Mame Diarra Ndiaye Gueye

Accuracy of syndromic management in targeting vaginal and cervical infections among symptomatic women of reproductive age attending primary care clinics in Dakar, Senegal

To assess the effectiveness of the WHO syndromic algorithm in the management of vaginal discharge among women of reproductive age in Dakar.

A Rare Case of Extra-Uterine Pelvic Leiomyoma

Extra-uterine leiomyomas are rare, benign, and may arise in any anatomic sites. Extra-uterine leiomyomas are diagnostic challenge due to their rare unusual locations. We present a case of pelvic leiomyoma mimicking ovarian mass in a 34-year-old woman who was suffering for right pelvic pain. Clinical and imaging findings revealed an ovarian leimyoma. A laparotomy using Pfannenstiel incision was performed. Pelvic organs and both ovaries appeared normal. There was a firm mass about 5 cm in size distinct from the left ovary and attached to uterus with some fine adhesions that were cut allowing removal of the mass. Pathologic examination concluded to a benign leiomyoma. The recovery was uneventful and pelvic pain disappeared. Leiomyomas occur infrequently outside the uterus. Although they are histologically benign, extra-uterine leiomyomas may mimic malignant tumours at imaging and may present a diagnostic challenge. Surgical excision is the most common treatment.

Analysis of cesarean section rate according to Robson’s classification in an urban health centre in Senegal -

Background: Robson, proposed a new classification system, the Robson’s Ten-Group Classification System to allow critical analysis according to characteristics of pregnancy. The objective was to describe caesarean rates in an urban health centre in Dakar using Robson’s Ten groups classification Methods: This study was performed in Philippe Senghor health centre in Dakar (Senegal), a secondary health centre that performs CS since 2011. Before this date, only midwifes performed deliveries in this centre. The study took place between 1 January and 31 December 2013. All patients who delivered during this period by CS were included. Women were classified in 10 groups according to Robson’s classification, using maternal characteristics and obstetrical history. For each group, we calculated its relative size and its contribution to the overall caesarean rate. Results: The overall rate of caesarean was 18.2%. The main contributors to the overall caesarean rate were primiparous women in spontaneous labour (group 1) and women with previous caesarean section (group 5). Further analysis of group 1 showed that more than half of CS indications in this group were fetal-pelvic disproportion in 55.2% and fetal hypoxia in 27%. Conclusion: The Robson’s classification is easy to use. Each maternity unit can compare its rates with those of units with similar level, to find whether some groups of women have very high rates of caesarean sections. Attention should be made because CS rates is rising up and will be problematic in our low resource countries. It is time to implement obstetric audits to lower the CS rates.