The Place of Blood Transfusion in the Management of Obstetric Emergencies in the Gynaecology and Obstetrics Department of the Reference Health Center of Fana (Mali)

This is a prospective and descriptive study carried out at the gynecology and obstetrics department of the reference health center of Fana from 01 May 2019 to 30 November or 7 months. The main objective was to study the role of blood transfusion in the management of obstetric emergencies. During the study period we recorded 434 cases of obstetric emergencies of which 116 cases required an emergency blood transfusion or 26.73%. The most frequently found indications for blood transfusion are hemorrhages of the immediate postpartum 46.6% followed by severe malaria on pregnancy 27.6%. Blood remains the most prescribed and available Labile blood product in the department. Maternal prognosis was improved in 92.2%.

Factors of Low Birth Weight Risk in the Department of Gynecology-Obstetrics of the Ignace Deen National University Teaching Hospital in Conakry, Guinea

Introduction: The underweight at birth is recognized as a major cause of morbidity and mortality in childhood. Objective: To identify maternal and obstetric sociodemographic factors associated with low birth weight. Patients and Methods: This is a retrospective study of analytical type that examined the records of women who gave birth in the Obstetrics and Gynecology department of Ignace Deen National University Teaching Hospital from 1st December 2016 to 30th April 2017. The analysis was made with the R version 3.3.1 software. We did a univariate and multivariate analysis. Outcomes: Out of the 1633 live births of single pregnancies that occurred during the study period, 109 children were born with a low weight (<2500 g) corresponding to a rate of 6.7%. In univariate analysis, we found a significant association between low birth weight and maternal single status (p = 0.019), maternal weight less than 60 kg (p = 0.038), primary parity (p = 0.018), maternal history of abortion (p = 0.001), history of preterm birth (p < 0.001), arterial hypertension (p < 0.001), anemia (p < 0.001) and malaria (p < 0.001). In multivariate analysis, the variables associated with low birth weight were: history of preterm delivery with OR of 8.5 [1.8 - 40.1], history of abortion (OR = 4.4 [1.4 - 13.9]), malaria (OR = 23.8 [6.1 - 92.5]), anemia (OR = 11.8 [3.7 - 38.2]) and high blood pressure (OR = 5.4 [1.6 - 17.9]). Conclusion: The decrease in frequency of low birth weight in Guinea will be done by improving the quality of prenatal care with an emphasis on screening, prevention and treatment of malaria, anemia and high blood pressure during pregnancy, prevention of abortion and premature birth.

Liposarcoma Retro-Peritoneal in the General Surgery Department of the Hospital of the District of the Commune IV

Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.

Problem of Invasive Cervical Cancer’s Management in the Obstetric Gynecologic Department of the National Hospital Donka, Conakry

Introduction: The objectives of this study were to describe the diagnostic and therapeutic aspects, identify problems and evaluate the survival rate of invasive cervical cancer patients. Patients and method: It was a retrospective descriptive study of 7 years from 1 January 2006 to 31 December 2012. Records of invasive cervical cancer were histologically confirmed. The clinical and therapeutic data collected were transferred to Epi info 7 and SSPS version 18 software with a significance level p as used to provide information on the vital condition after confidential agreement. Kaplan Meier was used to assess the overall survival rate. Results: Invasive cancer of the cervix was frequent (58.79%) with an annual median rate of 16.7%, with extremes of 5.8% and 20.6%. 88.70% of the patients was referred from regions of the country (54.02%);the median age was 50 years with extremes of 16 and 84 years and a peak of 29.6% between 35 and 44 years;76.20% were housewives;uneducated women were about 60.12%;Stage III was about 45.3%. Most of the patients were confirmed histologically after 30 days (68%). The means of treatment were surgery about 91 (29.26%), palliation 75 (24.12%), radiotherapy 59 (18.97%) and chemotherapy 41 (13.18%) with surgery (9, 65%) or radiotherapy (4.82%). The main complication was metrorrhagia, 164 cases (56.55%), with overall survival rate of 51.8% at 2 years and 5.1% at 5 years. Conclusion: Invasive cervical cancer in later stages is treated for low survival in the context of our work. Early detection and treatment of precancerous lesions would reduce the incidence and mortality of this cancer.

