Objective: Analyze the maternal mortality in the two departments of CHU Point "G" in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point "G". All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of Chi 2 , the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20-24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%; the evacuation without any evacuation sheet: 259/389 making 66.6%), poor CPN (Prenatal consultation) quality (undone CPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389

Cesarean operation permits to save the mother and fetus. However, in developing countries as ours, complications related to this cesarean are not to be neglected. It constitutes an important cause of maternal and fetal morbidity and mortality. Here we rapport the experience of our structure about the complications of cesarean. Objectives: The objectives of this study were to study the complications the complications of cesarean section at teaching hospital Gabriel TOURE, Bamako Mali. Materials and methods: We have carried out a cross sectional analytic study from January 1 st 2003 to December 31 st 2013. All the patients who gave birth by cesarean operation in gynecology-obstetric service of teaching hospital Gabriel TOURE were included during this period of study. Descriptive statistics were used, Chi-square test Pearson, and Cochran Armitage test have been used to calculate the P-value of trend. We performed multivariate analyses with a high alpha threshold of 10%, and then logistic regression multivariate. Results: We have registered 28,376 deliveries with 9509 cases of cesarean (33.5%) and a complication cesarean rate of 32% (3049/9509). The main risk factors for cesarean operation completions were adolescence primiparity, obesity, the non-realization of antenatal care, evacuations and co-morbidities.

Background: We initiated this study for determining the maternal and fatal outcome of deliveries among the teenage to formulate the recommendations for reducing the maternal and neonatal morbidity and mortality among the teenage. We compared maternal and foetal outcome of deliveries among the teenage to that of adult women.Methods: It was a prospective analytical case/control study running in the Bamako’s district for 6 month comparing deliveries among one population of teenage elderly of 14-19 years and another population of women of 20 to 29 years having birth in our service hang the same period of the study. Used test statistics is the chi square of Pearson. For both groups we determined Odds Ratio (OR) and its interval of confidence (IC) to 95%.Results: We recorded 350 teenagers’ deliveries among 3703 deliveries (9.4%). The pelvic was normal among 66.3% of case versus 73.5% among the controls (p >0.05). The extended labor (≥12 hours) was found among 6.6% of case versus 3.3% of controls (p >0.05). We recorded 57.3% vaginal deliveries among the case versus 46.2% among the controls (p >0.05). We recorded 3 cases of maternal death all among the controls. 71% of new-born had an Apgar score ≥7 to the first minute among the case versus 81.2% among the controls. It was no significant difference in terms of vital outcome of new-born and of small weight birth in both groups (p >0.05).Conclusions: If teenage pregnancies are benefit the adequate prenatal care, there would be any significant difference between maternal and perinatal outcome of the deliveries among the teenage and of adult's people.

We compare maternal and neonatal outcome of breech delivery among the primipara as. Vaginal breech deliveries in single pregnancies at term were compared with deliveries in vertex presentation among the primipara in the same conditions. We determined Odds Ratio (OR) and confidence interval (CI) of 95% for analysis. During the study period 41.919 deliveries were recorded out of which 152 were primipara (0, 36%). The duration of the first period of labor was from 8 to 12 hours among 38% of case vs 35% among the controls (p>0, 05). The Apgar score at 1 minute of < 7 was found among 25% of cases vs 26% of witnesses. The early neonatal outcome was good in 87% of the cases and 95% among the witnesses (p>0, 05). Vaginal breech delivery must be possible among primipara if an experienced clinical team is available.

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11 th , 2016 to August 29 th , 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis How to cite this paper: Bocoum, A., Fané, with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infections associated with the care remain frequent in our service and dominated by the infections of the operating site. Isolated organisms were all resistant to amoxicillin in 88.88% case ciprofloxacin. 20%15% 35% 10% 5% 15% Acinetobacter baumannii Enterococcus faecalis Escherichia coli Klebsiela pneumoniae Pseudomonas aeruginosa Staphylococcus aureus 39.13% 17.4% 17.4% Escherichia coli Acinetobacter baumannii Enterococcus faecalisA. Bocoum et al.