Obstetrics and Gynecology


    Objectives: -to determine the maternal mortality ratio at the Kolda Regional Hospital; -to describe the socio-demographic characteristics of the deceased patients; -to clarify the causes of maternal mortality and to identify the associated risk factors. Materials and method: This was a prospective, descriptive and analytical study conducted between January 1st, 2012 and December 31st, 2016 at the Kolda Regional Hospital Center. We collected data from maternity records, resuscitation records, anesthesia records and the operating protocol register. Results: During this study period, we recorded 120 maternal deaths out of 4116 living births, a maternal mortality ratio of 2915.4 per 100,000 living births. The average age of our patients was 27 years old. The average parity was 4 deliveries and multiparas accounted for half of the patients. In our series, 84% of patients were evacuated; high blood pressure (35.8%) and obstructed labor (18.8%) were the most common reasons for evacuation. More than half of the deaths (52.5%) occurred in the postpartum and 32.5% in the 3rd quarter. More than half of the deaths occurred within the first 24 hours after of admission (52%). Just over a third of patients (39%) had delivered by caesarean section and we had 58.8% of perinatal deaths. The conclusions of the audit were a delay in consultation (57%) followed by a delay in evacuation (28%) and a delay in the management of patients (25%). Conclusion: The multiple factors influencing the high maternal mortality rate in this region of Senegal can be attributed to the community, the medical team, and / or the health system. Strategic interventions to reduce this mortality rate should be based on community education on safe motherhood, on the improvement of the level of education, on communication systems and better transportation, on access to quality reproductive health services and availability of emergency obstetric care.

  • Genital Prolapse on Pregnancy: Case Study and Literature Review

    Genital prolapse is a common gynecological condition, but it is exceptional during pregnancy. It can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. We report the case of a third third-generation 32-year-old third gesture second pare with no particular health history. The last two pregnancies proceeded normally with stage 2 genital prolapse occurring in the second trimester of pregnancy that was aggravated by abdominal expression during childbirth.

  • Term Abdominal Pregnancy with Live Fetus: about a Case and Review of the Literature

    Objectives: To specify the diagnostic difficulties and the criteria allowing a conservative load taking. Observation: We report a case of abdominal pregnancy with live fetus diagnosed ultrasonically at 23WA in a context of abdominal urgency on the background of secondary amenorrhea with prospective follow-up and birth at 36WA. Ultrasound is essential to diagnosis. The treatment is always surgical and the difficulty is dominated by the removal of the placenta. The fetal prognosis is reserved and the maternal mortality is not negligible. Conclusion: Abdominal pregnancy is a rare event. Her diagnosis is difficult and a conservative attitude of pregnancy is possible.

  • Male infertility : immunological and clinical aspects at the University Health Center of Brazzaville

    Summary : The objective of this study is to contribute to the knowledge of the immunological and clinical aspects of the male infertility at the University Health Center of Brazzaville. Patients and methods : it was a descriptive, transversal and analytical study over a period ranging from the 1st november 2015 to the 31st october 2016. All patients with infertlity were concerned among them we distinguished between those having agglutinates of sperm in the semen on the one hand (G1) from those who did not have any (G2). So we looked for the presence of the antisperm antibodies in the two groups. Results : During the period of study, 1889 spermograms had been realised, and 67 among them were pathological approximately 3,5 % and among them there were 18% with the ASA. The patients were on average 37,4 +/- 5,8 years old, extreme (27-56 years old). They consulted after a delay of 5,3 +/3,7 years on average, extremes (1-16 years). The infertlity was primary in 50,7% and secondary in 49,3%. As far as the scrotum is concerned, the varicocele was more found in 34,3%. In the spermogram, 18 % had agglutinates of sperm against 82 %. The. oligoasthenozoospermias represented 41,8% followed by azoospermia, 20 %. The stigmata of infection have been noticed, they are alkaline PH (9,9%),many leukocytes (10%) and hyperspermia (0,9%). For the 9 patients who had sperm with antispermatozoïd antibodies, 1 patient had IgA, 2 patients had IgG and 6 patients had both IgA and IgG. The age of those having agglutinates ranged between 50 and 56 years (58,%) versus 30 and 39 years at 60 % (p˂0,05). The story of uro genital infecion was more present. The ASA were more identified in those having agglutinates in 58,33% of cases (p=0,0001). The average of the percentages of the…

  • The Development of Rs2853826 Genotyping and the Initial Association with Breast Cancer Risk in Vietnamese Women

