Study of Harmful Vaginal Practices of Women in the Municipality of Ouagadougou, Burkina Faso

Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the different vaginal practices of women using non-pharmaceutical products. Methodology: This was a cross-sectional study with descriptive and analytical purposes that took place from January 15 to April 23, 2023, in the four largest markets in the municipality of Ouagadougou. This was performed using the data collection sheet in the KoboCollect application. Epi info 7.2.5.0. software was used for data analysis. For the analysis of associated factors, a p-value Results: In total, 977 women were surveyed. Among them, 43.19% underwent vaginal procedures using non-pharmaceutical products. The female practitioners were 34.34 ± 7.44 years old. The products used included plants, mineral substances, ointments, tablets, and solutions. Among the practicing women, 40.99% were looking for vaginal tightening. The main purpose was to maintain their partners (45.97%). Three-point thirty-two percent (3.32%) of the women who underwent vaginal procedures had reported adverse events. Conclusion: Raising awareness of the consequences of vaginal practices and encouraging women to go to a health center for any gynecological problem could significantly reduce the prevalence of vaginal practices.

Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.

Effects of β-Glucan Supplementation on Repairing of Phenol-Induced Vaginal Mucosal Epithelium Damage in Rats

Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.

Spontaneous Paravesical and Broad Ligament Hematoma after Vaginal Delivery Had Uterine Artery Embolization after Evacuating the Hematoma

Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.

A Clinical Study to Assess the Effectiveness of Oral Combination Kit Therapy in Syndromic Management of Abnormal Vaginal Discharge (FEMINE Study) in Kinshasa, Democratic Republic of Congo

Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS® combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS® combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.

Vaginal microbes confounders and implications on women's health

The vagina has diverse vaginal microbes(Vm).A disturbance in the delicate balance maintained in Vm is linked to women's obstetrical and reproductive tract problems.Vaginal microbes play an essential role in protecting the health of the female reproductive tract by alleviating gynecological infection.However,Vm profiling has many confounders that need to be addressed during sampling,including age,race,pregnancy,medical illness,and smoking.Vm profiling improves reproduction odds,may serve as a marker for genital malignancies and have a therapeutic application in menopausal women and women with cervical cancers.

Vaginal Progesterone (VP) versus VP plus Intermittent Intramuscular Progesterone (IMP) Use in Frozen/Thawed Blastocyst Transfer Cycles: An Observational Cohort Study

Objective: Comparison of vaginal progesterone (VP) versus VP and intermittent intramuscular progesterone (IMP) use in frozen/thawed blastocyst transfer cycles. Study Design: A single center retrospective analyses of 470 elective FET cycles which were performed between January 2015 and September 2019 were evaluated. Patients were divided into two groups. Control group was consisted of VP (n = 272), the study group was consisted of VP plus IMP (n = 198) users. Results: The number of transfer attempts in control and study groups was 272 and 198, respectively. Age (29.8 ± 4 vs 30.6 ± 4;p = 0.09), BMI (22 ± 2 vs 21.9 ± 3;p = 0.79) and the number of transferred embryos (1.4 ± 0.5 vs 1.4 ± 0.5;p = 0.48) were comparable between groups. Altough, implantation rates (43.7% vs 43.6%;p = 0.9), ectopic pregnancy (0.8% vs 0.3%;p = 0.46) and abortion rates (8.2% vs 4.8%;p = 0.07) were similar. Biochemical pregnancy rate (8.4% vs 3.4% p = 0.01) in control group and ongoing pregnancy rate (OPR) (27.9% vs 38.1%;p = 0.005) in study group were significantly higher. Conclusion: Within the FET cycles in which good quality blastocyst are being transferred additional IMP supplementation to VP may increase OPR while reducing the biochemical pregnancy rate.

