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.

Objective: Study the fetal-maternal and neonantal prognosis of sickle cell pregnancies managed in Cotonou's hospitals (R. Benin). Material and methods: This is a descriptive study on retrospective data from January 2008 to December 2018. The maternities of the Lagoon Mother and Child Hospital and University (CHU-MEL) center and of the CNHU/HKM gynecology and obstetrics university clinic had served as a framework. Complete patients records were analyzed. Included were pregnant women or delivered at 28 weeks of amenorrhea (AW) or beyond, sickle cell disease SS or SC confirmed by hemoglobin electrophoresis. Sociodemographic, clinical, therapeutic, and fetal-maternal and neonatal prognosis were analyzed. EPI DATA 3.1 and SPSS 2.0 software were used to analyze our data. The difference is significant for a p-value ≤ 5%. Ethical and professional standards and rules were respected. Results: The delivery of a patient suffering from sickle cell disease represented 0.82% of births. The SS phenotype was observed in 27.3% (n=105) versus 72.7% (n=279) of SC (p=0.000). A history of obstetric complications was noted in 56.8% (n=218). The course of the current pregnancy was marked by obstetric complications in 97.4% and the most important were: the threat of premature delivery (28%) and the vaso-occlusive crisis (19.5%). The caesarean was performed in 92% of sickle cell patients. Premature delivery was observed in 60% with 6.3% very premature (28-33AW). It was registered 91% (n=352) live births, 48% (n=169) hypotrophs, 60% premature, 1.1% (n=4) intrapartum deaths and 8% (n=4) intrapartum deaths and 8% (n=31) deaths in utero. Perinatal mortality represented 9%. The after-effects of childbirth were complicated in 12% (n=46). The puerperal infections (32.6%), hypertension (28.2%) and its complications and severe anemia (19.2%) were the most common complications. Five (5) maternal deaths were deplored, ie a mortality rate of 1420 maternal deaths per 100,000 live births. Conclusion: In Benin, pregnancy and delivery of sickle cell disease are at high risk of fetal, maternal and neonatal mortality. Caesarean section was almost routine in this group. The practice of transfusion exchange or bleeding may improve prognosis.

Introduction: Spontaneous fertility after myomectomy for pregnancy desire remains a concern. Objective: Appreciate spontaneous fertility after a myomectomy for pregnancy desire. Methods: This was a descriptive and analytical study to collect retrospective data on cases of myomectomy pregnancy desire realised between 2016 and 2020 in the university maternity wards of Cotonou. All myomectomy records for desire for pregnancy were identified. The post myomectomie fertility related data and the clinical characteristics influencing the occurrence of pregnancy and its outcome after myomectomy were analyzed with regard to the rules of professional conduct and ethics. Results: On 188 myomectomies performed for desire of pregnancy, 102 had been analyzed. The mean age was 34 years ± 5.7. Nulligest and nulliparous were the most numerous in the respective proportions of 39.2% and 71.6%, and 16.7% (n=17) had a history of polymyomectomy. Fertility after myomectomy was observed in 16.7% (n=17) of cases. The mean time to return to fertility (pregnancy) after myomectomy was 27 months. Alcohol addiction (p=0.00), gestality (p=0.01), myoma size (p=0.00) and adenomyosis (p=0.00) had an negative impact on the time to onset pregnancy after myomectomy. Of 17 pregnancies recorded after myomectomy, 11 (64.7%) progressed normally with term delivery and 5 spontaneous abortions (29.4%) were recorded. One (1) pregnancy was ongoing at the time of the survey. Planned caesarean section (n=9) was the most frequent mode of delivery. Eleven (11) newborns were welcomed and the diaper suites were simple. Conclusion: Spontaneous fertility after myomectomy remains low in our series. Factors with a negative impact on fertility must be taken into account.

The authors, through a descriptive retrospective study have evaluated the results of surgical treatment, by Tension-Free Obturator tape (TOT) technique, of urinary incontinence in the first 68 patients operated in the Department "C" of Obstetrics and Gynecology of the Maternity and Neonatology Centre of Tunis (WTSC). The average age in those patients was 55.14 ± 8.47 years with extremes of 40 and 82 years. The majority of the patients (72%) were under the age of 60 years. In sixty-one patients (89%), no urine leak has been detected and they were healed. In three patients (4%) there was improvement with partial recovery. Three other (4%) did not notice any improvement after the surgery. No case of dysuria or rejection of the strip has been reported. It was concluded that the declared satisfaction rate is 93%.

Objective: To measure for each of the ten (10) groups of women defined in Robson's classification, the cesarean section rate, group size and its contribution to the overall cesarean section rate in four maternities in Benin. Methods: This was a retrospective study over a period of 3 years, from January 1, 2014 to December 31, 2016. Two workshops were organized for training in data collection and interpretation of results. Results: A total of 5442 files were included for the four health facilities during the study period. The overall cesarean section rate was 43.9%. The most represented group (30.3%) was multiparous women without scarred uterus, with a single term fetus, in cephalic presentation, and spontaneous labour (Group 3). The largest contributor to the overall cesarean section rate was that of multiparous women with at least one uterine scar with a single fetus, eventually in cephalic presentation (Group 5) with 29.5%. Conclusion: Caesarean section rates are high in groups of women with a favourable prognosis for vaginal delivery. It is also high in women with scarred uterus (Group 5).