Sacrospinous Fixation in the Gynecology Department of Hôpital du Mali

Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du Mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. During the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital stay was 5 days. The anatomical result was satisfactory in all patients. However, two patients presented with grade II rectocele one year after the operation. Sacrospinous fixation is a technique suitable for our patients who present with genital prolapse with extreme laxity of the suspension ligaments. Well done, it brings anatomical satisfaction and its complications are rare and slight.

Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-term follow-up is needed.

Cystic Degeneration of Uterine Myoma Simulating Ovarian Cancer in Postpartum: A Case Report at the Teaching Hospital of Angre

The transformation of uterine fibroids is common in relation to their development. Giant forms of cystic degeneration are rare. They raise diagnostic difficulties with other pelvic tumors, such as ovarian tumors and leiomyosarcomas. Magnetic resonance imaging specifies the original organ, the volume and the main relationships of fibromyoma with adjacent structures. The diagnosis of certainty is based on laparotomy coupled with histology. The authors illustrate these difficulties by observing a giant cystic degenerative fibroma in a 26-year-old G1P1 woman in the postpartum period.

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

Lupus and Pregnancy

Introduction: Systemic lupus erythematosus is a multifactorial autoimmune disease characterised by its clinical polymorphism and its course in flares. The aim of our study was to determine the effects of pregnancy on lupus and vice versa. Material and Methods: This is a retrospective study conducted over a period of 14 years from 2002 to 2015. We included cases of systemic lupus erythematosus associated with pregnancy followed at the obstetrics and gynecology department “C” of the Ibn Rochd University Hospital in Casablanca. Results: The mean age of our parturients was 31.4 years. All our patients were known to have lupus and were followed up. Pregnancy was terminated in six (20%) cases. We noted one (3%) case of intrauterine fetal death, four (13%) cases of intrauterine growth retardation, and five (16%) cases of prematurity. Lupus flare during pregnancy occurred in 16 (52%) cases, including one (3%) patient who developed superimposed pre-eclampsia, had a renal relapse in the third trimester requiring an abortion at 32 weeks of gestation with three sessions of hemodialysis, and another patient who developed eclampsia. Conclusion: A better understanding of the aggravating factors and compatible treatments has led to a more widespread authorization of pregnancy.

Knowledge Practical Attitude of Health Professionals on Breast Cancer at the Hospital of the District of the Commune IV of Bamako

Introduction: The level of knowledge and attitude of health professionals about breast cancer are important determinants. General objective: To study the knowledge, attitude and practice of health professionals of the hospital of the district of the commune IV on breast cancer. Methodology: This was a cross-sectional, prospective, descriptive, qualitative and quantitative study. The study period was from 01 October 2022 to December 2022. Results: In one week of survey, 110 health workers (intern, obstetrician nurse, general practitioners and specialists) received the survey sheet, 80 health workers informed it, a participation rate of 73%. The male sex was most represented at 63.75% with a sex ratio of 1.76. The average age was 39.59 years with extremes of 22 and 61 years. The clinical signs evoked by the participants were: breast nodule (81.25%), followed by breast discharge (48.75%). In relation to risk factors: interns and obstetrician nurses had no good knowledge, 51.72% of general practitioners had good knowledge, 43.48% of specialist doctors had good knowledge, and 5.88% of the wise had good knowledge. Conclusion: Breast cancer is a common pathology around the world, health professionals are at the forefront of the fight against breast cancer, and this fight cannot be effective without trained personnel.

Umbilical Cord Prolapse Managed by Assisted Vacuum Delivery

G4P3L3 was at 40 weeks of gestation who was admitted in active stage of labor with normal fetal heart rate. At 8 cm cervical dilatation she experienced spontaneous rupture of membrane with clear liquor. Cord prolapse was detected and was prepared for caesarian section meanwhile she was kept in knee chest position and bladder was filled with normal saline 0.9%. 30 min before operation she was fully dilated with signs of Non reassuring fetal status, vacuum extraction was done to assist delivery as soon as possible. The APGAR score was 6 and 10 in the first and fifth minutes respectively. Mother and the baby were discharged the next day in good condition.

Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the Reference Health Center of Commune III of the District of Bamako in Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

Evaluating the Role of Measuring the Perineal Length as a Predictor of Progress of Labor and Obstetrical Trauma

Objective: Evaluating the effect of perineal length on the duration of the second stage of labor, the mode of delivery, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Participants and Methods: It is a prospective hospital-based observational study done on 483 parturient women in a university hospital. Personal, medical and obstetric data together with the measurement of perineal length were recorded in the first stage of labor. We followed up the progress of labor until delivery. Regression models were used to consider possible risk factors of episiotomy or tears needed repair. Results: The mean duration of the second stage of labor was significantly longer among women with a perineum of ≥4 cm length when compared with those with a perineal length of Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. Obstetricians should expect the need of episiotomy when confronted with circumcised primigravida with long perineum. However, if the perineum is short they should not be deceived, short perineum is more probably torn.

