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Introduction: OVT is rare, with an incidence of 0.05% to 0.18% and occurring preferentially in postpartum period. Any delay in management may compromise the patient’s vital prognosis. Observation: We report a case of a 34-year-old patient, G2P3, who delivered twins by cesarean section at 39 weeks of amenorrhea. She presented abdominal pain and fever on the 4th day of postpartum. Biological tests showed a biological inflammatory syndrome and a positive blood culture with gram-positive Staphylococcus. After 72 hours of antibiotics with no clinical or biological improvement, a CT scan revealed a 12 mm thrombus in the lumen of the right ovarian vein’s connection to the inferior vena cava. Antibiotic treatment was continued, associated with an anticoagulant. The evolution was been favorable. Conclusion: Rare and serious pathology, the diagnosis is made using medical imaging. The outcome is generally favorable with antibiotic therapy and anticoagulant therapy.

Introduction: Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. Objective: To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomde Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabawere Peripheral Care Unit). Method: This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. Results: During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). Conclusion and Suggestion: The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.

Introduction: Cervico-isthmic pregnancy is rare, and serious because of its hemorrhagic complication. Its management varies according to the teams. Observation: We report a case of cervico-isthmic pregnancy on a cesarean scar. This is a 35-year-old, G2P2, who consulted for bleeding from the 1st trimester of pregnancy. The clinical examination found a minimal uterine bleeding. The diagnosis was made by a vaginal ultrasound which found a cervico-isthmic implantation of the pregnancy on the caesarean scar. A protocol of Mifepristone and Misoprostol followed by administration of a single dose of 1 mg/kg of Methotrexate was performed. Cure was obtained 1 month after treatment by negativation of plasma HCG. No bleeding complications were noted. A follow-up ultrasound performed 2 months later showed a uterine vacuity and the presence of an isthmocoele. It was in fact a pregnancy that had implanted in the isthmocoele. Conclusion: Cervico-isthmic pregnancy is rare. His treatment is not codified. Drug management was successful.

Introduction: Teenage pregnancies have serious consequences for the health of mothers and their children. The aim of this work was to study the circumstances of the onset of teenage pregnancy. Methodology: This was a cross-sectional and descriptive study, which took place from July 1st to 31st, 2019 at the Peripheral Care Unit (USP) of Gbodjome in Togo. Results: A total of 100 adolescent girls were interviewed (12.6%). The average age of adolescent girls was 17.2 years (12 - 19 years). Adolescent girls were predominantly in primary school (42.0%) and single status (58.0%). Forty-two decimal zero percent of adolescent girls (42.0%) were living with their partners. In 5.0% of cases, adolescent girls were victims of sexual harassment. The pregnancy was the result of rape in 10.0% of cases. Ten decimal zero percent of adolescent girls (10.0%) had more than one sexual partner. Nearly half of the respondents (49.0%) knew at least one method of contraception, but only 8.0% used it. Financial help from the partner (57.0%) was the leading cause of sex. Conclusion: Teenage pregnancies have a negative impact on both the young mother and the unborn child. The ideal would be to make schooling for girls free, from primary school to the A-level.

