Introduction: Late pregnancies are a hot topic for both women and perinatal health workers because of their increasing increase. In the elderly primiparous pregnancy, pregnancy has always preoccupied birth attendants for a long time because high-risk pregnancy is the one that is associated with certain risk factors that can hinder its normal evolution. Objective: Study childbirth in the elderly primiparous at the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a retrospective and analytical case/control study (1 case for 2 controls), from 1January 2019 to 31 December 2021.It had covered all deliveries recorded in the ward. Results: The frequency of delivery in the elderly primiparous was 0.36%. The most educated elderly primiparous accounted for 73.3% (p=0,000; OR= 2.014; 95% CI = [0.006-0.31]). Dystocia was the most common obstetric complication (p=0.13; OR= 0.69; 95% CI = [0.42-1.12]). Caesarean delivery accounted for 77.1% in cases versus 49% in controls (p=0.000; OR= 0.28; 95% CI = [0.170.48]). Apgar's score was greater than or equal to 8 in 90.5% of cases versus 82.4% of controls. We have not recorded any maternal deaths. Conclusion: Pregnancy and childbirth in the elderly primiparous are risk situations in some cases. Childbirth in the elderly primipare requires a skill that can detect and prevent morbid situations and allow adequate care.

Abdominal wall malformations correspond to a wide spectrum of congenital anomalies that are due to a defect in the closure of the anterior abdominal wall and can be fatal. We report the case of laparoschisis associated with a poly malformation syndrome in the same fetus at the reference health center of commune III of the district of Bamako. The objective is to clarify the interest of antenatal ultrasound in the diagnosis and prognosis of these malformations. It was a 19-year-old prim gravid woman received as part of the prenatal check-up. Antenatal ultrasound had allowed the diagnosis of malformation of the anterior abdominal wall of the gastroschisis type associated with abnormalities of the neural tube, the urogenital system and the bone skeleton. The antenatal diagnosis of the malformations had motivated the realization of a therapeutic termination of pregnancy at 19 weeks of amenorrhea and 3 days by triggering and vaginal delivery, allowing the confirmation of the diagnosis of gastroschisis and the poly malformation syndrome which is extremely rare. Antenatal ultrasound remains an ideal means of imaging for monitoring pregnancy and had made it possible to make the prognosis and antenatal diagnosis of multiple malformations in association, and to indicate better therapeutic decision-making.

Introduction: It is estimated that 60 to 80% of women in developing countries continue to give birth at home without any assistance or with the help of unskilled people and usually in an unsanitary environment. Purpose: It was tostudy unassisted home birth in two districts of Commune V. Materials and Methods: This was a prospective, crosssectional and analytical study from 1 March 2019 to 28 February 2020. Results: We recorded 263 home deliveries or 13% of deliveries in Sabalibougou and 62 home deliveries or 3% of deliveries in Badalabougou. The proportion of women not attending school was 74.64% in Sabalibougou against 25.36% in Badalabougou. In Sabalibougou, 89.40% of women had given birth at home due to lack of financial means compared to 10.60% in Badalabougou. Haemorrhage by uterine atony was the most represented complication in the two districts, 72.92% in Sabalibougou and 27.08% in Badalabougou.

Introduction: Medical evacuation in general is characterized by the need for the rapid transfer of a patient from one medical centre to another more equipped or better specialized. Obstetric emergencies are multiple causes of maternal and neonatal death. Purpose: Was to study the reasons for reference / medical evacuation obstetrical at the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a descriptive study with a retrospective collection from January 1, 2017 to December 31, 2020. Results: We collected 4280 referrals/evacuations out of 28974 admissions; or 14.8% of admissions. The median age was 26.17 years. Housewives accounted for 45.4%. Dystocia was the main reason for references/evacuations with 41.1%. The reasons for referral/evacuation were consistent in 60.3% of cases. These evacuations were relevantin 21.8%. Maternal mortality was 0.8%. Conclusion: Evacuations accounted for 14.8% (4280) of deliveries. The most commonly cited reasons were dystocia, antepartum haemorrhage and high blood pressure and its complications. Dystocia, fetal asphyxia and high blood pressure and its complications were the main diagnoses.

Introduction: In Mali, adolescent girls aged 15 to 19 contribute nearly 14% total fertility carried health risks for the mother and the fetus during pregnancy and childbirth. Purpose: To study knowledge attitudes and practices among adolescents relating to contraception in school in Commune V of the District of Bamako. Material and Methods: This was a cross-sectional study with an evaluative and descriptive aim on knowledge attitudes and practices among adolescents relating to contraception in school in Commune V of the District of Bamako. Results: In our study, 87% of adolescents knew about contraception and 29% usued to contraceptive method. The 16-17 age group represented 74%. 36.33% of adolescents girls had already had sexual intercourse. The most usued contraceptive method was the condom with 24. 34%. The use of contraception in school was influenced by sci o-cultural, religious weigtht and ignorance (lack of sex education). Conclusion: Knowledge of contraception does not equate to its pratical use among adolescents. The majority of teenage girls said they knew about contraception, of which only a Fès of them used a contraceptive.