7% of cases and medical factors in 25.4% of cases. Death was non-preventable in 76.2% of cases compared to 23.8% of preventable deaths. Conclusion: Maternal mortality is a major public health problem at the maternity hospital of the university hospital Yalgado Ouedraogo. Hemorrhage is the first cause of death. Hypertensive diseases are more and more worrying. Solutions must be found to improve the practice of audits in the obstetrics and gynecology department of UTH-B.

Management of a Severe Form of Verneuil’s Disease in Its Genitoperineal Localisation in Bobo-Dioulasso

The authors report a severe form of genitoperineal localisation of Verneuil’s disease managed in a surgical environment, having evolved favorably with improvement of the patient’s quality of life, but persistence of unsightly skin scars. They insist on the unexceptional nature of this disease whose prognosis is reserved, sometimes leaving severe functional sequelae. The long evolution of the disease with prolonged hospitalization in a professionally active young patient and the extension of suppurations to the perineal, scrotal and inguinal regions was the features of this observation. After wide excision of the lesions with antibiotic associated with local care, evolution had taken to complete wound healing with improved quality of life and a recovery of his professional activity.

Acute Urinary Retention among Adult Men at Bobo-Dioulasso University Teaching Hospital: Epidemiology, Aetiologies and Initial Management

We conducted a cross-sectional study between February 1st, 2012 and September 30, 2012 at Bobo-Dioulasso University Teaching hospital. The target population was all patients seen at the emergency services for acute urinary retention. Among the 155 patients admitted for urological emergencies, 104 (67.1%) had acute urinary retention. The average age of patients was 65 years, ranging from 23 to 89 years and the majority was more than 60 years old (77.8%) and lived in rural areas (64.4%). Prostate tumor pathology and urethral stricture were the most frequent diagnosis, and the renal function was impaired in 33.7% of cases. Urethrovesical drainage, cystocatheterism, and suprapubic cystostomy were the treatment approach in 56.0%, 28.0% and 15.2% of the cases. Acute urinary retention is the most common urological emergency and many complications are associated with urethrovesical sounding. These complications should therefore be prevented by improving acute urinary care.

An Unusual Intravesical Foreign Body for Abortion Attempt. About a Case Report at Bobo Dioulasso University Teaching Hospital (Burkina Faso) and Literature Review

We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and therapeutic of intravesical foreign body. This observation also highlighted the lack of information in our teenagers about reproductive and sexual health.

Particularities of Pregnancy and Childbirth among Adolescents’ Girls in the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou, Burkina Faso

Objectives: To study the particularities of pregnancy and childbirth among adolescent girls at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Patients and Method: This was a comparative, descriptive and analytical cross-sectional study conducted over a 6-month period on 138 adolescent girls and 276 adults who gave birth in the obstetrics and gynecology department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou during the study period from May 1 to October 30, 2017. The statistical analysis had used the Chi square test and the strength of the association was appreciated by the Odds Ratio (OR). The significance threshold was set at 5%. Results: Adolescent girls had an average age of 17.04 ± 0.72 years and 64.49% were married. The majority came from urban areas and was educated. Housewives were more represented with 73.2% and 65.94% of adolescent girls were of low socio-economic status. Concerning the level of education, 48 (34.7%) were out of school, 57 (41.3%) had primary level, 32 (23.2%) secondary level and 1 (0.7%) higher level. Primigravida was the most numerous and only 39 adolescent girls used a contraceptive method. Malaria (p = 0.0247), preeclampsia (p = 0.0008) and anaemia (p = 0.0002) dominated pathologies during pregnancy in adolescent girls. The pelvis was borderline in 10.8% of adolescent girls. For newborns, teenage girls had a lower weight and an Apgar score of less than 7 higher. Perinatal mortality was higher (p = 0.0269). Postpartum outcomes were marked by complications with endometritis type (p = 0.0315) and higher maternal mortality (p = 0.0049). Conclusion: The teenagers’ pregnancy experience is marked by high maternal and perinatal morbidity and mortality. The promotion of contraception among adolescents should help to resolve this unpleasant situation.