Routine prenatal ultrasonography: The pregnant woman’s expectations and perspectives on safety in a Central African obstetric population

Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Objective: To assess the pregnant woman’s expectations during routine prenatal US scan and her perspective ofUSsafety during pregnancy in a Central African obstetric population. Methods: A cross-sectional descriptive survey of consenting pregnant women who reported for routine prenatal US scan using an anonymous questionnaire. A convenient sample of 200 participants was adopted. Results: Thirty-three (16.8%) respondents (on a total of 196) declared they had never done anUSscan. One hundred and eleven (58.4%) on a total of 190 stated that they had not received any information on what ultrasonography is all about. Before theUSscan the respondents would like to receive information on the aim or purpose of ultrasonography, possible inconveniences or risks, and on how to prepare before the scan. The most reported expectations were assurance of the wellbeing of the fetus (58%), gender determination (44.5%) and information on fetal position (20.5%). Thirty-four respondents considered ultrasonography as not perfectly safe for the mother or the “baby”, with the relevant reasons being the use or production of some potentially harmful “rays”. Conclusion: Pregnant women would want to be assured of the wellbeing of the fetus, the gender and position during routine prenatal US. They however need to be informed of its purpose and safety.

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.

Review of Maternal Deaths in Two Health Regions of Togo: About 69 Cases (Epidemiological and Sociodemographic Aspects)

Introduction: Maternal mortality is a public health problem. It is common in hospitals in Togo. From 401 per 100,000 live births in 2013, in 2017 we are 396 per 100,000 live births. Despite several programs ranging from subsidized caesarean section (CARMA) yezou (assistance for pregnant women), the establishment of maternal death reviews in maternity wards to compensate for avoidable causes;we are seeing preventable maternal and fetal deaths in our hospitals. No study on these reviews has been done since its establishment. The objective of our study was to determine the frequency of reviews of maternal deaths, the epidemiological, sociodemographic aspects and the causes of these reviewed maternal deaths. Method: This was a descriptive and cross-sectional, multicenter study lasting four and a half years, from the 1st of January 2018 to the 30th of June 2022, relating to the review of maternal deaths in three reference hospitals of two health regions of south Togo. Any maternal death occurring in one of these hospitals during the study period was included in this survey. The data collected using a collection sheet were analyzed using Epi Info version 7 software. Results: During the study period, the maternal mortality ratio in the three hospitals was 722.3 per 100,000 live births. Only 12.2% of maternal deaths were reviewed in the three hospitals. The patients were young with an average age of 29.9 years, housewives (71%), uneducated (21.7%). The causes of maternal deaths were dominated by direct obstetric causes (89.7%). The main cause was hemorrhage (72.5%), the main cause being immediate postpartum hemorrhage (50.7%). Conclusion: This study shows that the maternal mortality ratio still remains high in our country with a low frequency of maternal death reviews. Young, poor, uneducated women are the most affected by these deaths, the main cause of which remains hemorrhage. Preventive measures deserve to be taken at all levels with a view to reducing maternal mortality.

Seroprevalence, Importance of Rapid Testing and Factors Associated with HBsAg Carriage in Pregnancy in Three Referral Maternity Hospitals in Mono (Benin), in 2020

Introduction Difficulties in accessing the screening test for viral hepatitis B in maternity wards could be a factor in underestimating the prevalence of anti-HBV antibodies. The rapid diagnostic orientation test (RDOT) could improve seroprevalence and obstetrical prognosis. The aim of this study was to use the rapid diagnostic orientation test (RDOT) to determine the seroprevalence of HBs antigen carriage in pregnant women while highlighting the associated factors. Methods This was a cross-sectional and descriptive study that took place from October to December 2020 (three months) in three (03) reference maternities in western Benin (Mono). Consenting pregnant women received in prenatal consultation had been screened by RDOT. Positive cases were confirmed by ELISA test. The follow-up of these cases made it possible to establish the obstetrical prognosis. Results Of 201 women studied, 11 (5.5%) were positive for RDOT HBV and confirmed by the ELISA test. The factors associated with HBsAg carriage during pregnancy were multiple sexual partnerships (p = 0.01), female circumcision (p = 0.0001), and ignorance of prior HBV serological status (p = 0.0001). No influence of hepatitis B on pregnancy was noted. Conclusion The seroprevalence of hepatitis B in pregnancy was intermediate in the reference maternities of western Benin. The associated factors were multiple sexual partnerships, female circumcision and unawareness of prior HBV status. Free RDOT in maternity wards would improve early detection and management of viral hepatitis B in pregnancy.

Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

Split Hand/Foot Malformation about Two Family Cases

Split hand/foot malformation (SHFM), formerly known as ectrodactyly is a rare congénital anomaly, its incidence varies from 1/8.500 to 1/25.000 live birth. It mainly affects the development of the limbs, its clinical variability is standard, can present as an isolated feature or as a syndrome associated with other congenital anomalies. Our objective was to present the two cases of SHFM, and to review the literature on the clinical aspects and discuss a probable origin. The father went to school and is a driver because the malformations concerned only the fingers, were less severe, and did not prevent the realization of certain simple gestures of the daily life. On the other hand, the malformations of the fingers of the newborn were severe and the absence of the thumbs compromised the later prehension function. Also the association of a microglossia and a cleft palate contributed to a weight loss that justified hospitalization. The clinical presentation of split hands and feet is variable and the prognosis depends on the type of anomaly. Familial cases suggest a probable genetic origin. Genetic testing is necessary to establish genetic counseling.

The Risk Factors of Lymphedema in Breast Cancer Patients Post Axillary Clearance

Introduction: Breast cancer is the number one malignancy affecting females in Saudi Arabia with a prevalence of 22.4%. Breast cancer incidence increases annually due to the aid of established screening programs, leading to the discovery of breast cancer in its early stages. Surgical treatment is an integral part of early breast cancer management to achieve local control. Axillary surgical interventions such sentinel lymph node biopsy (SLNB) and axillary lymph node clearance (ALND) aim to stage the axilla as an adjunct to the management of the primary breast tumor. In this paper, we reviewed female breast cancer patients aged 30 - 60 who underwent surgical treatment of SLNB and/or ALND with reporting the prevalence of lymphedema and other associated complications and risk factors. Methodology: A cross-sectional non-interventional study, with a sample size of 250 including breast cancer cases from 2016 to 2019 at National Guard Hospital (NGH) in Jeddah, Saudi Arabia. Results: A total of 253 breast cancer cases were included in this study, with a mean age of 53 years, 52.7% were postmenopausal and positive family history was present among 21% of cases. Further, 90.9% of the cases had unilateral disease. Staging was as follows: stage I 14.5%, stage II 45.2%, stage III 37.1%, and stage IV 3.2%. Mastectomy was done in 73.4% cases and lumpectomy was performed in 34.1% of cases. In addition, 93.3% of patients had SLNB and 49% of them were positive. Axillary dissection was performed in 69.6% of our patients. Radiotherapy and chemotherapy were given to 71.8% and 80.4% of cases respectively. Among the chemotherapy (chemo) recipients, 40.2% received adjuvant chemo, 54.5% received neoadjuvant chemo, and the remaining 5.3% received both. Further, the most prevalent complication was pain accounting for 42.1% of total complications, and the least prevalent was cellulitis 4%. Also, seroma developed in 18.3% cases, paresthesia noted in 5.6% of cases, winged scapula was reported as 2%, weakness and necrosis were seen in 6% and 13.1% of cases respectively. Axillary vein thrombosis and lymphangiosarcoma were reported in none of the patients (0%). Lymphoedema accounted for 16.1% of overall complications, 85% of the patients who developed lymphedema had undergone ALND, and 12.9% and 14.4% received radiotherapy and chemotherapy respectively. Lymphedema was observed in breast cancer stages as follows: stage I 1.2%, stage II 7.2%, and stage III 5.2%. Patients with body mass index (BMI) of 30 - 39 kg/m2 had 7.2% prevalence of lymphedema compared to other BMI groups. Overall mortality was 8.3%. Conclusion: The findings of our study suggest that the prevalence of lymphedema was higher in ALND patients with locally advanced tumors, and higher BMI, compared to patients with stage I breast cancer and low BMI. Further, the prevalence of lymphedema in patients who underwent ALND was significantly lower than those who were treated by lumpectomy 10.3% (p-value = 0.034) in comparison to mastectomy 19.3%.