Prediction of Success Rates of Vaginal Birth after Cesarean Delivery According to the Previous Indication for Cesarean Delivery

Background: Trial of labor after cesarean delivery (TOLAC) has long been accepted as a safe option for women with previous cesarean delivery. Previous efforts have been exerted in trials to predict the success rates of TOLAC according to specific parameters related to previous cesarean section and before TOLAC. We aimed to investigate the different indications of previous cesarean delivery as independent predictors for successful vaginal birth. Methods: A retrospective study was conducted in Armed Forces Hospitals of the Southern Region between December 15, 2019, and July 1, 2020. The included 566 patients with previous cesarean section who were willing to undergo a trial of labor were divided into two groups according to the success of vaginal birth (VBAC). Results: The nonrecurring indications for previous cesarean delivery were higher in the successful group (fetal distress 54.7% vs 41.1%, malpresentation 26% vs 21.4%, multifetal pregnancy 3.8% vs 2.7%). Additionally, the successful VBAC group had a significantly higher percentage of previous successful VBAC (47.7% vs 21.9%) and prior vaginal deliveries (58.5% vs 44.2%) and less coincidence of medical disorders and meconium-stained liquor (18.1% vs 26.3% and 3.2% vs 8.2%, respectively) than the unsuccessful group. Conclusion: During counseling regarding trial of labor after cesarean section, indications for previous cesarean section not related to arrest of labor can predict higher success of VBAC. Moreover, previous successful vaginal delivery or VBAC improves the success rates.

Vaginal Caesarean Section: A Review of Indications in Mali

Introduction: The vaginal caesarean described since the 19th century remains unknown to many practitioners. The publications available on the subject are rare. The objective of this review is to report the experience of our team in Mali on vaginal cesarean section. Materials and Methods: This is a documentary review of a series of 5 cases on the practice of vaginal caesarean section at the Sominé Dolo Hospital and Reference Health Center of the Sanitary District of Bla in Mali between 2005 and 2022. Results: We performed a vaginal caesarean section on 5 patients in this series. The indications were retroplacental hematoma in 2/5 cases including 1 with a live fetus, eclampsia crisis in 1/5 cases, dystocia on uterine prolapse in 1/5 cases and beating cord prolapse in 1/5 cases. In the 5 cases, the pregnancy was not at term. In 3/5 cases, cesarean section was indicated to save the non-term fetus with a very low possibility of success by classic cesarean section and in 2/5 cases for maternal rescue with fetal death in utero. 2 live newborns were released in satisfactory condition, 1 died after 6 hours of life. Antibiotic therapy was not necessary in the majority of cases. The average length of hospitalization was 3 days. Conclusion: The circumstances of the realization of the vaginal cesarean section in our series of studies remain frequent in the practice of modern obstetrics. The short duration of hospitalization and the low use of antibiotics can contribute to the reduction of the medical cost of caesarean section in low-income countries, such as Mali.

Prevalence and Risk Factors of Vaginal Trichomoniasis in Women: Study at the University Hospital of Pikine in the Suburbs of Dakar, Senegal

Introduction: This study aimed to investigate the epidemiology of genital trichomoniasis in Senegal. It sought to determine the prevalence and risk factors associated with this condition in Senegal. Methodology: The study took place at the university hospital of Pikine in the suburbs of Dakar. For each of the women recruited, socio-demographic data, clinical examination data and the results of direct examination of the vaginal sample were collected in a questionnaire designed for this purpose. Results: A total of 312 women with a mean age of 31.13 (±8.41) years were recruited in this study. The majority of these women (59.94%;95% CI = 54.25 - 65.38), were seen for an infectious diseases assessment. Leucorrhea (58.33%;95% CI = 52.63 - 63.83) and genital discharge on vaginal touch (99.36%;95% CI = 97.45 - 99.89) were the predominant signs on clinical examination. The overall prevalence of vaginal trichomoniasis after direct examination of the specimens was 1.28% (95% CI = 0.41 - 3.47). Only the distribution of this prevalence by occupation was statistically significant (p = 0.0004). Conclusion: The low prevalence of genital trichomoniasis in women and the risk factors associated with it found in this study, which took place about ten years ago, should prompt an update of the data to better define the problem in Senegal.