Quality Control of Second Trimester Ultrasound Examinations in the Gynecology and Obstetrics Department of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou, Burkina Faso

Objective: To evaluate the quality of second trimester ultrasound examinations in patients consulting in the gynecology and obstetrics department at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Method: Our study took place from January 1st to March 31st 2017, in the department of Obstetrics and Gynecology of the University Teaching Hospital Yalgado Ouedraogo of Ouagadougou. This was a descriptive study on the records of the second trimester ultrasound of pregnancy, with analysis of the iconography. We used the criteria of the Technical Committee of Fetal Echography (TCFE) of France to analyse all the ultrasound reports brought by the patients. Results: Three hundred ultrasound reports were collected over three months. It revealed that, in terms of patient identification, 100% of the reports bore the surname and first name of the pregnant woman;88% and 94.67% of the ultrasound scans bore the surname and first name of the ultrasound specialist respectively. Only 2% presented the brand and type of ultrasound scanner. The study of the quality of the appointment showed that 52% of the ultrasounds had been performed at the right time, between 20 Gestational Age (GA) and 25 GA. For the quality of the iconography, referring to the recommendations of the Technical Committee of Fetal Echography (TCFE) of France and taking into account the data confirmed by the literature, we found that the quality was slightly acceptable either respectively for biometric and morphological sections. Conclusion: The quality of the ultrasound reports of the second trimester ultrasounds in patients consulting in the obstetrics and gynecology department of the University Hospital Yalgado OUEDRAOGO was not totally satisfactory.

Management of Malaria in Pregnant Women at the Maternity Unit of the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou: About Report on the Quality of Care

Objective: To do a report on the quality of the treatment of malaria in pregnant women at University Teaching Hospital Yalgado Ouedraogo (UTH-YO) in Ouagadougou. Materials and Methods: This was a descriptive cross-sectional study conducted from 29 July to 02 October 2016. The targets were pregnant women and gynecology and obstetrics service care providers. The study used an individual questionnaire administered and clinical parasitological research by the Rapid Diagnostic Test (RDT). Some information was verified in the patient’s prenatal consultation logbook. A total of 351 women and 44 providers participated in the study. The data was captured on a microcomputer and analyzed using Epi info version 7 software. Results: Regarding preventive measures, patients’ responses were correct for long-lasting impregnated mosquito net (LLIN) in 98.8% of cases and for intermittent preventive treatment (IPT) in 96.5% of cases. About providers, they had given a good answer in all cases for using LLIN and taking IPT. Regarding care providers’ knowledge of the clinical signs of malaria, fever was cited in 95.5% of cases for simple malaria and Frankish jaundice in 97.7% of cases for severe malaria. With regard to curative treatment, 77.3% of the care providers surveyed stated that quinine was the reference molecule for the treatment of simple malaria in pregnant women. In terms of the availability of inputs used for malaria management, our survey found no RDTs. Also, the only molecule available was quinine in its compressed and injectable forms. Conclusion: Care Providers’ and patients’ knowledge of malaria in the obstetrics and genecology department is quite satisfactory. However, some shortcomings were noted in the provision of screening and curative and preventive treatment. The elimination of malaria in our country will require joint efforts at all levels.

Prognosis of Misgav-Ladach Caesarean Sections in an African Environment: Case of the Banfora Regional Hospital in Burkina Faso about 110 Cases

Objective: To analyze the caesarean section prognosis aspects according to Misgav-Ladach versus classical technique in the regional hospital of Banfora. Materials and Methods: This is about a randomized clinical test of 2 groups carried in the regional hospital in Banfora on a two-month period from 1st October to 30 November 2015. In the first group, 66 patients had benefited from a caesarean section by the Misgav-Ladach technique. In the control group, 44 patients had benefited from a caesarean in the conventional technique. Were included in our sample all patients having benefited from a cesarean in the study site during the study period and who had consented to participate in the study. All patients were followed until the postpartum healing of the surgical wound. All prognostic elements have been compared. The results were analyzed with Epi Info 3.5.1 software and the significance level was set at 5%. Results: The indications for cesarean section were dominated by maternal causes in 70 cases (63.6%). The average duration of the surgical procedure was 27.98 mm for Misgav-Ladach technique versus 28.27 mm for the conventional technique (p = 0.49). The evaluation of blood loss by the change in hemoglobin pre- and post-operative did not find statistically significant differences between the two techniques (p = 0.6). The evaluation of the number of intraoperative suture used, was in favor of the technique of Misgav-Ladach (p = 0.007). The evolutionary trend in the intensity of postoperative pain was in favor of the technique of Misgav-Ladach. The average time of wound healing was 16.33 days for group 1 versus 21, 27 days for group 2 (p = 0.0001). Postoperative morbidity was greater with the conventional technique in comparison to Misgav-Ladach’s (p = 0.046). There was no statistically significant differences in length of hospital stay (p = 0.056). Conclusion: The Misgav-Ladach cesarean section reduces operative risk. The adoption and diffusion of this technique to the national level and its effective integration into training curriculas should contribute to reducing maternal morbidity and mortality of abdominal delivery.

