Blood Transfusion Practices at the Gynecology-Obstetrics Department of the Sylvanus Olympio University Hospital in Lomé: A Study of 254 Cases

Objective:?To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lomé. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June 2017 to 31 May 2018 at the gynecology-obstetrics department. The study focused on transfused pregnant, parturient and delivered women. Study parameters were sociodemographic, clinical, therapeutic and prognostic. Results: 252 patients, aged 16 to 49 with an average age of 30.4 years, referred in 74% of cases. Hemorrhage was observed in 238 cases (94.4%) and anemia in 14 cases (5.6%). Blood transfusion was urgently used in 89.7% of cases and hemorrhagic abortion was the main indication. Blood group O+ (34.5%) was the most used and blood products were obtained after two hours in 81% of cases. Conclusion: Blood transfusion is often performed urgently and for bleeding. But the Gynecology-Obstetrics department does not have any blood in reserve, whereas the Sylvanus Olympio University Hospital collection and distribution station covers less than 10% of the needs.

Ovary cancer incidence and mortality in China, 2011

Objective： To evaluate and analyze ovary cancer incidence and mortality in China in 2011 using ovary cancer data from population-based cancer registration in China, and to provide scientific information for its control and prevention. Methods： Invasive cases of ovary cancer were extracted and analyzed from the overall Chinese cancer database in 2011, which were based on data from 177 population-based cancer registries distributing in 28 provinces. The crude, standardized, and truncated incidences and mortalities et al. were calculated and new and deaths cases from ovary cancer throughout China and in different regions in 2011 were estimated using Chinese practical population. Results： The estimates of new ovary cancer cases and deaths were 45,223 and 18,430, respectively, in China in 2011. The crude incidence rare, age-standardized rate by Chinese standard population （ASR-C） and age- standardized rate by world standard population （ASR-W） incidence were 6.89/100,000, 5.35/100,000 and 5.08/100,000, respectively; the crude, ASR-C and ASR-W mortalities were 2.81/100,000, 2.01/100,000 and 1.99/100,000, respectively. The incidence and mortality in urban areas were higher than those in rural areas. The age-specific incidence and mortality increased rapidly from age 35-39 and peaked at age 60-64 or 75- 79 years. After age 45 or 55, the age-specific incidence and death rates in urban were much higher than those in rural areas. Conclusions： Compared with GLOBOCAN 2012 data, the ovary cancer incidence in China in 2011 was at middle level, but its mortality was at low level worldwide.

Clinical Research on Efficacy of Cassia Twig Tuckahoe Capsule and Mifepristone Combined with Laparoscopic Surgery for the Treatment of Endometriosis

Objective: To compare the clinical efficacy of Cassia Twig Tuckahoe capsule (Chinese Medicine) and Mifepristone combined with laparoscopic surgery for the treatment of endometriosis. Designs: Prospective cohort study. Setting: Gynecology and Obstetrics Department, Jingzhou Central Hospital, affiliated to Yangtze University. Methods: We selected 67 patients suspected with endometriosis and divided randomly into 2 groups on patient choice. Outcome Measures: Treatment efficacy, side effects, recurrence rate and pregnancy rate. Results: Comparing the effect of treatment between the two groups, the success rate was almost same (P > 0.5). However, the disappearance of pain was faster in Cassia twig Tuckahoe group (P Conclusion: After analysis of the result, Cassia twig Tuckahoe capsule combined with Laparoscopy is superior to the Mifepristone combined with Laparoscopy. Cassia twig Tuckahoe capsule is a very propitious medicine for treating endometriosis for long term benefits.

