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In line with policies to combat maternal mortality, the medicalization of childbirth is increasing in low-income countries, while access to healthcare services remains difficult for many women. High caesarean section rates have been documented recently in hospitals in Mali and Benin, illustrating an a-priori paradoxical situation, compared with low caesarean section rates in the population. Through a qualitative approach, this article aims to describe the practice of caesarean section in maternity wards in Bamako and Cotonou. Workshops with obstetricians and midwives; participant observation inside labour rooms; and in-depth interviews with caregivers, patients and policy makers have indicated increased recourse to caesarean section due to women's and caregivers' suffering and under-resourced facilities. Within these procedures, two types of caesarean section were documented: 'maternal distress caesarean section' and 'preventive caesarean section'. The main reasons for these caesarean sections are maternal fear and pain, and a lack of resources. Inadequately resourced facilities lead to staff suffering and ethical breakdowns, and encourage the inappropriate use of technology. The policy of access to free caesarean section procedures exacerbates the issue of non-medically-justified caesarean sections in these countries. The overuse of caesarean section is particularly alarming in countries with high fertility as it constitutes a danger to both mothers and babies in the short and long term. Currently, conditions are in place in Benin and Mali for an increase in non-medically-justified caesarean sections. In the short term, such an increase could constitute a new burden for these two sub-Saharan countries, where maternal mortality is high.

Objective: To analyse the colposcopy results at the Gynaecological Clinic of Houéyiho. Patients and methods: Retrospective, descriptive and analytical studies were conducted by the Clinic of Houeyiho in Cotonou from January

Introduction l´hépatite C est une infection dont la transmission mère-enfant est possible. L´objectif de ce travail était d´étudier la prévalence du portage des anticorps anti-VHC chez des femmes enceintes à Cotonou et d´identifier les facteurs qui y sont associés. Méthodes il s´est agi d´une étude transversale menée du 01/06/2018 au 01/09/2018 auprès de 253 gestantes reçues pour des soins prénatals dans quatre grandes maternités de Cotonou (Bénin). Les anticorps anti-VHC avaient été détectés par des tests rapides d´orientation diagnostique. Un échantillon de sang veineux avait été prélevé chez les gestantes avec anti-VHC positifs en vue de tests sérologiques de confirmation et d´un dépistage du diabète gestationnel. Résultats la prévalence des anticorps anti-VHC était de 1,2% (3/253 gestantes). Les facteurs associés au portage du VHC n´avaient pu être identifiés compte tenu du faible nombre de cas positifs. Cependant, les gestantes porteuses des anticorps anti-VHC avaient une moyenne d´âge élevée (32 ± 3) comparativement au reste de la population (29,58 ± 5,5). Les facteurs de risque potentiels d´infection par le VHC retrouvés étaient les scarifications, le piercing, le tatouage, le partage du matériel de manucure, un antécédent d´intervention chirurgicale et de transfusion sanguine. La prévalence du diabète gestationnel dans notre étude était de 7,9% (20/253). Aucune association n´était trouvée entre le diabète gestationnel et l´hépatite C. Conclusion la prévalence des anticorps anti-VHC chez les gestantes à Cotonou était faible. Une étude d´envergure nationale s´avère nécessaire afin d´identifier les facteurs associés à cette infection.

Objective: The objective of this work is to compare two gestational diabetes screening strategies. Patients and methods: We conducted a comparative randomized study that screened gestational diabetes on pregnant women who are between 24 th and 28 th weeks of amenorrhea. We conducted the trials either by measuring fasting glucose values or by a glucose tolerance test performed two hours after oral loading of 75 g glucose (WHO test). The study involved 580 pregnant women (290 for each type of trial) who came for antenatal appointment at the reference maternity hospital in Porto-Novo (Benin) between February 2 nd , 2015 and January 31 st , 2017. Results: We detected 26 cases (9%) of gestational diabetes by the "fasting glucose value measurement method" as compared to the 18 cases (6.2%) detected by the WHO test, leading to a p-value of 0.209. The two types of test were equally relevant: Sensitivity (59.09% vs. 40.91%), specificity (50.75% vs. 49.25%), positive predictive value (8.97% vs. 6.21%), and predictive value negative (93.79% vs. 91.03%). All pregnant women tested "negative" between their 24 th and their 28 th weeks of amenorrhea, were tested again during the 32 nd week of amenorrhea, using the WHO test method and no new case of gestational diabetes was detected. Conclusion: Fasting glucose value measurement method can be an alternative method for gestational diabetes screening in a population where the WHO test is not available.