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Abstract Background Abdominal pregnancy is a rare medical condition that is still missed in developing countries due to inadequate medical facilities. The clinical indicators manifest in various forms and are nonspecific, making it challenging to diagnose and often leading to delayed detection. However, obstetric ultrasound serves as an essential tool in early detection. Our objective was to share our experience dealing with this condition and emphasise the importance of early ultrasound diagnosis through efficient pregnancy monitoring in our regions. Case presentation 35-year-old Black African woman who had ten months of amenorrhea sought consultation due to an absence of active foetal movements. Her pregnancy was of 39 weeks with fetal demise which was confirmed following clinical examination and ultrasound. She underwent cesarean section in view of transverse position of fetus. During cesarean section, the fetus was found within the abdominal cavity with the placenta attached over the left iliac fossa including surface of left ovary. The uterus and right adnexa were within normal limits. A 2600 g macerated fetus with placenta and membranes were extracted without any complications. The maternal outcome was successful. Conclusions Abdominal pregnancy remained an inadequately diagnosed condition in developing countries. It is imperative to increase awareness among pregnant women regarding high-quality prenatal care, including early obstetric ultrasound, from conception. Meanwhile, healthcare professionals should receive continuous training and the technical platform modernised. To ensure accurate diagnosis, the location of the gestational sac must be identified for every pregnant woman during their initial ultrasound appointment.

Myomectomy during pregnancy is a rare situation, reserved for exceptional cases. We report two cases of myomectomy during pregnancy. Case 1 was a 31-year-old primigravida with a large transmural myoma complicated by intense pelvic pain not responding to medical treatment due to red degeneration in a 6-week pregnancy. Case 2 was a 30-year-old primigravida with multiple myomas complicated by necrosis and hydronephrosis. We performed multiple myomectomy at 17 weeks’ pregnancy after failure of medical treatment. Concerning the operative technique, we performed myomectomy during pregnancy followed by prophylactic cerclage of the cervix. The operation is carried out as quickly as possible by the most experienced surgeon of the team, in order to shorten the operating time and limit blood loss. Myomas that are in contact with the uterine cavity are not removed. In all, 500mg of hydroxyprogesterone was administered intramusculary 24h before the procedure, intraoperatively, and after operation to limit the risk of abortion. In Case 1, myomectomy was performed successfully without maternal or fetal complications. However, the patient developed placental abruption at 33 weeks of pregnancy. The newborn died 3h after birth. In Case 2, myomectomy was complicated by a spontaneous abortion at the end of the operation. The patient developed necrosis of the remaining myomas and endometritis leading to hysterectomy. Thus myomectomy during pregnancy should be performed as a last resort in only well-selected patients.

Introduction Complications due to unsafe abortions are an important cause of morbidity and mortality in many sub-Saharan African countries. We aimed to characterise abortion-related complication severity, describe their management, and to report women’s experience of abortion care in Africa.Methods A cross-sectional study was implemented in 210 health facilities across 11 sub-Saharan African countries. Data were collected on women’s characteristics, clinical information and women’s experience of abortion care (using the audio computer-assisted self-interviewing (ACASI) system). Severity of abortion complications were organised in five hierarchical mutually exclusive categories based on indicators present at assessment. Descriptive bivariate analysis was performed for women’s characteristics, management of complications and reported experiences of abortion care by severity. Generalised linear estimation models were used to assess the association between women’s characteristics and severity of complications.Results There were 13 657 women who had an abortion-related complication: 323 (2.4%) women were classified with severe maternal outcomes, 957 (7.0%) had potentially life-threatening complications, 7953 (58.2%) had moderate complications and 4424 (32.4%) women had mild complications. Women who were single, multiparous, presenting ≥13 weeks of gestational age and where expulsion of products of conception occurred prior to arrival to facility were more likely to experience severe complications. For management, the commonly used mechanical methods of uterine evacuation were manual vacuum aspiration (76.9%), followed by dilation and curettage (D&C) (20.1%). Most frequently used uterotonics were oxytocin (50∙9%) and misoprostol (22.7%). Via ACASI, 602 (19.5%) women reported having an induced abortion. Of those, misoprostol was the most commonly reported method (54.3%).Conclusion There is a critical need to increase access to and quality of evidence-based safe abortion, postabortion care and to improve understanding around women’s experiences of abortion care.

INTRODUCTION: L´objectif de cette étude était de déterminer la fréquence et d´évaluer le pronostic maternel et périnatal lors de la grossesse suivi de l´accouchement chez les élèves mineures mariées, dans la ville de Niamey. METHODES: c´était une étude cas-témoin des gestantes et parturientes de janvier 2018 au 31 d écembre 2018 à la Maternité Issaka Gazobi de Niamey. Les élèves mineures (18 ans) ont été comparées aux élèves âgées de 18-27 ans. Les paramètres sociodémographiques maternels, la morbi-mortalité maternelle et périnatale ont été analysées. Les statistiques usuelles et la régression logistique ont été utilisées pour analyser les résultats. Le seuil de signification a été fixé à une valeur de P-value (p=0,05). RESULTATS: la fréquence d´accouchement chez les élèves mineures était de 3,06%. Les mineures étaient plus assidues au suivi prénatal (46,7% vs 41,9%). La césarienne (ORa=2 [1,0-3,0]) l´éclampsie (ORa=2 [1,0-4,4]), l´épisiotomie (ORa=2[1,2-1,8]) et la dépression néonatale (P=0,05 (10,6% vs 5,8%)) étaient plus élevés chez les mineures que chez les adultes. La mortalité périnatale était élevée dans le deux groupes. CONCLUSION: nos résultats sont proches de ceux décrits dans d´autres études Européennes et Africaines. Les différences retrouvées pour les risques obstétricaux et périnatals semblent être liées aux facteurs sociodémographiques entourant ces gestantes mineures. Ces derniers devraient être pris en compte dans toute démarche de prévention des complications des grossesses chez les mineures.

