Dicephalic parapagus are one of the rare forms of conjoined twins. Their prognosis is usually very poor. Early prenatal diagnosis of these serious congenital abnormalities remains a real challenge for health systems in the low-income countries. The late antenatal diagnosis of a case of this abnormality was presented. The diagnosis was made at the 33rd week on the only ultrasound performed during the pregnancy. The pregnancy was interrupted with the agreement of the couple and delivery was performed by caesarean section.
Introduction La planification familiale est une stratégie à haut impacts pour la réduction de la mortalité maternelle et pour la prévention de la transmission mère-enfant du VIH. L'objectif de cette étude était de décrire les pratiques contraceptives des femmes infectées par le VIH suivies en ambulatoire au CHU de Treichville Méthodes Une enquête transversale descriptive a été réalisée dans les unités de soins ambulatoires aux personnes vivant avec le VIH du CHU de Treichville du 1 er avril au 30 juin 2016. Durant cette période, toutes les patientes VIH positives en âge de procréer, fréquentant les services de gynécologie-obstétrique, pneumo-phtisiologie, dermatovénérologie et médecine interne ont été invitées à renseigner un questionnaire standardisé portant sur les caractéristiques sociodémographiques, médicaux et les pratiques contraceptives Résultats Au total, 283 femmes ont accepté de participer à l'étude, l'âge médian était de 36 ans avec une parité moyenne de 1,7. Les patientes étaient nullipares dans seulement 22,3% des cas et vivaient en couple dans 54,8% des cas. Elles n'avaient pas d'enfant avec le conjoint actuel dans 68,2% des cas. Le conjoint était informé du statut VIH dans 51,6% des cas. Elles étaient sous traitement antirétroviral dans 92,9% des cas avec une médiane de CD4 de 382 éléments/ml. La majorité des patientes (62,9%) avaient déclaré utiliser une méthode contraceptive moderne. Elles utilisaient surtout les progestatifs injectables (45,5%) et l'implant (32,6%). La pratique de la double protection n'a été signalé par seulement 17,4% d'entre-elles. Le niveau scolaire secondaire et supérieur (OR=2,23 [1,35-3,69], p=0,01), la multiparité (OR=1,84 [1,11-3,06], p=,002) et la révélation du statut VIH au conjoint (OR=1,86 [1,14-3,03], p < 0,01) étaient les facteurs significativement associés à l'utilisation de la contraception Conclusion Les pratiques contraceptives des femmes infectées par le VIH dans notre expérience restent globalement décevantes. Il faut développer des stratégies visant à améliorer l'intégration de la planification familiale dans la prise en charge les femmes infectées par le VIH.
Umbilical endometriosis is a very uncommon condition which presents as a pigmented umbilical nodule, papular or cystic, with symptoms punctuated rhythmed by menses. The authors report the case of a 32-year-old with spontaneous umbilical endometriosis. Surgical resection was performed with a good cosmetic result and no recurrence at six months. A review of the literature allowed the authors to discuss the diagnosis difficulties and treatment in a underdeveloped country.
Background: Congenital malformation is responsible for spontaneous abortion, the birth of a child born dead or a child with disabilities that can lead to long-term disability and have a detrimental impact on the individual, his family and society. The etiologies are diverse. The discovery in our maternity is not rare. The absence and high cost of these prenatal diagnostic are a brake on the detection of congenital malformations. It is these various malformations diagnosed in the ante natal and at birth in our service that we describe in this work which aims to make their panorama.Methods: The purpose of this cross-sectional and descriptive study curried out between 1 January 2003 and 31 December 2013 (10 years) was to describe the various congenital malformations observed at the maternity of the Gynecology and Obstetrics ward of the Treichville University Hospital Center and to identify the socio-demographic characteristics of mothers. This study concerned all women who had given birth at the Treichville University Hospital Center and whose child had a malformation.Results: During the period, 151 parturients gave birth to at least one child with a congenital malformation and among 30,698 newborns, 161 newborns (0.52%) had a malformation. Pregnant women were between 20 and 30 years old (66%), were primiparous in 46.4% of the cases, and 41.7% were housewives. The malformations were isolated in 101 newborns (62.4%), multiple in 60 newborns (37.6%), and dominated by those of the osteoarticular system and the nervous system. Fetal malformations had a poor prognosis in 77 cases (48%) and the fetus was stillborn in 44 cases (27%).Conclusions: Congenital malformations are a reality at the maternity clinic at Treichville. In our countries, the ultrasound stays a fundamental element for the congenital diagnosis of the malformations. A good training of the doctors in prenatal diagnosis is also necessary to make of good diagnoses who will allow a better care of new-born.
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