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Background The practice of a first caesarean section can condition the future obstetric prognosis. The aim of this work was to study the indications of the first caesarean sections at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou. Methods: This was a cross-sectional study with prospective collection. The data were collected from 1 March to 30 May 2018. The women who benefited from caesarean section for the first time were the study population. The review of the documents, the interview with the patients and the expert opinion were the techniques used. The expert opinion made it possible to determine whether or not the caesarean section was preventable. Results: The first caesarean sections accounted for 62.5% (280/448) of all caesarean sections and 34.6% (280/810) of all childbirths in the period. Caesarean section was urgently performed in 95% of cases. It was mostly an obstetrical indication. Probable fetal asphyxia was the first major indication (27.5%) followed by preeclampsia/eclampsia (15.7%) and uterine pre-rupture syndrome (8.9%). Caesarean section was found to be avoidable in 53 cases (18.9%). Probable fetal asphyxia was the most common indication (22.4%) of these preventable caesarean sections. Conclusions: The good management of preeclampsia, the strengthening of the birth room in fetal and maternal monitoring equipment, the close coaching of physicians in specialization and the periodic audits of practices would reduce the preventable caesarean sections.

Objective:To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data.Design:This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student’s t test, ANOVA, the χ2 test, Fisher’s exact test and logistic regression.Setting:All thirteen Burkinabè regions were categorised using quartiles of urbanisation rates.Participants:The participants were 1730 rural women aged 25–64 years.Results:The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P < 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P < 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (> 49 years old) and smokeless tobacco users. Age > 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor.Conclusion:The prevalence of underweight in rural Burkinabè women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.

Background: Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. The 10-Group Classification System is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. Objective: The purpose of this study was to analyze cesarean section (CS) rates using the classification system of Robson’s ten groups and to identify the main contributors to the overall CS rate in Burkina Faso’s regional and university hospitals. Materials and Method: A cross-sectional study with retrospective collection was carried out. All women who gave birth between July 1, 2017 and June 30, 2018, in the Regional Hospital Centres (RHC) and University Hospital Centres (UHC) of Burkina Faso were classified according to the Robson ten-group method. The overall CS rates and in each Robson group were calculated, as well as the contribution of each group to the overall CS rate. Results: The CS rate was 26.5% (8543 out of 32,240 deliveries) during the study period. nulliparous women with single term pregnancy in cephalic presentation during spontaneous labour (group 1), multiparous women with single pregnancy in cephalic presentation, gestational age ≥37SA, spontaneous labour (group 3) and multiparous women with previous CS (group 5) were the main contributors (67.7%) to the overall CS rate. In addition, we observed a variation in CS rates between different hospitals, especially among women with full-term pregnancies in cephalic presentation without previous CS (groups 1 to 4), showing large differences in emergency obstetric and neonatal care across the country. Conclusions: Women in groups 1, 3 and 5 were the most important contributors to the overall CS rate in Burkina Faso. It appears that efforts to reduce the overall rate of CS should focus on vaginal delivery on the scarred uterus, reduction of CS rates in nulliparous women with full-term pregnancy in cephalic presentation (groups 1) and proper monitoring of multiparous women with full-term pregnancy in spontaneous labour (group 3).

Introduction: A simulation laboratory has been set up in the Department of Obstetrics and Gynaecology at Yalgado Ouedraogo Teaching Hospital. The objective of this study was to evaluate the role of the simulation in training of 7th grade students on interval IUD insertion. Material and Method: This was an evaluation study of skills before and after training that included 38 students of 7th grade medicine. Pre-training knowledges and skills were compared to those based on training using the paired Student test with a 5% significance level. Perceptions and suggestions for improvement of training made by students were collected. Results: The sex ratio of the study participants was 1.1. Their average age was 26.8 ± 0.9 years. The training increased the average knowledges score from 48.2% to 93.0% (p th grade medicine students had a good perception of this training. Conclusion: The training of 7th grade medicine students in IUD insertion using simulation had a positive impact on their knowledges and skills and was well appreciated.