Vaginal Birth after a Cesarean Section at Good Shepherd Mission Hospital at Tshikaji in Democratic Republic of the Congo (DRC)

Background: The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%, the lack of the information about the safety of vaginal birth after cesarean delivery pushes most of obstetricians to increase the num ber of cesarean sections following a previous cesarean section. Guidelines for Vaginal birth after cesarean (VBAC) indicate that TOLAC offers women with no contraindications and one previous transverse low-segment cesarean. The objective of the current study was to study the outcome of trial of labour after caesarean section (TOLAC), the indications for emergency repeat cesarean section and to determine the maternal and fetal prognosis in vaginal birth after caesarian section (VBAC) at Tshikaji Mission Hospital. Patients, Material and Methods: This is a retrospective study of the records of 126 women were selected to undergo the TOLAC in the department of gynecology and obstetrics at the Tshikaji Mission Hospital over the period from January 1st to December 31st, 2021. The data on demography, antenatal care, labour and delivery and outcomes were collected from the maternity unit of this hospital. The data were analyzed using SPSS version 2.0. Results: The TOLAC in 126 studied women. The course of work allowed vaginal delivery 107 parturient women, a success rate of successful VBAC of 85% after the TOLAC. The repeat emergency cesarean section was necessary for delivery in 15% of cases for failed TOLAC. There was no maternal mortality, but we recorded one fetal death or 0.8% of perinatal mortality, 2 cases of cicatricial dehiscence, the incidence of 1.6%. Maternal morbidity after delivery on cicatricial uterus was dominated by postpartum hemorrhages, with 19 cases or 15.1% of cases. Cervical dilatation of more than 3 cm at the time of admission, the parity more than 3 and were the significant factors in favor of a successful VBAC. Birth weight of more than 3500 g, fetal distress and malpresentation were associated with a lower success rate of VBAC. The TOLAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. Conclusion: Pregnancy on a cicatricial uterus represents a high-risk pregnancy. Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. There is a significantly high vaginal birth after caesarian section (VBAC) success rate among selected women undergoing trial of scar in Tshikaji Hospital. TOLAC remains the option for childbirth in low resource settings as Kasai region in DRC. Adequate patient education and counselling in addition to appropriate patient selection for TOLAC remain the cornerstone to achieving high VBAC success rate.

Predictive value of the trans-perineal three-dimensional ultrasound measurement of the pubic arch angle for vaginal delivery

BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distributional characteristics and to ascertain SPAA’s ability to predict the type and duration of labor.METHODS We determined the SPAA and analyzed the corresponding data.We also evaluated the relationship between the SPAA and the mode of delivery and the duration of labor by regression.The present study comprised a total of 301 pregnant women who had given birth at Beijing Tiantan Hospital of the Capital Medical University between January and December of 2021.RESULTS Our analysis of 301 pregnant women revealed that the SPAA measured using three-dimensional trans-perineal ultrasound had a minimum angle of 81°and a maximum angle of 122.2°.The angle in the normal vaginal delivery group was greater than that in the labor cesarean group(P=0.000).The SPAA was a highly significant positive predictor of normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000;95%CI:0.717-0.848).We found the length of the second stage of labor to be positively influenced by the SPAA using linear regression analysis(P=0.045).CONCLUSION The SPAA was a highly significant positive predictor of normal vaginal delivery.The length of the second stage of labor and normal vaginal birth were predicted by SPAA.

Rationale of Cross-Sectional Descriptive Study on Clinical Effectiveness of Oral Combination Therapy Based on Secnidazole, Azithromycin and Fluconazole in Syndromic Treatment of Abnormal Vaginal Discharge in Kinshasa/DR Congo