Introduction The WHO Global Survey on Maternal and Perinatal Health aims to develop a network of health institutions worldwide that collects up-to-date information on services provided and on how evidence-based [...], Objective To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. Methods The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health was abstracted from hospital records and entered in a specially developed online data management system. Data were collected over a two- to three-month period in each institution. The project was coordinated by WHO and supported by WHO regional offices and country coordinators in Africa and the Americas. Findings The initial survey was implemented between September 2004 and March 2005 in the African and American regions. A total of 125 institutions in seven African countries and 119 institutions in eight Latin American countries participated. Conclusion This project has created a technologically simple and scientifically sound system for large-scale data management, which can facilitate programme monitoring in countries. Objectif Mettre en place dans 54 pays repartis dans l'ensemble du monde un systeme mondial de surveillance de la sante maternelle et perinatale. Methodes L'Enquete mondiale sur la surveillance de la sante maternelle et perinatale de I'OMS s'est operee par le biais d'un reseau d'etablissements de soins, selectionnes par echantillonnage en grappe stratifie a plusieurs niveaux. Une information ciblee sur la sante maternelle et perinatale a ete extraite des registres hospitaliers et entree dans un systeme de gestion des donnees en ligne, specialement developpe. Les donnees ont ete recueillies sur une periode de deux a trois mois dans chaque etablissement. Le projet a ete coordonne par I'OMS et appuye par les bureaux regionaux de I'OMS et par ses coordinateurs nationaux en Afrique et dans les Ameriques. Resultats L'enquete initiale a ete realisee entre septembre 2004 et mars 2005 en Afrique et dans les Ameriques. Ont participe au total a l'enquete 125 etablissements de sept pays africains et 119 etablissements de huit pays d'Amerique latine. Conclusion Ce projet a cree un systeme technologiquement simple et scientifiquement rigoureux pour la gestion grande echelle des donnees, pouvant faciliter la surveillance programmatique dans les pays. Objetivo Establecer un sistema mundial de vigilancia de la salud materna y perinatal en 54 paises de todo el mundo. Metodos La Encuesta mundial OMS de vigilancia de la salud materna y perinatal se llevo a cabo a traves de una red de instituciones sanitarias seleccionadas mediante muestreo polietapico estratificado por conglomerados. La informacion focalizada y resumida sobre la salud materna y perinatal extraida a partir de las historias clinicas se introdujo en un sistema de gestion de datos en linea especialmente desarrollado. A lo largo de un periodo de dos a tres meses se reunieron datos en cada institucion. El proyecto fue coordinado por la OMS y respaldado por las oficinas regionales de la OMS y los coordinadores en los paises en Africa y las Americas. Resultados La encuesta inicial se llevo a cabo entre septiembre de 2004 y marzo de 2005 en las regiones de Africa y de las Americas. Participaron en total 125 instituciones de siete paises africanos y 119 instituciones de ocho paises latinoamericanos. Conclusion Este proyecto ha generado un sistema tecnologicamente sencillo y cientificamente solido para gestionar datos a gran escala, lo cual puede facilitar la vigilancia de los programas en los paises. [TEXT NOT REPRODUCIBLE IN ASCII]

Introduction: The aim of this study was to determine the frequency, the socio-demographic aspect, the consequences on the schooling of girls and the control measures of underage pregnancy in schooling in Niger., Methods: This was a prospective cohort study over a 12-month period. The study concerned pregnant and parturient girls who were minors and in the process of attending school in the city of Niamey in the Republic of Niger. The socio-demographic, obstetric and school data of 184 underage girls admitted to the Issaka Gazobi Maternity Hospital in Niamey during the study period were collected and analysed. At the same time, we conducted interviews in 30 schools and educational inspection services in the city of Niamey, in order to gather qualitative data on the phenomenon of pregnancy and childbirth among minors in schools., Results: The frequency of childbirth among under-age students was 3.06% in our maternity. The average age was 15.7 years. Nine out of 10 minors (90.7%) had become mothers by the end of the study. School drop-out rates were high (53.8%). According to our interviews with school leaders, the factors at the root of pregnancy in Niamey schools are socio-cultural and religious (factors linked to the vulnerability of young girls, the lack of sex education within families and schools, and peer pressure, cultural and religious considerations which encourages early marriage and pregnancy, and the low contraceptive prevalence rate in Niger)., Conclusion: Pregnancy in the school environment is common in Niger and has repercussions on the normal progress of schooling. This study recommended adequate parental implication, eradication of street hawking and inculcation of moral values through religious bodies as ways of reducing underage girls' pregnancy in schooling in Niger., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2024.)