Objective To study the contribution of blood transfusion management in the improvement of maternal and perinatal outcomes in pregnant women with sickle cell disease in Ouagadougou. Methods A cross-sectional retrospective study with data collected from February 2012 to January 2014 was used. Patients were differentiated into three groups: patients with at least one exchange transfusion, patients who received blood transfusion, and patients who did not receive any transfusion. Data were collected from patients' patient care documents. Results One hundred and sixty-four patients were included, of whom 53 were in the first group, 32 in the second group, and 79 in the third group. Maternal complications in the last trimester of pregnancy were significantly less important (P=0.000) in the first group (58.5%) than in the second (78.5%) and third group (91.1%). The same trend was observed for postpartum maternal mortality (5.7%; 12.5%; 12.6%; P=0.009). Fetal complications such as preterm birth and early neonatal death were lower in the first group (15.1%; 1.8%) than in the second (40.6%; 23.1%) and third group (32.9%; 7.6%). Conclusion Prophylactic blood transfusion is an important part of the management of pregnant patients with sickle cell disease.

Background: Maternal mortality is of considerable magnitude. It is particularly relevant to developing countries, including those in Sub-Saharan Africa. The aim of this work was to study the cases of maternal deaths in the Dori Regional Hospital, Burkina Faso in the Sahel region, by analyzing the epidemiological aspects of these deaths in order to guide decision-making. Methods: This was a descriptive cross-sectional study which spanned the period from January 1, 2014 to December 31, 2016. Cases of maternal death and live births that occurred in the hospital during this period were collected by documentary review. Results: A total of 141 maternal deaths and 2,626 live births were recorded with a maternal mortality ratio of 5,369 for 100,000 live births. In 99 (72.20%) cases, death occurred in the postpartum. A home delivery had been reported in 33.70% of cases. Direct obstetric causes were found in 72.10% of cases. They were mainly represented by infections (32.40%) and hemorrhages (23%). Anemia was the indirect cause of death in 25 women (17.80%). The delay in health care access and the lack of blood products contributed to maternal deaths in 64.50% and 26.20% of cases. Conclusion and Global Health Implications: An intensification of awareness-raising messages about the importance of the rapid use of health care is necessary. Also, systematic audits of maternal deaths in the care environment and in the community would make it possible to clarify the determinants of maternal mortality in the Sahel region and to provide adequate solutions. Key words: Maternal Death • Maternal Mortality • Women’s Health • Burkin Faso • Dori Hospital • Sahel Region Copyright © 2018 Zamané et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Anaemia in pregnancy is a public health issue in developing countries because of its high prevalence and its maternal and perinatal bad outcomes. It affects 24.8% of the world population and 67.6% of the population in sub-Saharan Africa. In Burkina Faso, anaemia prevalence is estimated at 68.3%. In Burkina, preventive measures for anaemia in pregnancy have been implemented by the ministry of health to reduce its burden. This study aimed to assess the epidemiological, clinical and the outcomes of anaemia in pregnant women at OUAHIGOUYA REGIONAL HOSPITAL. Findings will be used to strengthen the preventives measures for anaemia in pregnancy. Methods: A cross-sectional descriptive and analytical study was conducted during a four-month period from October, 28th, 2014 to February, 28th, 2015. pregnant women with haemoglobin level below 11 g/dL was considered anaemic according to WHO criteria, and who are willing to participate and who were admitted at the obstetrics and Gynecology department of the REGIONAL HOSPITAL of OUAHIGOUYA. Results: Four hundred eighty three pregnant women were anaemic out of eight hundred eighty three women hospitalized. The prevalence of maternal anaemia was 54.7% with significant monthly variations. The mean age was 24.7 ± 6.6 years. The women without non-salary occupation (housewives and pupils) represented 90.1%. A past medical history of haemoglobin defects (6.6%), twin pregnancies (6.0%), malaria (23.6%) bleeding during pregnancy (20.3%) were the most frequent. Monitoring the pregnancy was effective in 91.1% of women. The mean haemoglobin level was 8.8 ± 2.1 g/dL. The outcome was marked with 1.7% and 18.9% maternal and perinatal death respectively. The most common contributory factors were: Occupational status, number of prenatal visits, length of treatment with iron and folic acid, history of malaria, history of haemorrhage and brachial perimeter low (p < 0.05). Conclusion: Maternal anaemia is a major health issue at the OUAHIGOUYA REGIONAL HOSPITAL in Northern Burkina Faso. Maternal and perinatal outcomes could be improved by reinforcing the preventive measures but also by improving the nutritional status and the living conditions of pregnant women.