Placentas and Newborns of Patients Suffering from High Blood Pressure in University Hospital of Brazzaville

Objective: To analyze placentas and newborns of patients with high blood pressure (HBP). Materials and Methods: Case-control study conducted from 1 January to 31 October 2017 in University Hospital of Brazzaville (birth room, anatomy and pathology laboratory) and Faculty of Health Sciences of Brazzaville (laboratory of anatomy and organogenesis). It concerned 40 placentas freshly delivered and newborns of patients with HBP compared to 40 placentas and newborns of patients without HBP. The variables analyzed were related to mothers, placentas and the newborns. Results: The patients were similar in age (26.9 ± 1.2 years VS 26.5 ± 1.1 years, p = 0.17) and parity (1.26 ± 0.7 VS 1.61 ± 0.3, p = 0.26). The type of hypertension in the cases was dominated by pre-eclampsia (68%). A significant reduction in placental measurements was more observed in case of HBP: weight (431 ± 37 g VS 503 ± 26 g, p < 0.05), diameter (17.40 ± 1.2 cm VS 19.25 ± 1 cm, p < 0.05), and area (239.82 ± 15.7 cm2 VS 292.1 ± 22.2 cm2, p < 0.05). The macroscopic lesions were calcifications (75% VS 43.8%, p < 0.05) and the retro placental hematoma cup (18.8%) among the cases. Microscopic lesions were more observed in hypertensives: infarction (68.8% VS 18.8%, p = 0.004) and endarteritis (93.8% VS 12.5%, p < 0.05). The characteristics of newborns were significantly different between the two populations: prematurity (34.3% VS 9.3%, p < 0.05), mean weight (2577 ± 102 g VS 3060 ± 109 g, p < 0.05), the average APGAR score (6.7 ± 1.6 VS 7.8 ± 0.9, p 0.05). Conclusion: High blood pressure affects the placenta and the newborn. The placenta deserves to be systematically examined.

The Value of Tumor Markers in Endometrial Carcinoma: Review of Literature

Endometrial cancer is the most common gynecologic malignancy in more developed countries. Most endometrial carcinomas cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15% - 20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited responsiveness to systemic therapy. Although it has a comparatively low mortality rate compared with other gynaecological cancers, it is capable of aggressive behaviour. Diagnosis at an early stage is the most important determinant of survival. Discovery of new diagnostic biomarkers/panels for early diagnosis of endometrial cancer is one of the main challenges of modern medicine. For endometrial cancers, there are no established serum markers. We will review the present knowledge regarding tumor markers, assessing how such markers could be applied to address in screening, diagnosis and monitoring of endometrial carcinoma.

Performance of the Vaginal Touch in the Diagnosis of Vertex Presentation in Posterior Variety

Objective: To evaluate the performance of the vaginal touch in the diagnosis of vertex presentation in posterior variety. Materials Populations and Methods: Transversal analytical study conducted during 4 months (November 2017 - February 2018) at the University Hospital of Brazzaville. This study included parturients with a living foetus in term and in vertex presentation.? The membranes were broken with less than 6 cm of vaginal dilatation. In each case the ultrasound was associated to verify the accuracy of the results of vaginal examination. The statistical tests used were: sensitivity, specificity, positive and negative predictive values, and Youden’s index. Results: One hundred and twenty-two vertex presentations were recorded, of which 31 (25.4%) had a posterior variety diagnosed successively with vaginal examination and ultrasound, while 23 (42.6%) were only on ultrasound. Parturients with foetuses in the posterior and anterior variety were similar in median age (30 [25.5 - 33.5] vs 27.5 [24 - 34], p > 0.05) and parity (2 [1.5 - 3.5] vs 2 [1 - 3], p > 0.05). Vaginal touch had: sensitivity of 57.4% [44.4 - 70.4], specificity of 94.1% [86.7 - 99.3], and Youden’s index of 0.52. The positive and negative predictive values were respectively 88.5% and 73.5%. The vaginal examination was influenced by: examiner (OR = 2.7 [1.21 - 6.07];p 25 kg/m2 (OR = 3.4 [1.07 - 11.07], p Conclusion: The vaginal touch is not very effective in the diagnosis of the vertex presentation in posterior variety.

Progress of Integrative Chinese and Western Medicine in Treating Polycystic Ovarian Syndrome Caused Infertilit

Polycystic ovarian syndrome （PCOS） is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine （ICWM）. It can be seen from these materials that using traditional Chinese medicine （TCM） recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.