Impact of Delivery Mode on Morbidity in Preterm Infants with Very Low Birth Weights (<1500 Grams)

The mode of delivery and gestational age for very-low-birth-weight (VLBW) preterm infants are not yet well established and are constant topics of debate. Objective: To analyze the impact of delivery mode on morbidity in preterm infants weighing less than 1500 g. Results: Among 21,957 births, 81 were analyzed;53 were delivered vaginally, and 28 were delivered by cesarean section. The median maternal age, gestational age and body mass index among those delivered vaginally and by cesarean section were 20 years and 22.5 years, 27.6 weeks and 30.1 weeks, and 26.0 kg/m2 and 27.8 kg/m2, respectively. With respect to neonatal blood gas parameters, for those born vaginally and by cesarean section, the median pH was 7.32 and 7.24, the pCO2 was 41.5 mmHg and 51.1 mmHg, and the pO2 was 22.3 mmHg and 16 mmHg. The median fetal weight among those born by cesarean section and vaginally were 1180 g and 955 g, respectively. The median Apgar scores at the first and fifth minutes among those born by cesarean section and vaginally were 5.00 and 8.00 and 4.50 and 7.00, respectively. Conclusion: There was no significant difference between the results of vaginal and cesarean delivery for VLBW infants. Thus, further studies on this subject are needed.

Ectopic Pregnancy Combined with Intra-Uterine Pregnancy with a Full-Term Live Baby: A Case Report and Review of Literature

Heterotopic pregnancy is no more a medical breakthrough. It combines intrauterine pregnancy and extra-uterine pregnancy regardless of location. We report a case of intra-uterine pregnancy associated with a ruptured abdominal ectopic pregnancy located on the pelvic colon in a 29-year-old patient, third gestation, primigravida, having a live baby and a prior history of two abortions. She has blood group O negative of Rhesus. It has been diagnosed at the stage of the rupture of ectopic pregnancy. An emergency laparotomy performed under blood transfusion has revealed heavy hemoperitoneum (1100 ml), a ruptured abdominal extra-uterine localized on the pelvic under blood transfusion and a bulging uterus. We have proceeded with the aspiration of hemoperitoneum, the ablation of the extra-uterine pregnancy and the hemostasis of the section part. The post-operative follow-up has been easy. The intra-uterine pregnancy has developed normally and has given birth to a full-term live, and healthy baby.

Retroperitoneal Liposarcoma Mimicking an Ovarian Tumor: A Diagnostic Dilemma

Introduction: Retroperitoneal liposarcoma is a malignant, primitive and rare mesenchymal tumor. We report an observation of a retroperitoneal liposarcoma mimicking an ovarian tumor. Case: A 36-year-old female presented a pelvic pain type gravity whose examination found an abdominopelvic mass, an abdominopelvic computed tomography showed a large abdominal-pelvic mass with a fatty component leading to the diagnosis of ovarian teratoma. At exploratory laparotomy, we found a large abdomino-pelvic mass of 30 × 35 cm, and a large resection was realised. The histopathologic examination found a liposarcoma well differentiated (grade 1). Conclusion: The different pathological aspects, the therapeutic options and the prognostic factors of the abdominal liposarcomas will be discussed in this article.

Outcomes of Thyroid Surgery at Niamey National Hospital

Introduction: Goiter is the most common endocrine disease in the world. The objective of our study is to assess and compare the morbidity linked to the surgical management of goiters and thyroid tumors in the general surgery department of the Niamey National Hospital. Result: We collected data on a prospective basis on 112 cases having undergone a thyroidectomy between March 2019 and April 2020. The female sex is predominant with 96.4%, i.e. a sex ratio of 0.037. The average age is 41.2 years with extremes ranging from 22 to 72 years old. The average duration of evolution of goiter is 7.5 years with extremes ranging from 5 months to 20 years old. The first reason for consultation is anterior cervical swelling. TSH testing confirmed euthyroidism in 107 patients (95.5%). Therapeutically, loboisthmectomy is the most performed procedure with 43.7%. The postoperative hormonal assessment revealed 32% hypothyroidism at 6 months, with a significant difference for cases of total thyroidectomy. The occurrence of postoperative hypocalcemia was significantly greater after total and subtotal thyroidectomy. There is no significant difference in terms of recurrent complications. Conclusion: Thyroidectomies must be performed after adequate preparation and information to the patient on possible postoperative complications, hence the need for close medical monitoring immediately and remotely.