Objective: The objective of our study was to study the surgical activities carried out in the gynecology-obstetrics department of the CHU-YO (Teaching Hospital Yalgado Ouedraogo) from January 1st 2015 to December 31st, 2015. Patients and Methods: This dealt with a cross-cutting descriptive and analytic study with retrospective data collection. Our study has included the female patients who underwent surgery in the operating room and whose medical records were usable. Results: 45% of female patients admitted in the concerned department underwent a surgery. The average age of patients was estimated at 28.02 years ±7 years with extremes of 13 years and 80 years. Obstetrical surgery has involved 89.9% of cases. Female patients have received a loco-regional anesthesia in 92.7% of cases. Emergency surgical operations accounted for 88.8% and caesarean section was the main surgical operation carried out in 87.1% of cases. The mortality rate of the overall surgical operations was 1.04%. Conclusion: A better availability of labile blood products is more likely to reduce the mortality rate of surgical operations under the threshold of 1%.

Objective: To describe the epidemiological, clinical and therapeutic aspects of cases of vaginal bleeding in the nonpregnant patient received in emergency at Yalgado OUEDRAOGO University Hospital. Materials and Methods: It was a retrospective and descriptive study that involved the clinical records of 326 patients collected from January 01, 2009 to December 31, 2013. Results: The average age of women was 47 years old with extremes at 12 and 82 years old. Women of childbearing age accounted for 61.6% and postmenopausal women 18.7%. 70.7% of women were pauciparous or nulliparous. Menorrhagia and pelvic pain were the main signs associated. This symptomatology required hospitalization in 85.2% of cases. The main aetiologies were uterine myomas 49.69%, cervical cancer 23% and functional metrorrhagia 11.04%. Progestin was the most used drug in 67.1% of cases. Total abdominal hysterectomy and abdominal myomectomy were the most commonly used surgical methods with 22.3%, 44.4% of cases. Eleven death cases were observed. Conclusion: Gynecological metrorrhagia is more common in women of childbearing age than in menopausal women. The main causes are fibroma, cervical cancer and functional metrorrhagia.

Objective: To determine the frequency of obstetrical vacuum deliveries in the service of obstetrics and gynecology of regional teaching hospital of Ouahigouya and then to assess fetal outcomes. Patients and Methods: It was about a cross sectional and descriptive retrospective data collection from 1st January 2014 to 31st December 2016 in the service of obstetrics and gynecology of regional teaching hospital of Ouahigouya. Patients who had vacuum delivered in the service with single pregnancy, at least 34 weeks gestation age and summit presentation and had a useful medical folder were included in our study. The data were collected and the analysis used epi-info software 7.2.1.0. version, 2010 Word and excel. The results were presented in percentage for qualitative variables and in means standard deviation for quantitative variables. Results: We have collected 6233 deliveries from 1st January 2014 to 31st December 2016, out of which 312 were done by using obstetrical vacuum giving a frequency of 5.0%. The mean age of patients was 23.5 ± 6.4 years. The average parity was 1.3 ± 0.7 women per delivery and 73.1% of our patients were pauciparous. 90.1% of patients were referred. The main indications were maternal weakness (43%), fetal distress (36.5%), prolonged expulsive phase (6.1%), stopping progression (4.8%) and the scar uterus (4.5%). Fetal prognosis was dominated by the caput in 13 cases (4.2%) and excoriations of the scalp in 5 cases (1.7%). Conclusion: Vacuum extractions are very limited in low setting countries. Its popularization is essential to reduce maternal and fetal mortality.

Aim: To report a case of bilateral tubal molar and embryonic pregnancy diagnosed and treated at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. Observation: It was an 18-year-old patient, G2P0 with no known pathological history. She was received in obstetric emergencies for suspicion of ectopic pregnancy in a two-month amenorrhea context. At the admission, the physical examination had found a sensitivity of the hypogastric region with a cry of the umbilicus and the bleeding. At pelvic ultrasound, the uterus was empty with a medium-abundance pelvic effusion and a left extra uterine mass. The initial rate of beta HCG was 5700 ml IU per ml. A framed laparotomy was carried out. The operative exploration has revealed a right tubal pregnancy cracked and a left unbroken tubal pregnancy. The diagnosis of a bilateral ectopic pregnancy was retained. A right salpingectomy and a left tubal caesarean section were carried out. Histological analysis confirmed the diagnosis of a left embryonic ectopic pregnancy associated with a right molar ectopic pregnancy. Conclusion: The systematic use of histological analysis for any extra uterine pregnancy treatment is required to not ignore an associated molar pregnancy.