Background: Vaginal discharge is one of the most common troubles faced by childbearing age women. About 20% - 25% of women who visit service of gynecology complain of vaginal discharge and leucorrhoea. Management of vaginal discharge in low-income countries generally depends on syndromic approach, which limits the understanding of specific responsible agents. Thus targeted management is based on the identification of causal organism and targeting of therapy against it, while syndromic management is based on presence of high risk factors. Thus the oral combination kit (Azimyn FS Kit®) offers convenience of a one-day treatment compared to other multidose treatments, which will also ensure high patient adherence to treatment, thus increasing chances of desired results. Due to its widespread use, it is proposed to evaluate the effectiveness of this oral association kit therapy in management of vaginal discharge in the population of our milieu in the Democratic Republic of Congo (DRC) particularly those received in outpatient consultation in some medical facilities in city of Kinshasa. Expensive laboratory tests and the associated waiting period for result mean that patient remains without treatment while waiting for test results. Therefore, by adopting a syndromic management approach, patient’s eligibility for treatment will be decided based on abnormal vaginal discharge, their characteristics, severity and other presentations symptomatic. This approach will also avoid losing sight of patients during follow-up and will help to reduce financial burden for patients. Objectives: To determine the efficacy and safety of oral combination kit therapy containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultation in some medical facilities in the city of Kinshasa;to measure rate of recurrence of abnormal vaginal discharge in these patients. And to identify the adverse effects observed in these patients who received treatment with the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in outpatient consultation in some medical facilities in the city of Kinshasa. Methods: It will be a cross-sectional descriptive study. Sample size will be 319 women of childbearing age who consult the gynecology department with complaint of abnormal vaginal discharge and suspicion of vaginal infection, who agree to abstain from sex during treatment and who have given their written consent to use their personal and/or health data in the study. Conclusion: A study on clinical efficacy of oral combination therapy based on secnidazole, azithromycin and fluconazole is beneficial.

Vaginal Carriage of Group B Streptococcus in Pregnant Women in Rural Areas in Senegal

Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the antibiotic sensitivity of the isolated strains. We conducted a cross-sectional and prospective study in rural Senegal (in the health district of Sokone). Socio-demographic, clinical and gynaeco-obstetrical data were collected. Vaginal swabs were taken by the midwives on specific settings in order to test for GBS and other High Risk Vaginal Bacteria (HRVB). Antibiotic susceptibility testing was done according to the recommendations of the CA SFM/EUCAST 2020. In total, 100 pregnant women were targeted and 97 pregnant women were included. Their age ranged from 18 to 40 years with 64.9% (63/97) of participants belonging to the “20 - 30” age group. The overall prevalence of Group B Streptococcus carriage was 15.5% (15/97). However, the proportion of women with at least one high risk infectious bacteria was 29.89% (29/97). No statistically significant differences were found between GBS carriage and the potential factors studied. However, the study also looked for the presence of other high-risk bacteria and coinfections were indeed found between GBS and E. coli and Staphylococcus aureus. Antibiotic susceptibility testing shows that GBS strains were fully susceptible to penicillin G, erythromycin, clindamycin, chloramphenicol, rifampicin and vancomycin. Sensitivities to norfloxacin and gentamycin were 73.3% and 86.7% respectively. In contrast, high resistance to tetracycline (86.7%) was observed. GBS carriage remains a major public health issue because of its consequences for the mother and the newborn. Correct screening and proper monitoring of strain susceptibility remain one of the most effective means of patient management and care.

Stone accumulation overlying vaginal mesh exposure:A case report

BACKGROUND Vaginal stones are rare with current literature limited to case reports.Vaginal stones are classified as primary or secondary stones.Primary stones form in the vagina when there is urinary stasis.Secondary stones form in the presence of a vaginal foreign body that acts as a nidus for the deposition of urinary salts.Foreign bodies,such as surgical mesh,make vaginal stone formation more likely,particularly in patients with urinary incontinence and conditions that predispose them to urinary calculi formation.CASE SUMMARY A 71-year-old female with a history of sacrocolpopexy,hyperaldosteronism,and urgency urinary incontinence presented with vaginal stone accumulation overlying two areas of vaginal sacrocolpopexy mesh exposure.The vaginal stones were initially removed to permit examination,but the stones reaccumulated at the site of the exposed mesh,later requiring definitive surgical management.CONCLUSION Patients with vaginal mesh exposure and conditions that predispose them to kidney stones are not ideal candidates for expectant management of mesh exposure,particularly if they have coexisting urinary incontinence.These individuals should be counseled about possible vaginal stone accumulation,and surgical management should be considered.

