No abstract

The objective of this study was to take stock of instrumental extractions using an obstetric suction cup at the Nabil Choucair Health Center in Dakar. It was a retrospective, descriptive study on instrumental extractions by vacuum cup from January 1, 2010 to December 31, 2017 (144 months) at the maternity unit of the Nabil Choucair Health Center. This study included all patients who had experienced vacuum assisted delivery. The parameters studied concerned socio-demographic, clinical characteristics, indications and maternal-foetal complications. The collection was carried out using the fact sheet completed on the basis of the analysis of the files, the delivery register, and the anaesthesia register of the operating room. Data entry was carried out using Sphinx version 5 software and data analysis by Epi info version 3.5 software and descriptive analysis was carried out by studying the frequency, the mean and the standard deviation. During the study period 66,000 women gave birth and we collected 360 instrumental extractions. The frequency of the vacuum cup was 0.5% for instrumental extractions. The average age of the patients was 24.5 years, parity was 1.6. The average gestational age was 39.4 Weeks of Amenorrhea (SA), the average uterine height was 33 cm, the noises of the foetal heart were normal in 98% of parturients. The indications were dominated by a stop in the progression of foetal mobile (39%). The mean average birth weight was 2994 g and 97% of new-borns had an Apgar score of 9. Maternal complications were dominated by simple perineal tears (7%) and 3 cervical tears (1.2%). The neonatal prognosis was dominated by 13 caput succedaneum (chignon) (7%). The obstetrics suction cup is still decisive for the foetal outcome in our maternities. The mastery of the technique and the right indications help to avoid complications.

This case report, it's about a patient I met during prenatal consultation, she was in the 2 nd semester of her pregnancy, exactly at 25 weeks. During the physical examination, we found, she had a hypoplasia of minor labia, an incomplete vaginal diaphragm with a vaginal cup, and a hypertrophy of clitoris. We decide to make some biological and instrumental examinations. After getting the result, we concluded she has a pseudo hermaphroditism associated with malformation of 1/3 of vagina. Reason why the way of the delivery choose was a C-section. Female pseudo hermaphroditism is the most frequent (FPH) sexual ambiguity. It is characterized by the extension of abnormality of the sexual differentiation during the fetal life in the female fetus by a maternal or fetal hyper-genesis. The authors propose through a clinical case with a patient 46XX DSD pregnant. The main cause of this pathology is congenital adrenal hyperplasia, which we lead to deficits of 21-hydoxylase, 11-beta-hydroxylase, 3-beta-hydroxysteroid dehydrogenase, but 95% of the congenital adrenal hyperplasia is the deficiency of 21-hydoxylase. The treatment of congenital adrenal hyperplasia depend of the cause, hormone replacement therapy like (dexamethasone, hydrocortisone), most often the treatment for life is needed. From this we propose to make review of literature focusing on it.