Objective: The objective of our study was to study the risk factors of low birth weight at term in the Teaching Hospital Yalgado (CHU-YO) Ouedraogo. Patients and Methods: This dealt with a comparative and analytical control case study. The group of cases was made up of female patients who gave birth to newborns with low birth weight at term and that of control cases included female patients who delivered a normal-weighted newborn at term. Results: The frequency of low birth weight at term was therefore estimated at 4.4%. The average age of the parturients was 25 ± 6.36 years. Female patients living in a marital setting accounted for 93.1% of cases and 64.4% of them had no income-generating activities. A maternal underweight, a height below 155 cm, passive smoking, and malaria during pregnancy have been identified as the factors associated with a low birth weight. Conclusion: Quality prenatal care could reduce the incidence of low birth weight at term.

Background Giant ovarian cyst is very rare in gravid-puerperium period. It is a cause of a maternal-fetal morbidity. We report a case of a giant benign ovarian cyst in gravid-puerperium period which was diagnosed and managed in a hospital of a low-resource country. Case presentation Data were collected by historical review, clinical examination, laboratory investigations, imaging examination, and by histopathological study of the excised surgical specimen. It is the case of a 25-year-old woman who was third gravida and third para with unknown pathological history. After she had given birth through vagina, a giant ovarian cyst, unknown during pregnancy, was diagnosed. A left oophorectomy carrying the cyst was performed after laparotomy in Yalgado Ouedraogo University Hospital Center of Ouagadougou (Burkina Faso). The cyst was 42 cm long and weighed 19.7 kg. The histology of the operative specimen revealed serous cystadenoma of the ovary. The postoperative course was uneventful. Conclusion This case reports that vaginal delivery is possible with a giant ovarian cyst associated with pregnancy. Surgical management of the cyst can be performed in the postpartum with satisfaction.

Introduction A simulation laboratory has been set up in the Department of Obstetrics and Gynaecology at Yalgado Ouedraogo Teaching Hospital. The objective of this study was to evaluate the role of the simulation in training of 7th grade students on interval IUD insertion. Material and method This was an evaluation study of skills before and after training that included 38 students of 7th grade medicine. Pre-training knowledges and skills were compared to those based on training using the paired Student test with a 5% significance level. Perceptions and suggestions for improvement of training made by students were collected. Results The sex of the study participants was 1.1. Their average age was 26.8 ± 0.9 years. The training increased the average knowledges score from 48.2% to 93.0% (p

The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.

Objective: To study epidemiological, clinical ant therapeutic aspects of placental abruption in the service of obstetrics and gynecology of regional hospital center of Ouahigouya. Methods: We conducted a cross-sectional study scheduled for 3 years, from 1st January 2013 to 31st December 2015. Data were collected from patients’ folder, theater register and maternity delivery register. Results: We recorded 5791 deliveries, out of which 89 were placental abruption cases giving a rate of 1.54% of deliveries. The women most affected were whose with age ranging 25 - 30 years (30.33%), the nulliparous women (32.58%), the married women (83.52%) and whose with bad antenatal clinic attendance (54.6%). The clinical aspect was most often complete: nil fetal heart rate (82.00%), hypertony uterine (79.90%) and vaginal bleeding (74.20%) were the most signs found. Spontaneous vaginal delivery has been made in 64.04%. Maternal prognosis was dominated by a morbidity linked by an anemia in 53.90%. Maternal lethality was 2.20%. Fetal newborn-death was 88.80%. Conclusion: Placental abruption represents an obstetrical and medical emergency by its start of brutal installation, its unforeseeable character and its materno-fetal consequences. Only a tacking of risk populations, precocious of diagnosis and a speed management in surgical and medical unit allow improving the prognosis of this disease.

