Uterine Leiomyomas Surgery: Assessment of Five Years in the Gynecology Department of Hôpital du Mali

Uterine leiomyomas (myomas) are the most common benign tumors of the female genital tract. They affect 20% to 25% of women of childbearing age and are 3 to 9 times more common in black women. We initiated this study in order to report the socio-demographic aspects and the indications for leiomyomas surgery at Hôpital du Mali. This was a retro-prospective descriptive study, conducted in the gynecology department of Hôpital du Mali from January 1, 2015 to December 31, 2019. Any patients, regardless of their age, in whom a leiomyomas had been detected and surgically treated were included. We had collected 180 cases of surgery for leiomyomas out of 950 surgical procedures, with a frequency of 18.94%. The 36 - 45 age group represented 45% of our patients with an average age of 35 years. Nulligravida accounted for 48.9% and nulliparous (60%). The main reason for consultation was the desire to become pregnant (53.33%). A history of myomectomy was found out in 15.55% of patients. Pelvic ultrasound figured out 64.44% interstitial myomas. Myomectomy was performed in 88.88% of cases and hysterectomy in 11.12% of cases. Among our patients 39.37% had become pregnant. Operative complications were dominated by anemia 14.44%. Leiomyoma was the histological tissue found in all cases of myomectomy. The average duration of hospitalization was 3 days. Conclusion: Leiomyomas surgery is the first scheduled gynecological surgical activity. Laparotomy remains the primary route of entry. The indications are dominated by the desire for pregnancy.

Artificial Induction of Labor with Misoprostol: Maternal and Fetal Prognosis at the Referral Health Center of Commune I of the District of Bamako

Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.