Introduction: L’evaluation de la satisfaction montre l’adequation entre les attentes des patients et la qualite des soins recus. Objectif: evaluer la satisfaction des accouchees hospitalisees en suites de couches a la maternite de l’hopital de Be. Patientes et methode: Il s’est agi d’une etude transversale a visee descriptive et analytique menee du 1er juillet au 31 aout 2018 soit une duree de 2 mois. Elle a eu pour cadre, le secteur des suites de couches de la maternite de l’hopital de Be. La collecte des donnees par interview directe a ete faite a l’aide d’une fiche d’enquete anonyme sur le modele Saphora-MCO questionnaires Project COMPAQH et adapte a nos realites. Le traitement et l’analyse des donnees ont ete realisees grâce aux logiciels Epi data et Epi info. Resultats: Au total 300 accouchees ont accepte participer a l’etude. L’âge moyen etait de 29 ± 6,2 ans. La satisfaction globale etait de 94%. Les principaux elements de satisfaction etaient : l’accueil (94,7%), le respect de l’intimite (96,7%), la prise en charge des soins (94%), le delai d’attente (86,7%). L’insatisfaction etait due a l’insuffisance de communication des soignants (65,7%) et de proprete des chambres et des sanitaires (57%). L’âge, le niveau d’instruction, la parite, le mode d’accouchement avaient influence significativement l’insatisfaction des patientes. Conclusion: Cette etude a permis de relever les elements d’insatisfaction des clientes. Il est opportun d’associer les clients dans le processus de la qualite des soins a l’hopital de Be. Introduction: Satisfaction assessment shows the match between patient expectations and the quality of care received. Objective: to assess the satisfaction of women hospitalized in the maternity ward of the obstetrics and gynecology department of the Be hospital in order to contribute to the improvement of the quality of care in the maternity ward. Patients and method: This was a cross-sectional study with descriptive and analytical aims conducted from July 1 to August 31, 2018, i.e., a duration of 2 months. It took place in the puerperium section at the maternity of the Be hospital. Data collection by direct interview was done using an anonymous survey form on the Saphora-MCO questionnaires Project COMPAQH model and adapted to our realities. Data processing and analysis were carried out using Epi data and Epi info software. Results: A total of 300 women agreed to participate in the study. The average age was 29 ± 6.2 years. Overall satisfaction was 94%. The main elements of satisfaction were: reception (94.7%), respect for privacy (96.7%), management of care (94%), waiting time (86.7%). Dissatisfaction was due to insufficient communication from caregivers (65.7%) and cleanliness of rooms and toilets (57%). Age, level of education, parity and mode of delivery had a significant influence on the respondent’s dissatisfaction. Conclusion: This study identified factors that led to patient’s dissatisfaction. It is appropriate to involve patients in the quality of care process at the Be hospital.

Abdominal pregnancy is a rare form of ectopic pregnancy. Advanced forms with live children at birth are exceptional. We report a case of abdominal pregnancy of 35 weeks with live child, referred and after emergency management. Maternal prognosis was good. The newborn, admitted to pediatric intensive care for breathing difficulties, died 8 days after birth.

To report the first case of Demons-Meigs’ syndrome secondary to benign Brenner tumor with high CA125 plasmatic level managed in kara teaching hospital. A 40-year-old female patient was admitted with a 6-month history of abdominal distension. Clinical examination found abdomino-pelvic mass and declive dullness. Abdominal ultrasound found heterogeneous abdomino-pelvic mass of 180 mm in length and a large free ascites. Pelvic computorized tomography scan found heterogeneous extra-uterine mass of 180 mm in length, large ascites without pelvic or lombo-aortic lymphadenopathy or tumoral extension. Front thorax X-ray found bilateral pleural effusion; CA125 plasmatic level was 1138 IU/ml. Median laparotomy allow to aspire 2 liters of ascitic fluid and to perform left adnexectomy. Histological examination of surgery sample diagnosed begnin ovary Brenner tumor. Outcome after surgery was without complications with disappearance of ascites and pleural effusion, and CA125 plasmatic level back to normal value. Demons-Meigs’ syndrome is a rare benign ovarian tumor whose symptoms looks like ovarian cancer. Its fundamental characteristic is the disappearance of symptoms after ovarian tumor removal.

Objectives: To determine the prevalence of women who delivered in the two major sickle cell syndromes, “SS” and “SC”, and to identify maternal and early neonatal prognosis inherent to each form. Material and Methods: This is a comparative, descriptive and retrospective cross-sectional study of 226 files of women carrying major sickle cell syndrome (66 cases of “SS” form versus 160 cases of “SC” form), collected from May 2008 to May 2013 at the Gynecology and Obstetrics Clinic of the Sylvanus Olympio’s University Hospital of Lome. Data were processed by Epi Info 6 software. For comparison of variables, the Chi-2 test of Fisher with significance as p major sickle cell syndromes represent 0.8% of all the deliveries during the study period. Caesarean section, especially prophylactic one, was the dominant mode of delivery. The SS forms have been exposed to have more vaso-occlusive crises (22.7% vs. 13.1%; p = 0.04, OR = 0.31), more blood transfusion (57.6% vs. 29.4%; p = 7 × 10-5, OR = 3.2) and more puerperal infections (p gave exposure to greater maternal morbidity. Resuscitative measures in adults and newborns should be reinforced at the delivery time of these “at-risk-pregnancies”.