OBJECTIVE To assess the effects of strengthening family planning capacity on the uptake of long acting reversible contraceptive (LARC) methods at two primary health centers. METHODS Between April 2016 and March 2017, the Society of Gynecologists and Obstetricians of Burkina Faso (SOGOB) increased the capacity of two primary health centers in Ouagadougou, Burkina Faso, to offer LARC methods by training staff and providing family planning equipment and commodities. Uptake of LARC methods was compared between the year preceding the intervention and the year during the intervention. RESULTS Within a year, the number of new users of family planning increased 2.8-fold from 2936 new users before the intervention to 8267 during it. The rate of new users of contraception increased 1.9-fold (14.9% vs 28.1%; P

Les infections des sites opératoires sont fréquemment rencontrées dans les pays en développement. La césarienne étant l'une des interventions chirurgicales la plus pratiquée chez les femmes dans le monde, nous avons initié cette étude sur les aspects épidémiologiques, cliniques, thérapeutiques et pronostiques des suppurations pariétales post-césariennes dans le département de gynécologie-obstétrique du CHU Yalgado Ouédraogo en vue de réduire leur survenue. Il s'est agi d'une étude transversale à visée descriptive menée du 1er avril 2015 au 30 septembre 2015 soit une période de 6 mois. Soixante-dix cas de suppurations pariétales ont été notés sur 1998 cas de césariennes soit une incidence de 3,5%. L'âge moyen des patientes était de 26,2 ans ± 6,1. Les patientes étaient majoritairement des femmes au foyer (77%). La césarienne a été réalisée en urgence chez toutes les patientes. La suppuration a été diagnostiquée surtout à la 1èresemaine (60%). Le germe identifié était le staphylocoque aureus dans 37,8% des cas. Une reprise chirurgicale de la paroi abdominale a été nécessaire dans 34,3% des cas. L'évolution a été favorable chez toutes les patientes. La suppuration pariétale post césarienne reste fréquente. La prise en charge nécessite parfois une reprise chirurgicale. Une meilleure identification des facteurs favorisant cette affection par d'étude plus poussée pourrait permettre de réduire de façon significative leur incidence et par conséquent améliorer le pronostic maternel.

Background Abdominal pregnancy is defined as the partial or total insertion of the embryo into the abdominal cavity. It is rare, and can evolve towards the full term if it is not recognized in the early pregnancy. It carries a high risk of maternal-fetal morbidity and mortality. Case presentation We report a case of a 22 year-old gravida IV, para II with an asymptomatic and undiagnosed abdominal pregnancy presumed full term, in a context of health centers under-equipment. She had attended 5 routine antenatal care, but had not performed any ultrasound scan. She had been transferred from a medical center to the Hospital of Ouahigouya (Burkina Faso) for bowel sub-obstruction and intrauterine fetal death, with failure of labor induction. On admission, the hypothesis of uterine rupture or abdominal pregnancy with antepartum fetal demise was considered. A laparotomy was then performed, where an abdominal pregnancy was discovered, and a dead term baby weighing 3300 g delivered. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. Postoperative follow-up was uneventful. Conclusion This case report exposes the necessity for the practitioner to think about the possibility of abdominal pregnancy in his clinical and sonographic practice, irrespective of the gestational age, mainly in contexts where there is under-equipment of the health centers.

Introduction: This article is an analysis of post-abortion care in 56 health facilities after their capacity building by the Burkina Faso Society of Obstetricians and Gynecologists (SOGOB). Patients and Methods: In 2012, with funds from Safe Abortion Action Fund, the SOGOB trained care providers and equipped 56 health facilities for post abortion care. Statistical data on the management of incomplete abortions after the capacity building were analyzed. The significance level was set at 0.05. Results: There were 6316 cases of abortion that have been managed in 56 health facilities. The evacuation of the uterine contents for incomplete abortion has been provided to 6167 patients. Manual vacuum aspiration (MVA) and misoprostol were used respectively in 69.4% and 26.9% of cases to evacuate uterine content. Post-treatment complications were 1.8% for MVA and 0.9% for misoprostol (p = 0.004). MVA’s complication rate in the health facilities of the 1st level of care (1.7%) was not different from the third level of care (1.2%) with p = 0.21. A modern method of contraception was provided after abortion to 65.7% of the patients. In addition to the post abortion care, 7.3% of the patients received other reproductive health services. The community was involved in the development process of post abortion care in the facilities of the first level of care. Conclusion: The support of health facilities by SOGOB has provided post abortion care to thousands of women with little complications. Given the good results, an extension to other health facilities is desirable.

