Mouhamadou Mansour Niang

Spontaneous Uterine Rupture of an Unscarred Uterus before Labour

Uterine rupture is a public health problem in developing countries. When it is spontaneous, it occurs most often during labor in a context of scarred uterus. Uterine rupture during pregnancy is a rare situation. The diagnosis is not always obvious and morbidity and maternal and fetal mortality is still high. We report a case of spontaneous uterine rupture during pregnancy at 35 weeks of an unscarred uterus before labour. This is an exceptional case that we observe for the first time in our unit.

Gestational trophoblastic neoplasia after achieving a nondetectable serum human chorionic gonadotrophin level.

To determine the risk of recurrent trophoblastic disease after normalisation of human chorionic gonadotrophin (hCG) levels in women with hydatidiform mole.

Cervical cancer screening in pregnancy at the maternity clinics of Nabil Choucair health center and the Institute of Social Hygiene of Dakar, Senegal: a study on 67 cases

Background: This study aims were to develop the epidemiological profile of patients who received Pap smears during pregnancy, to describe aspects of cytological smears performed in pregnant women and to describe the therapeutic management in case of anomalies in the cervical smear during pregnancy. Methods: This was a prospective, descriptive and analytical study conducted from January 15, 2015 to June 31, 2015 at maternity of Nabil Choucair Health Centre and the Institute of Social Hygiene in Dakar. The Pap smear was performed in all patients who had given their consent to the experience. The parameters studied concerned sociodemographic aspects, gynecological and obstetric background, gestational age at the time of collection, cervicovaginal smear results, diagnostic and therapeutic management of cytological and histological abnormalities. The data collected on a survey sheet prepared for this purpose were entered and analyzed through the version 3.5.3 of Epi info software. Results: During the study period, 67 pregnant women had received a Pap smear. The epidemiological profile of our patient was a paucipare gestity with an average of 3 with extremes ranging from 1 to 7, an average parity of 2.4 with extremes ranging from 1 to 7. The mean age of pregnancy was 15.4 weeks of amenorrhea (range of 6 and 32 weeks). Only 5 patients (7.4%) had already received a cervical-vaginal swab before the study. The smear was normal in 88.7% of the cases but got abnormalities in 11.3% of the cases. The abnormalities were mainly found in squamous cells and were divided into low-grade lesions (57.1%) and skew-cell abnormalities whose meaning was undetermined (42.1%). Colposcopy was performed in 8 patients. Colposcopy was normal and satisfactory in 4 patients (50%) and identified as atypical grade 1 transformation in 2 patients (25%) and an atypical grade 2 transformation in 2 patients (25%). From a therapeutic point of view, diathermic loop conduction associated with strapping was performed in one patient (12.5%) for severe dysplasia. In postpartum, all dysplastic cervical lesions diagnosed during pregnancy had declined. Conclusions: In the context of our study, where there is no organized screening policy for cervical cancer, antenatal clinics are an excellent screening opportunity to seize.

Hemoperitoneum due to spontaneous uterine rupture of varicose veins in a twin pregnancy at term: A clinical case study presentation

Introduction: spontaneous rupture of uterine vessels during pregnancy is an exceptional situation. case report: We report a case of massive hemoperitoneum due to spontaneous rupture of uterine varicose veins, occurring in a patient with twin pregnancy at 38 weeks gestation. the patient presented abdominal pain associated with a sudden drop in blood pressure and severe decompensated anemia. Ultrasound scan revealed in-utero fetal demise of the twins with a peritoneal effusion. An emergency laparotomy followed by a cesarean section confirmed the diagnosis, etiology and management with a favorable maternal outcome. Mariétou Thiam1, Mouhamadou Mansour Niang2, Papa Abdoulaye BA3, Lamine Gueye4, Marie Edouard Faye Diémé5, Mamadou Lamine Cissé6 Affiliations: 1MD, Assistant Professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital, Faculty of Medicine, Thiès University, Thiès, Senegal; 2MD, Assistant Professor, Department of Obstetrics and Gynecology, Cheikh Anta Diop University, Dakar, Senegal; 3MD, Assistant Professor Department of General Surgery, Faculty of Medicine, Thiès University, Thiès, Senegal; 4MD, Department of Obstetrics and Gynecology, regional hospital Thiès, Senegal; 5MD, Professor, Department of Obstetrics and Gynecology, Cheikh Anta Diop University, Dakar, Senegal; 6MD, Professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital, Senegal, Thiès University, Thiès, Senegal. Corresponding Author: Mariétou Thiam, MD, Assistant professor, Department of Obstetrics and Gynecology of the Thiès Regional Hospital, Faculty of Medicine, Thiès University, Thiès, Senegal. BP 34 A Thiès; E-mail: maricoulibaly10@gmail.com Received: 19 December 2015 Accepted: 25 April 2016 Published: 24 May 2016 conclusion: spontaneous rupture of uterine varicose veins during pregnancy is a rare condition. clinicians should be aware with this rare condition as delayed diagnosis can be fatal for mother and fetus. the definitive diagnosis of this condition is often made intraoperatively. However, the clinical presentation with ultrasound scanning is very important in planning the management of this condition.

Funiculars anomalies during childbirth: about 562 cases collected in Pikine National Hospital -

Background: Establish an epidemiological description of the different types of umbilical cord anomalies in our reference structure and to assess their impact on the prognosis of childbirth. Methods: We conducted a descriptive study, cross over a period of one year in Obstetrics and Gynecology Service Level III of Pikine Hospital. We included all women in labor have reached the term less than 28 weeks gestation and delivering a newborn with umbilical cord abnormality diagnosed during labor or during the expulsion. Results: During this period, we compiled 562 anomalies of the umbilical cord, which gave a frequency of 23.8%. Length discrepancies were far the most frequent (67.4%). Only the prolapsed cord was an independent risk factor for cesarean section (p = 0.036). The rate of episiotomy and tear was significantly higher in case of brevity (primitive or induced) cord (p = 0.042). Apgar score ≤7 was significantly related to the presence of brevity (p = 0.000), excessive length (p = 0.048) or cord prolapse (p = 0.037). Conclusions: This study has allowed us to see that the funicular abnormalities impede the smooth running of childbirth. Their occurrence is facilitated by the excess amniotic fluid, prematurity and low birth weight. Their research during prenatal ultrasounds should be systematic.

Puerperal uterine inversion managed by the uterine balloon tamponade.

The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described. We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for postpartum hemorrhage due to uterine atony. After manual reduction of the uterus, the use of intra uterine balloon tamponade helped to stop the hemorrhage. The uterine inversion is a rare complication that may cause maternel death. The diagnosis is clinical and its management must be immediate to avoid maternal complications.