    Breast cancer (BC) is known as the leading cause of dead in women through worldwide including Vietnam. Recently, mitochondrial genome mutations concerned to breast cancer has been screened in order to propose new potential biomarkers. The SNP rs2853826 located at 10398-nucleotide position within the NADH-dehydrogenase3 has been demonstrated to be associated with BC in populations such as Malaysian, Northern Indian, Poland, Banglasdesh, African-American, Eropean-American, but Vietnam. Thus, rs2853826 was selected as the candidate SNP for investigation in Vietnamese population. In this study, the High Resolution Melting method is optimized for genotyping 100/100 cases/controls samples, then determined the association between this SNP and the disease. The genotyping results revealed SNP rs2853826 has high polymorphism with the minor allele frequency, G allele, was 17.2%. risk allele G was 17.2 %. The association result between rs2853826 and BC revealed that G allele tend to increases risk of BC among Vietnamese when comparing A allele (OR[95%CI]=1.224[0.818-1.832]); and homozygote and heterozygote model also showed this trend when compared to dominant model. Since the p-values were larger 0.05 (p=0.326), our results only show a trend correlation rather than a significant association between SNP rs2853826 and BC risk. However, the reliability of this association analysis result is low (7.57%), so this research needs to be conducted with a larger sample size to reach the greater power (>90%) for therelation.

  • To observe changes of female sex hormones after chemical induction of Diabetes Mellitus

    Introduction: Diabetes Mellitus is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia and glucose intolerance, able to cause metabolic changes. Objective: To observe changes of female sex hormones in mice, after chemical induction of Diabetes Mellitus, in intervals of 15, 30 and 45 days. Methods: Adult females of the Swiss mice (35-40 g) had their weight and glucose levels evaluated. Animals were divided into three groups diabetics (D-15, D-30 and D-45) with their respective controls. Chemical induction of diabetes was held by alloxan monohydrate-solution (60 mg/mL), intraperitoneal, in concentration of 120g/kg. The control group was given saline solution. Ten days after induction, the animals underwent 8 hours of fasting and reassessed their weights and blood glucose levels. Were considered diabetic animals with blood glucose under 200 mg/dL. Animals which have not obtained this index were again submitted to the induction protocol. Blood glucose levels were measured at weekly intervals during the study period. The animals were sacrificed and blood collected immediately by cardiac puncture, packaged in gel tube and centrifuged to obtain serum. Hormone concentrations were determined by chemiluminescence method, in duplicate. The research was submitted to the Ethics Committee and approved (CEP 123-2013, UFCG-CTRS Campus Patos). The results that showed homogeneity and normality were evaluated by analysis of variance (ANOVA), with a significance level of 5% (p < 0.05). Results and discussion: The values for the Luteinizing Hormones (p = 0.000) and Estradiol (p = 0.029) showed significant only within 15 days of chemical induction. The Follicle Stimulating Hormone was significant in the periods of 15 and 45 days (p = 0.023 and p = 0.036, respectively) when compared to the control. Conclusion: The chemically induced diabetes probably set off hormonal changes, however, additional studies are required in a larger number of animals.

  • Prevalence Of Venereal Diseases In Professional Sex Women: A Review Of The Last 10 Years

    Introduction:Sexually transmitted infections (STIs) affect over 500 million people annually and female professionals (PSF) maintain a risk behavior for acquisition and transmission of STIs. Knowledge of STIs in this group is important in order to create a preventive public health policy program. Objective: To describe as major STIs that affect as PSF. Methodology: Bibliographic review of articles indexed in the international scientific database (PubMed) from September 2007 to September 2017, aged between 19 and 44 years. We selected 39 articles among which 24 were analyzed. Results and Discussion: A major STI for aid associated with Herpes Simplex Type 2 infection (83.2%), HPV (27%), vulvovaginitis (19.1%), Hepatitis B (10.7%), Syphilis (5.2%). These studies were from different countries dominating China. A prevalence of STIs is related to the vulnerability of FHPs, which, linked to the contexts of poverty, violence, alcohol and drug use, and non-legalization of the professionalization of sex in some places may contribute to marginalization of the risk situation and thus, . It was evidenced a low prevalence of syphilis in these studies, but not Brazil, an increase in STI since 2015 has been observed. The increase of STIs in the elderly population has been observed, due to an increase in the number of opportunities and availability of medications for erectile dysfunction, boosting life the elderly, making them more vulnerable to STIs. Conclusion: A public health alert is needed about the increased prevalence of PSFs caused by STIs. What has been happening due to the lack of use of condoms, multiple partners, but also due to lack of support for diagnostic accomplishment, treatment of recent reports that deepen or knowledge in this area, and may impel a development of preventive and assistance strategies aimed at improving sexual health and reproductive health of a marginalized and vulnerable population.