Context: The use of hormonal contraceptives could lead to a rise in blood pressure with an onset of hypertension. The objective of the study was to describe the epidemiological, clinical and therapeutic patterns of hypertension occurring in women on hormonal contraception. Patients and Methods: A retrospective study was carried out over a period of 5 years. It involved clients on hormonal contraception who developed hypertension during follow-up at the Family Planning Unit of the Yalgado Ouedraogo Teaching Hospital in Burkina Faso. Results: The global frequency of hypertension in clients on hormonal contraception was 1.8%; it varied depending on the type of methods of contraception used; it was 4.2% for clients on oral combined pills, 1% for implant users and 0.97% for women on injectable. The mean age of patients was 35.6 ± 8.4 years. Sixty-seven patients (84.8%) had mild to moderate hypertension. The mean time to onset of hypertension was respectively seventeen (17), thirty six (36) and thirty eight (38) months for patients on OCPs, CIP, and implants. After the discovery of hypertension, the contraception methods have been changed in 75.9% of cases, stopped in 5.2% of cases and the same contraception method was continued in 8.9% of cases. None of the patients who continued the same contraceptive method had obtained a normalization of blood pressure. Blood pressure was normalized in 48.6% of patients who have changed contraceptive methods. The average time of normalization of the blood pressure varied from three to five months, depending on the method that induces the hypertension. Conclusion: Hypertension on hormonal contraception is not uncommon. It is important to assess the risk factors for its occurrence at the initiation of contraception.

Context: In pregnant women with sickle cell disease, the management with exchange transfusion could be useful in improving the prognosis of mother and child by reducing the level of hemoglobin S less than 40%. Objective: To analyze the maternal and perinatal outcome during the program of the exchange transfusion in pregnant women with sickle cell disease. Patients and Methods: We conducted a prospective study over a period of 18 months. Pregnant women with a major form of sickle cell disease were included. A manual blood exchange transfusion was performed monthly. We monitored the occurrence of maternal and perinatal morbidity during the follow-up. Results: A total of 42 pregnant women with sickle cell disease were monitored. The frequency of infectious episodes and vaso-occlusive crisis was significantly reduced, respectively from 47.6% and 83.3% before the beginning of the blood exchanges transfusion to 11.9% and 16.7% during blood exchanges transfusion program. All newborns were alive at birth with an Apgar score higher or equal to 7 at the 5th minute. The rate of admission of the newborns at neonatal intensive care unit was 9.3%. Maternal mortality was estimated at 7.1% and there was no early neonatal mortality. Conclusion: Prophylactic exchange transfusion reduces infections and the reoccurrence of vaso-occlusive crisis, which has an impact on perinatal prognosis.

Background: Complications during pregnancy and childbirth are the leading causes of death and disability for women of childbearing age. Objective of this study was to study maternal mortality of direct obstetric origin at the Boulmiougou district hospital from 2010 to 2014.Methods: This was a retrospective cross-sectional descriptive and analytical study of maternal deaths by direct obstetric cause at the maternity ward of Boulmiougou District Hospital during the period from January 1st 2010 to December 31st, 2014, i.e. 5 years.Results: The maternal mortality rate by direct obstetric cause of 147.68 maternal deaths per 100,000 live births. The average age of the patients was 27.09 years old. The direct causes of maternal death were hemorrhage (47.06%), hypertensive disorders (20.59%), infections (14.71%) and unsafe abortion (11.76%). Contributing factors to maternal deaths were delay in evacuation (47.06%) and delay in care (38.23%).Conclusions: Maternal mortality remains high in the Boulmiougou District Hospital. To effectively combat maternal mortality, it is important to focus on the continuous training of staff and the strengthening of the technical platform.

Background: The quality of care perceived by the users of health care services is an important indicator of the quality of care. The aim of this study was to assess the satisfaction of patients received in obstetric and gynecological emergencies department of Yalgado Ouedraogo Teaching Hospital before and after the introduction of free care.Methods: This was a cross-sectional investigation. Data collection was carried out from February to July 2016, covering the last three months before the start of free care and the first three months of implementation of this free policy in Burkina Faso.Results: A total of 620 patients formed the sample. The reception (p=0.0001), the waiting period (p=0.0001), respect for treatment schedules (p=0.0001), respect for intimacy (p=0.0001), communication between providers and patients (p=0.007), the comfort of the delivery room (p=0.003) and the comfort of the ward room (p=0.002) were more favorably appreciated by patients before the free treatment than during that period. Overall patient satisfaction was better before the effectiveness of free care (p=0.003).Conclusions: The realization of free care process was followed by a lower patient’s satisfaction reflecting an alteration in the quality of health care services. A situational analysis of this free health care process is necessary in order to make corrective measures. Also adequate preventive measures should be adopted before any implementation to a larger scale of this free policy.

