Clandestine Abortions and Its Complications at the University Hospital Center of the Sino-Central African Friendship

Introduction: In developed countries in general and particularly in the Central African Republic, clandestine abortions constitute a real health problem. The aim of our work was to study the method of carrying out clandestine abortions, to describe the profile of the providers and the complications that result from it. Patients and Methods: This was a descriptive cross-sectional study of patients hospitalized at the University Hospital Center for Sino-Central African Friendship (CHUASC) from 2015 to 2019 on 236 cases. Results: We identified a total of 254 patients for 8039 live births in the same period, a frequency of 3.16%. The age of the patients was between 15 years old and 48 years old with an average of 25 years old. Singles accounted for 42.5%. Induced abortions were more performed among students (32.6%) and the unemployed 53.6%. Contraception was used in 11.5% of cases. The methods used were numerous: misoprostol (32%), the traditional method (18%), the mechanical method (50%). In this method, we note the dilation of the cervix by the cassava stem;Hegar’s candles;the probes, which are infusion tubes cut and introduced into the cervix, of which 2 cases had escaped at the level of the uterine muscles and emerged under the skin at the pubis part two years later. The practice of induced abortions in our series was done by medical students in 37.3% followed by unqualified staff in 49.7%. It took place either at home or in centers managed by Non-Governmental Organizations. The aseptic conditions were not perfect. Some patients (43.2%) were aware of the ensuing complications. All complications were present: hemorrhage (60.7%), pelviperitonitis (23.6%), uterine perforation (6.6%), peritonitis (2.8%) and death (2%) related to sepsis. Conclusion: Clandestine abortion remains a real health problem for young Central African women.

Problematic of Clandestine Induced Abortions in Three Maternity Hospitals of Chad

Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). Conclusion: The clandestine induced abortion is a frequent situation in the Chad and is cause of numerous complications.

The Epidemio-Clinic Profile of Clandestine Abortion at Saint Joseph Hospital (Kinshasa)

Objective: To identify the epidemiologic profile of the woman having practiced the clandestine abortion, to determine the frequency and the complications of the clandestine abortion and to evaluate the prognosis of the clandestine abortion in our area. Method: The present study is descriptive and retrospective covering the period from January 2017 to December 2017, the one year period. On 118 patients received in the service for clandestine abortion, 60 were retained for the study. The 58 other files were excluded because of not containing sufficient information for this study. The descriptive statistical analyses were applied for the data analysis. Results: The frequency of the allowed patients for complication of clandestine abortion caused at the Saint Joseph hospital of Kinshasa was 6.03%. The most concerned population with this practice was less than 15 years and more than 45 years;they were unmarried (41.6%) and nulliparous (41.6%) in most cases. Ancillary medical staff (especially nurses) was accused the most in this practice of the illegal abortion caused by the dilatation and curettage with 50%. The genital haemorrhage constitutes the principal complication and reason for consultation and accounted for 78.3%. The assumption of responsibility is primarily medical and surgical. The vital prognosis is satisfactory for the immediate one, because no death is noted. Conclusion: The clandestine abortion remains public health problem in our communities. The results found in our study call for certain reflections so that to reduce its frequency and to avoid its complications.

Exploring non-invasive approaches to assist in the detection of clandestine human burials: developing a way forward

The analyses of physical evidence recovered from clandestine single and mass graves have been demonstrated to be of significant evidential and/or investigative value for both court purposes and humanitarian investigations.The detection of these types of graves is,therefore,pivotal to forensic investigations.This article reviews different remote and groundbased methods that have been used to attempt to detect deliberately concealed burial sites and summarizes the experimental research that has,to date,been undertaken in order to improve grave detection.The article then presents the preliminary findings of research being undertaken at the Australian Facility for Taphonomic Experimental Research(AFTER).This research,the first of its kind to be undertaken in the southern hemisphere,is based on experimental single and mass graves using human cadavers.The research is centred on current remote sensing methods and techniques combined with the analysis of the effects of below-ground temperature and moisture and ground-based weather data.It is hoped that identifying successful sensors and detectors will be beneficial to national and international agencies that are involved in forensic as well as humanitarian investigations that require the detection of deliberately concealed gravesites.

Geoforensic Methods for Detecting Clandestine Graves and Buried Forensic Objects in Criminal Investigations - A Review

Geoforensic techniques are being deployed in searches for hidden objects to counteract the shortcomings of conventional blunderbuss methods.Processing of crime scenes during searches for clandestine graves and buried objects is often destructive.Manual excavation and other invasive methods are restricted in many contemporary situations,and the location of a body is essential for forensic investigations.Geoforensics and geophysical surveys are important tools for assisting law enforcement agencies in locating crime scenes,clandestine graves,drugs,artifacts,hazardous waste,and illegal weapons and ammunitions stored underground in preparation for terrorist attacks.Geoscience search techniques such as the geoforensic search strategy are among many models used to help find mass graves,locate missing persons,and verify information acquired from incomplete intelligence.Trace amounts of soils,sediments,and other geological materials can provide geolocations and aid in the development of a primary search area.Forensic geoscience techniques and equipment such as metal detectors,magnetic surveys,electromagnetic conductivity surveys,ground penetrating radar surveys,augering(probing),detector dogs surveys,and gravity and seismic fluctuation monitoring are discussed in this paper.In addition to the location of potential graves and ambush sites,the soil beneath the decomposing cadavers can be used to predict the postmortem interval for the deceased.Soil information and geo-mapping data can provide productive intelligence for military and national security agencies.Antiquities crimes and crimes involving gemstones in which the evidence passes through many hands can be traced back to the place of origin by checking for their geo-morphology.Serious crimes,including murder,genocide,and terrorism,can be prevented by the use of operational and decisive geoforensic techniques.This paper highlights the multidisciplinary information exchange that occurs between forensic burial science,forensic geology,and trace evidence in criminal investigations.The paper also focuses on geoforensic approaches to clandestine grave searching,underwater investigations,forensic engineering fallacies,military intelligence,ambush detection,and weapons mining.

Adolescent Pregnancy: Epidemiological Survey in Schools and Obstetrical Outcomes in Douala (Cameroon)

Introduction: According to the World Health Organization (WHO), adolescence is the period of growth between 10 and 19 years of age. Complications from pregnancy are the second leading cause of death for adolescent girls aged 15 to 19 worldwide. Objective: In order to reduce the phenomenon of early pregnancy, we set out to determine its prevalence as well as its outcome among adolescent girls in secondary schools in the Douala 3rd district in Cameroon. Methodology: To achieve our objective, we conducted an analytical case-control study from November 08, 2018 to June 26, 2019, in ten secondary establishments in the Douala 3rd district. Included in the study were all adolescent girls, students in one of the secondary schools in the said district who agreed to participate in the study. Data analysis was done using SPSS 20.0 software. The significance threshold was set at p < 0.05. Results: A total of 445 adolescent girls were selected, including 89 cases and 356 controls. In 87.6% of the cases, the pregnancy was accidental and 58.4% used voluntary abortion. The univariate analysis of the results showed that the factor associated with the occurrence of teenage pregnancies was the age above 17 years (OR = 1.44;CI = 1.31 - 1.59) (p = 0.001). Conclusion: At the end of our study, it appeared that early pregnancies exist in Cameroonian schools with a high rate of 6.57% and an appeal to illegal abortion (62.9%).