Indications and Prognosis of the Hysterectomy Operation in the Obstetrics and Gynecology Department at the University Teaching Hospital of Ouagadougou(UTH-YO),Burkina Faso

Objective: To describe the indications and the prognosis of the hysterectomy operation in the obstetrics and gynecology department at the UTH-YO, Ouagadougou, Burkina Faso. Methodology: It has been a descriptive cross-sectional study over a period of 18 months from 1 January 2014 to 30 June 2015 in the obstetrics and gynecology department of the UTH-YO. The variables studied were demographics, clinical and prognostic aspects. Results: During the study period, we recorded 128 cases of hysterectomies including 20 obstetric causes (15.62%) and 108 gynecological cases (84.38%). The incidence of hysterectomy was 3 per 1000 births. Gynecological indications were dominated by uterine fibroids (47.3%), genital prolapse (20.4%), cervical dysplasia (9.3%) and functional bleeding (7.4%). Obstetric indications were dominated by uterine ruptures (60%), the postpartum haemorrhage (15%). The prognosis of obstetric indications was marked by 5 cases of bladder lesions or a morbidity rate of 3.9% and 4 deaths that to say a fatality rate of 3.1%. Conclusion: The prognosis of hysterectomies should be improved with further training of health workers in surgical techniques, the adoption of strategies to reduce maternal mortality and community awareness in attendance at health facilities.

Episiotomy: Epidemiological Aspects, Indications and Prognosis in the Bogodogo Health District

Objectives: To study the epidemiological aspects, indications and short and medium term prognosis of episiotomy in the health district of Bogodogo in Ouagadougou, Burkina Faso. Materials and Method: It was a descriptive prospective study over 4 months from 1 July 2016 to 30 October 2016. It was conducted in 4 health facilities in the health district of Bogodogo in the city of Ouagadougou. The study concerned the patients who gave birth after 28 gestational age (GA) and more, vaginally with episiotomy, in the 4 health facilities and who were reviewed at the appointment of the 9th day and the 3rd month. The data were collected using a questionnaire developed for the purposes of the study, seized with a laptop, then analyzed using the Epi-info software in its 3.5.1 version of the Atlanta C.D.C. Statistical comparisons were made using the Pearson chi-square test, with a significance level of p 0.05. Results: The overall episiotomy rate was 22%. For follow-up, 248 patients were reviewed on the 9th day and 109 patients on the 3rd month. The average age of our patients was 23.1 years. The average number of pregnancies was 1.7 with nulliparous women predominating (60.5% of cases). Excision was associated with episiotomy in 92.3% of cases, with perineal narrowing in 82.5% of patients. The mediolateral episiotomy was the most performed, in 76.6% of patients. Vulvo-perineal stricture was the main indication (75% of cases). The experience during the episiotomy and the evolution following the immediate layer was marked by pain. Dyspareunia was the main difficulty in resuming sexual intercourse. Conclusion: The episiotomy rate in our study was 22%. A program of continuous improvement of the quality of care concerning episiotomy encompassing various actions (audits, training) could reduce the use of episiotomies.

Intra-Hospital Delay in Emergency Care at the Obstetrics and Gynecology Department in the University Teaching Hospital of Ouagadougou(UTH-YO),Burkina Faso

Objective: To investigate the intra-hospital delay in the treatment of gynecological and obstetric emergencies in the obstetrics and gynecology department at the UTH-YO. Patients and methods: It has been a prospective and descriptive study over a period of four months from 1 May to 31 August 2015 in the obstetrics and gynecology department at the UTH-YO. All patients and their escorts were included in our study, admitted to gynecological or obstetric emergencies who have accepted to participate in the survey. Data were entered and analyzed using a PC equipped with the SPSS 16.0 software English version. Results: During the study period, we recorded 2627 admissions. Delays in the management involved 216 patients or a frequency of 8.2%. The average age of patients was 26.6 ± 6.2 years, ranging from 16 and 46 years. Patients had no income in 165 cases (that is to say 76.4%). The referred patients accounted for 165 admissions (85.7%). The intake patterns were dominated by obstetric acute fetal distress in 44 cases (20.4%), pre-failure syndrome in 27 cases (that is to say 12.8%) and in gynecology by the ectopic pregnancy in 171 cases (79.3%). The average waiting period between the arrival of a patient and the beginning of first aid was 2 hours and 23 minutes with extremes of 16 min and 546 min. The main reason for the delay was the unavailability of the operating room in 61.1% of cases. The opinion of escorts was dominated by improving communication with the creation of a post of information in 47% of cases. Maternal prognosis was marked by a maternal death in 0.1% of cases and maternal morbidity in 13.4% of cases. The fetal prognosis was dominated by death at birth in 13.8% of newborns. Conclusion: Despite the subsidy of the government in obstetric and neonatal emergencies, there remain intra-hospital delays in the management of emergencies. The opening of discussions between the various stakeholders responsible for the implementation of this grant is urgent to contribute more effectively to the fight against maternal mortality.