Ali Ouédraogo

Respectful maternity care in three health facilities in Burkina Faso: The experience of the Society of Gynaecologists and Obstetricians of Burkina Faso

The Society of Gynaecologists and Obstetricians of Burkina Faso (SOGOB) conducted a project to reinforce skills in respectful maternity care among its members and health workers at three facilities. The participatory process allowed health workers to self‐diagnose quality of care, recognize their own responsibility, propose solutions, and pledge respectful care commitments that were specific for each unit. Key commitments included good reception; humanistic clinical examination; attentive listening and responsiveness to patient needs; privacy, discretion, and confidentiality; availability; and comfort. These commitments can potentially be modified after each evaluation by SOGOB. Poor working conditions were found to negatively impact on quality of care. High staff turnover, frequent technical malfunctions, and inadequate infrastructure were identified as issues that require future focus to ensure improvements in quality of care are sustainable. Programs that aim to improve the maternity experience by linking good practice with humanistic care merit rollout to all healthcare facilities in Burkina Faso.

Audit of cesarean delivery in Burkina Faso

To assess the level and determinants of unnecessary cesarean delivery.

Effects of an intervention initiated by a national society to improve postabortion care in rural facilities in Burkina Faso

To evaluate the results of an intervention by the Societé de Gynécologues et Obstétriciens du Burkina (SOGOB) to improve postabortion care (PAC) in rural areas of Burkina Faso.

Emergency Cesarean Section for Teenagers at Yalgado Ouedraogo Teaching Hospital (YOTH), Ouagadougou, Burkina Faso: Frequency, Indications, Maternal and Perinatal Prognosis

Objective: To study emergency cesarean section in teenagers with the goal of reducing morbidity and maternal-fetal mortality. Methods: This was a descriptive cross-sectional study with prospective collection of data on 248 cases collected from July 1st to December 31st, 2016. Results: The incidence of cesarean section in teenagers was 56.4%. The average age was 18 ± 0.4 years old. The vast majority were primiparous (92.7%). The main indications for emergency Caesarean section were: pre-eclampsia and its complications (20.2%), acute fetal distress (18.5), pre-rupture syndrome (14.1%) and bone dystocia (11.7%). The maternal mortality rate was 1.6% and perinatal mortality was 134 per 1000 live births. Conclusion: The rate of caesarean section is high at Yalgado OUeDRAOGO Teaching Hospital of Ouagadougou. Postoperative complications are sometimes serious and compromise the maternal and fetal outcome. There is a need for increased surveillance of all pregnant and recently delivered women to reduce maternal and perinatal mortality in teenagers.

Vaginal Bleeding in the Nonpregnant Patient Received in Emergency at Yalgado Ouedraogo University Hospital of Ouagadougou, Burkina Faso

Objective: To describe the epidemiological, clinical and therapeutic aspects of cases of vaginal bleeding in the nonpregnant patient received in emergency at Yalgado OUEDRAOGO University Hospital. Materials and Methods: It was a retrospective and descriptive study that involved the clinical records of 326 patients collected from January 01, 2009 to December 31, 2013. Results: The average age of women was 47 years old with extremes at 12 and 82 years old. Women of childbearing age accounted for 61.6% and postmenopausal women 18.7%. 70.7% of women were pauciparous or nulliparous. Menorrhagia and pelvic pain were the main signs associated. This symptomatology required hospitalization in 85.2% of cases. The main aetiologies were uterine myomas 49.69%, cervical cancer 23% and functional metrorrhagia 11.04%. Progestin was the most used drug in 67.1% of cases. Total abdominal hysterectomy and abdominal myomectomy were the most commonly used surgical methods with 22.3%, 44.4% of cases. Eleven death cases were observed. Conclusion: Gynecological metrorrhagia is more common in women of childbearing age than in menopausal women. The main causes are fibroma, cervical cancer and functional metrorrhagia.

Iatrogenic Lesions of the Ureter Following Obstetric or Gynaecological Surgery Managed at Yalgado Ouedraogo University Hospital: A Series of 14 Cases

Objective: To describe the aetiology, clinical presentation, management and outcomes of a series of patients with iatrogenic lesions of the ureter following obstetric or gynaecological surgery treated at Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso. Methods: This is a case series looking at 14 consecutive patients from 1 January 2011 to 28 February 2017, operated on for urological complications following obstetric and gynaecological surgery. Results: Our study focused on fourteen cases. The average age was 32.9 years (range 20 - 60 years). Thirteen were housewives. Eleven lived in rural areas. The aetiological factor was Caesarian section in seven cases, laparotomy in four cases and hysterectomy in three cases. The type of ureteral injury was bilateral ligation in nine cases. The average time to diagnosis was 16 days (range 2 - 120 days). Anuria was the commonest presenting symptom. Ultrasound in ten patients showed evidence of uretero-hydronephrosis. Eight patients required renal dialysis. Surgical management was uretero-vesical re-implantation in eleven cases, disunion of sutures associated with catheterization in two cases and a termino-terminal ureteral anastomosis in one case. The average hospital stay was 26 days (range 9 - 44 days). The post-operative period was complicated by two cases of vesico-vaginal fistula, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis. No deaths were recorded and a complete cure was ultimately obtained in all patients. Conclusion: Urological complications of obstetric and gynaecological surgery are dominated by ligation of the ureters in our setting. Caesarian section is the commonest cause. Treatment is essentially surgical.

Postpartum Arterial Hypertension in African Setting, Ouagadougou

Objective: The study’s objective was to determine the epidemiological, clinical, ancillary investigations, therapeutic patterns and the outcome of postpartum hypertension. Patients and Methods: A retrospective study was carried out from January 2013 to December 2014 in the departments Obstetrics and Cardiology of two Teaching Hospitals in Ouagadougou, Burkina Faso. All cases of hypertension or eclampsia which newly occurred within 42 days postpartum without prior medical history of hypertension were included in the study. Results: One hundred and seventeen cases of postpartum hypertension were recorded representing 1.08% of deliveries. The mean age was 26.7 years, primiparous represented 39.1% of cases. The mean days between delivery and diagnosis were 5.6 ± 6.3 days. Hypertension was discovered as eclampsia in 61.95% of cases. It was severe hypertension in 42.39% of cases. The blood pressure was controlled in 90.22% within the first 48 hours. Conclusion: Postpartum period follow up with systematic blood pressure and urine protein measurements are necessary.

[Obstetric endometritis at the UTH-Yalgado Ouedraogo of Ouagadougou (Burkina Faso): about the management of 102 cases].

This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.

Les endométrites obstétricales au CHU-Yalgado Ouédraogo de Ouagadougou (Burkina Faso). À propos de la prise en charge d’une série de 102 cas Obstetric endometritis at the UTH-Yalgado Ouedraogo of Ouagadougou (Burkina Faso): about the management of 102 cases

This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.

Les endométrites obstétricales au CHU-Yalgado Ouédraogo de Ouagadougou (Burkina Faso). À propos de la prise en charge d’une série de 102 cas

This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.