  • Anti-proliferative Activity of Lauric Acid in the Protista Trichomonas Vaginalis

    Introduction:Trichomonas vaginalis is the etiologic agent of trichomoniasis, a sexually transmitted infection associated with infertility, gestational complications, predisposition to cervical and prostate cancer, and increased risk of human immunodeficiency virus (HIV) transmission and infection. Metronidazole, the only drug available for treating, has dubious efficacy, high toxicity, it is contraindicated in first trimester of pregnancy and drug-resistant cases are increasing. Thus, there is an urgent need for the development of alternative strategies to combat trichomoniasis. In this context, lauric acid or dodecanoic acid, a fatty acid found in breast milk, coconut milk and coconut oil, has been used as an antimicrobial and antiparasitic compound. Aim: To evaluate the anti-proliferative effect of lauric acid on T. vaginalis. Methodology: Parasites were axenically cultured in TYM medium (Tryptone – Yeast Extract – Maltose) supplemented with bovine fetal serum and antibiotics for 28-36h at 37 ° C. Next, 105 parasites were transferred to eppendorf tubes, containing 500 μl of TYM medium with bovine fetal serum and antibiotics, and treated with 20, 50 and 100 μg/mL lauric acid at concentrations of (stock solution: 50 mg/mL) at 37 °C for 24 h. Parasites treated with DMSO and in the absence of lauric acid were used as controls. Cell growth was determined after 24h by direct counting in Neubauer chamber. Results and Discussion: Similar to described in other parasitic microorganisms, our data showed a growth inhibition of 23,27%, 39,57% and 53,53% when the parasites were treated with 20 μg/mL, 50 μg/mL and 100 μg/mL lauric acid, respectively. Conclusion: Lauric acid inhibited the proliferation of T. vaginalis in a dose-dependent manner after 24h of treatment. Further studies are needed to elucidate the action mechanisms of this compound on T. vaginalis.

  • Case Report: Attention to Women Before the Clinical Climate Board

    Introduction:Climacteric processes and menopause are milestones in the women life, in which the first symptoms vary in each body. In order to reduce the discomfort caused by the climacteric and menopause, it is important to understand them. Objective: Disseminate information pertaining to identification of climacteric phenomena. Methodology: The case study occurred in a polyclinic from Cabedelo-PB in order to target academics to conduct humane and encouraging health education. Results and Discussion: M.S.A., 53 years search service in 16/08/2017 with chief complaint of dyspareunia, being routed by the urologist to evaluate possible low estrogenic for amenorrhea for three months and urinary incontinence. The anamnesis, reported irregularities in the menstrual cycle, flow reduction and shortening of the cycle (a: 13/08/17 for three days in a small amount and look like “coffee grounds”), and politeness. After the physical examination showed: flat and thin, vulva with rare sebaceous glands, dense, dry vaginal wall and urogenital atrophy, accompanied by fine as requested by ultrasound urologist. Reached the climacteric diagnostic hypothesis, FSH blood test, 2-estradiol, and prescribed estriol due peripheral action. It was subsequently opened a moment of dialogue with the patient about your knowledge of the subject and its aspirations, it became apparent that the lack of knowledge did identify themselves as “sick”, however, after the explanation of this physiological and mark the next stage of menopausal, we noticed a patient relief by decreasing your anxiety and helping in the understanding of the requested examinations and medication prescribed your membership and encouraging relationship doctor-patient. Conclusion: there was the urgent need to improve the knowledge about the menopause, to improve the attention and empower it, because it is a period of life characterized by physiological deficits which ovarian endocrine changes, provides psychological and somatic, known as climate syndrome, which has significant marker menopause.

  • Prevalence of Micro-organisms Found in Cervical and Vaginal Cytolic Scraps

    Introduction: Cervico-vaginal cytology, or cervical cytology, has been the main method of detection and prevention of cervical cancer and studies the exfoliated cells of the squamocolumnar junction, as well as the detection of premalignant and malignant lesions, as well as the presence of pathogenic microorganisms. For the susceptibility to infections by carcinogenic viruses. Objective: The purpose of this work is to elucidate the frequency with which the microorganism is present in the cervico-vaginal cytology, providing an explanatory view of it. Methodology: This is a descriptive study of the type of bibliographic review on the subject, based on scientific articles published in the years 2000 to 2013 and journals indexed in the following databases SCIELO and Google academic, comparing the information from these sources comparatively of research. Results and Discussion: The vast majority of etiologic agents that can be found in the Pap smear. Among the microorganisms transmitted by sexual contact, such as Trichomonasvaginalis, which is also an infection frequently seen in pre-drugs, represents about 10 to 15% of the causes of vaginal discharge, Candidasp, corresponding to 58.54%; Gardnerellavaginalis (13.41%) Chlamydiasp, corresponding to 4.88%, Actinomycespp 16.1%, Mobiluncussp 2.0% Conclusion: As shown, it is inferred that a wide range of microorganisms can be identified in cervico-vaginal cytology, it is concluded that a significant portion of microorganisms can be analyzed through the Papanicolau method, being an important tool to detect agents of great clinical interest.