The Efficacy and Safety of Dinoprostone Vaginal Insert for Labor Induction Following Optimization of Standard Operating Procedure: A Retrospective Study in China

Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.

Uterovaginal Prolapse in the Newborn: A Case Report from the University Hospital of Conakry

Uterovaginal prolapse is an exceptional pathology in the newborn. It is defined by the descent and protrusion of the uterus and vaginal walls to the outside via the vaginal orifice. It particularly affects newborns with neural tube defects. The diagnosis is usually made at birth. Different types of conservative or surgical treatment have been suggested for genital prolapse in neonates. We report the case of a newborn of 6 hours of life who was received for congenital utero-vaginal without neural tube closure anomaly. He was successfully treated with digital reduction of the mass associated with a cerclage of the vaginal orifice. Conclusion: Digital reduction of the prolapse associated with a cerclage of the vaginal orifice is simple, effective and avoids any recurrence.

Longitudinal analysis reveals characteristically high proportions of bacterial vaginosis-associated bacteria and temporal variability of vaginal microbiota in northern pig-tailed macaques （Macaca leonina）

The complex and dynamic vaginal microbial ecosystem is critical to both health and disease of the host. Studies focusing on how vaginal microbiota influences HIV-1 infection may face limitations in selecting proper animal models. Given that northern pig-tailed macaques （Macaca leonina） are susceptible to HIV-1 infection, they may be an optimal animal model for elucidating the mechanisms by which vaginal microbiota contributes to resistance and susceptibility to HIV-1 infection. However, little is known about the composition and temporal variability of vaginal microbiota of the northern pig-tailed macaque. Here, we present a comprehensive catalog of the composition and temporal dynamics of vaginal microbiota of two healthy northern pig-tailed macaques over 19 weeks using 454-pyrosequencing of 16S rRNA genes. We found remarkably high proportions of a diverse array of anaerobic bacteria associated with bacterial vaginosis. Atopobium and Sneathia were dominant genera, and interestingly, we demonstrated the presence of Lactobacillus-dominated vaginal microbiota. Moreover, longitudinal analysis demonstrated that the temporal dynamics of the vaginal microbiota were considerably individualized. Finally, network analysis revealed that vaginal pH may influence the temporal dynamics of the vaginal microbiota, suggesting that inter-subject variability of vaginal bacterial communities could be mirrored in inter-subject variation in correlation profiles of species with each other and with vaginal pH over time. Our results suggest that the northern pig-tailed macaque could be an ideal animal model for prospective investigation of the mechanisms by which vaginal microbiota influence susceptibility and resistance to HIV-1 infection in the context of highly polymicrobial and Lactobacillus-dominated states.

Antimicrobial resistance of abnormal vaginal discharges microorganisms in Ouagadougou,Burkina Faso

Objective:To assess the prevalence of bacterial strains and fungal strains infecting the vaginal tract and test their sensitivity to antibiotics in women attending Saint Camille Medical Centre in Ouagadougou.Methods:From January 2008 to December 2009,a total of 2000 vaginal swabs were cultivated for bacterial and fungal identification and isolation.Furthermore,bacterial strains were tested for their susceptibility to several antibiotics used in routine in the centre. Results:The results revealed that microbial isolation and identification was attempted for 1536/2000 sample,a positivity rate of 76.80%.Candida albicans(48.76%),followed by Escherichia coli(16.67%),Streptococcus agalactiae(8-14%) and Staphylococcus aureus(7.55%) were the major agents of genital tract infections in patients.Mycoplasma hominis and Ureaplasma urealyticum combined accounted for less than 7%.Trichomonas vaginalis was identified in 1.04%coses.The antimicrobial tests revealed that the microorganisms developed resistance to several antibiotics including beta lactams.However,antibiotics such as cefamenzol,ciprofloxacin and norfloxacin were still active on these bacteria.Conclusions:The results reveal that many sexually active women are infected by one or more microbial pathogens,probably because of the lock of hygiene or the adoption of some risky behaviors,such as not using condoms or having multiple sexual partners.Efforts should be made to address these points in the country.