Objective: The study’s objective was to determine the epidemiological, clinical, ancillary investigations, therapeutic patterns and the outcome of postpartum hypertension. Patients and Methods: A retrospective study was carried out from January 2013 to December 2014 in the departments Obstetrics and Cardiology of two Teaching Hospitals in Ouagadougou, Burkina Faso. All cases of hypertension or eclampsia which newly occurred within 42 days postpartum without prior medical history of hypertension were included in the study. Results: One hundred and seventeen cases of postpartum hypertension were recorded representing 1.08% of deliveries. The mean age was 26.7 years, primiparous represented 39.1% of cases. The mean days between delivery and diagnosis were 5.6 ± 6.3 days. Hypertension was discovered as eclampsia in 61.95% of cases. It was severe hypertension in 42.39% of cases. The blood pressure was controlled in 90.22% within the first 48 hours. Conclusion: Postpartum period follow up with systematic blood pressure and urine protein measurements are necessary.

Objective To evaluate the results of an intervention by the Societe de Gynecologues et Obstetriciens du Burkina (SOGOB) to improve postabortion care (PAC) in rural areas of Burkina Faso. Methods From June 1, 2012, to May 31, 2013, SOGOB increased capacity for PAC by providing training in health care and equipment to 45 rural health facilities. Performance in PAC in the year before intervention (June 1, 2011, to May 31, 2012) was compared with that in the year following intervention (June 1, 2013, to May 31, 2014). Results The number of cases of incomplete abortion managed within a year increased from 1812 before the intervention to 2738 afterwards. Before capacity building, none of the health facilities was using misoprostol for management of incomplete abortion. After capacity building, misoprostol was used in 805 (29.4%) cases. The use of inappropriate methods to empty the uterus decreased (27.5% [498/1812] vs 1.4% [38/2738]; P

Background: Female students are exposed to unsafe sex, sources of unwanted pregnancy and abortions. It is recognized that emergency contraception can effectively prevent pregnancy. The purpose of this study was to evaluate the knowledge and practices of Ouagadougou public university students in relation to emergency contraception in order to propose solutions to reduce the proportion of unwanted pregnancies among female students.Methods: This was a cross-sectional study conducted between May 1st and October 31st, 2016 in the public universities of Ouagadougou. A questionnaire was administered to a sample of 732 students randomly selected.Results: The average age of female students was 22.7 years old. The age group 19 to 24 was the most represented (68.03%). Of the students surveyed, 87% knew or had heard of emergency contraception. The students only used the emergency contraceptive pill. The emergency contraceptive use rate was 44.42%. Approximately, 83% of users were aware of the delay in using emergency contraception. The reasons for using emergency contraception were condom breakage (25.10%) and unprotected sex (74.9%). Female students purchased the contraceptive directly in pharmacies (93.61%).Conclusions: Emergency contraception gives women a last chance to avoid an unwanted pregnancy after unprotected sex. Awareness and free availability of emergency contraception (EC) could improve the reproductive health of female students.

The Society of Gynaecologists and Obstetricians of Burkina Faso (SOGOB) conducted a project to reinforce skills in respectful maternity care among its members and health workers at three facilities. The participatory process allowed health workers to self-diagnose quality of care, recognize their own responsibility, propose solutions, and pledge respectful care commitments that were specific for each unit. Key commitments included good reception; humanistic clinical examination; attentive listening and responsiveness to patient needs; privacy, discretion, and confidentiality; availability; and comfort. These commitments can potentially be modified after each evaluation by SOGOB. Poor working conditions were found to negatively impact on quality of care. High staff turnover, frequent technical malfunctions, and inadequate infrastructure were identified as issues that require future focus to ensure improvements in quality of care are sustainable. Programs that aim to improve the maternity experience by linking good practice with humanistic care merit rollout to all healthcare facilities in Burkina Faso.