Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

Introduction: Impalement wounds are defined by foreign objects usually steel bars or a wooden object, piercing a body cavity in part or from one end to another and always remaining in place. Thoraco- abdominal impalements are cases of rare trauma in our exercise context. We report a case of thoraco-abdominal impalement in an 11-year-old patient as well as our therapeutic attitude in our exercise context. Observation: this is an 11-year-old student, with no medical and surgical history, received in emergency for thoraco-abdominal trauma following a play activity in the family home. Discussion: Penetrating thoraco-abdominal wounds are most often caused by gunshot wounds. Impalement is a potentially serious lesion that can be immediately life-threatening and depends on the organs affected. Our case study concerns a patient victim of a domestic accident following a playful activity within the family home. The injuring agent was a concrete rod positioned within the home without any security measures and which was used to tie up sheep intended for domestic breeding. Management of impalements must comply with rules so as not to aggravate the lesions. Conclusion: Thoracoabdominal impalement injuries are potentially serious and can be life-threatening. Its management is a challenge in countries with limited resources like ours. Good coordination of medico-surgical care allowed optimal management of the patient.

Introduction: The multidimensional crisis (security, institutional and humanitarian) that Mali experienced in 2012 caused a massive displacement of populations, particularly the most vulnerable, i.e. women and children. During the occupation, numerous cases of violence were reported by rights organizations and non-governmental organizations. Objective: The objective was to highlight the contribution of the obstetrics and gynecology department of the Sominé DOLO hospital in Mopti in dealing with violence against women and girls during this period. Methods and Materials: This was a cross-sectional study from January 1, 2016 to August 31, 2017 on victims admitted to our service for cases of gender-based violence. The sample size was 20 and was randomly selected. The inclusion criteria were all victims of violence against women and girls admitted to the service during the study period. The noninclusion criteria concerned cases of violence against women and girls not recorded and managed in our service. Results: In total, we recorded 6971 outpatients in the obstetrics and gynecology department of the Sominé DOLO

A relatively rare congenital malformation, hematocolpos is the progressive accumulation of menstrual blood in the vaginal cavity at puberty. It is often the consequence of a hymen imperforation. It is clinically manifested by cyclic pelvic pain and primary amenorrhea and, more rarely, by a pelvic mass syndrome. The diagnosis is primarily clinical. Ultrasound and magnetic resonance imaging (MRI) are additional tests to confirm hematolcolpos and exclude other associated genitourinary malformations. Treatment consists of a hymenotomy to drain the hematocolpos. The age of discovery of hematocolpos varies from 13 to 14 years. We report a case of hematocolpos secondary to hymenal imperforation diagnosed in a 17-year-old girl with periodic pelvic pain, primary amenorrhea and a pelvic mass. A first ultrasound trap had evoked a large ovarian cyst but the repeat pelvic ultrasound in our hospital confirmed the diagnosis of hematocolpos.

Introduction: Hysterectomy is a surgical procedure commonly performed in obstetrics gynecology at the Sominé Dolo hospital in Mopti, but no study had been conducted. The aim of this study was to determine the prevalence of hysterectomy and to review gynecological and peripartum hysterectomies. Methods: This was a descriptive cross-sectional study conducted over a period of 12 months from January 1, 2017 to December 31, 2017 in the obstetrics gynecology department of the Sominé Dolo hospital in Mopti Mali. Eligible patients were represented by all those who had undergone a peripartum or gynecological hysterectomy during the study period in our service. Our supports consisted of patient files, patient interviews, the operating report register, the delivery register and the hospitalization register. Data were entered and analyzed using Epi info3.5.3 software and word processing was performed using Word 2007 software. Results: During the study period, all the surgical interventions represented 522 cases, i.e. an overall prevalence of 9.2% (57/522) among which hysterectomies during the gynecological period represented 70% (38/57) against 30% (19/57) peripartum hysterectomies. The average age of the patients was 46.5 years with the extremes of 18 and 75 years. The types of hysterectomies were represented in the vast majority by total interadnexal hysterectomy 77.2% (44/57) followed by subtotal hysterectomy 15.8% (9/57) and hysterectomy plus bilateral adnexectomy 7% (4 /57). Conclusion: Hysterectomy is one of the most practiced surgical activities at the Sominé Dolo hospital in Mopti. It constitutes an alternative solution for the practitioner to save the life of the patient, particularly in the event of emergency hysterectomies which represented a significant proportion in our study.