Gynaecology

Abdominal pregnancy is a rare condition related with non negligible risks to mother and foetus. It can occur primarily or secondary to tubal abortion or rupture with implantation of the conceptus in the peritoneal cavity. We present a case of a 39 years old woman in her second pregnancy, with 33 weeks amenorrhea, which was admitted with abdominal pain and blackish bleeding. The ultrasonography revealed a foetal death located in the abdomen and the ct scan confirmed the diagnosis. The patient was successfully managed.

The association diabetes and pregnancy is a common gestational situation that constitutes a real public health in Morocco. The gestational diabetes is defined by the World Health Organization (WHO) as glycemic tolerance disorder that begins or is diagnosed for the for the first time during pregnancy and may cause maternal and/or fetal complications. Our work’s goal is to analyse the epidemiological profile of the diabetic women studied, to follow the course of pregnancy and childbirth and to assess the maternal and fetal morbidity. We present a descriptive retrospective study conducted at the obstetrical gynecology department of high-risk pregnancy within the hospital of maternity SOUISSI in RABAT, MOROCCO, involving 19 pregnant and diabetics women over 326 women consulted. The study lasted 12 months, from January 2019 to December 2019. Data was collected by using medical records. In our series, the prevalence of gestational diabetes is 5,8 %. 8 women have pre-existing diabetes (42,2%) and only 3 have scheduled their pregnancy (15,7%). 11 women have gestational diabetes (57,9%). All our patients were followed and had a controlled glycemic index. This study revealed a large number of maternal complications dominated by urinary tract infections, which represents 31 %, followed by hypoglycemia with a 10,5%, preeclampsia and cetoacidosis in 5% each. For fetal complications, we had 53% cases of macrosomia, 23% of respiratory distress, 18.6% of prematurity, 2,32% of congenital complications. Our results are consistent with most of the series in the literature. These pregnancies remain with more risks than under normal glucose tolerance. Nevertheless, the prognosis of these pregnancies can be improved by early and multidisciplinary management to achieve a glycemic balance avoiding maternal-fetal complications.

Nigeria contributes 14% to the global estimate of maternal deaths. The role of men in maternal and child health interventions is understudied despite the crucial and indispensable role they play. This study was carried out to assess knowledge of birth preparedness and complication readiness (BPACR) and associated factors among male respondents in Benin City, with a view to improving their participation and support in maternal and child health interventions. A community based analytical cross sectional study was conducted in Benin City. Interviewer administered pretested structured questionnaires were used to interview 237 consenting male partners/family members of pregnant women in selected communities in Benin City. Data collected was sorted for completeness, coded, entered and analysed using SPSS version 20.0 statistical software. Results were presented as pros, tables and figures; bivariate and multivariate analysis was carried out in line with study objective, statistical significance was set at p?0.050 and 95% confidence interval. The mean age of male respondents studied was 37.8 ± 9.9 years, 191(75.8%) of them were in the Upper Socio-economic class (SEC) while 61(24.2%) in Lower SEC. In relation to knowledge of BPACR, 219(92.4%) of them had good knowledge while 18(7.6%) had fair knowledge of BPACR. Awareness of BP (OR=0.131; 95% (CI) 0.051 - 0.334; p <0.001) was the only significant predictor identified that influenced knowledge of BPACR. Respondents who never heard of Birth Preparedness (BP) were 7.7 times less likely of having good knowledge of BPACR than those who had heard of BP. Majority of respondents had good knowledge of BPACR. There is need to sustain this level of knowledge on BPACR, through regular awareness and sensitization programmes involving men as relevant stakeholders needed for the success of maternal and child health interventions.

Uterine rupture and retroperitoneal hematomas are all associated with increased risk for hemorrhage at the time of delivery. Prior cesarean section and Obstetric trauma are significant risk factors for uterine rupture. Except for the most superficial tears, these situations require surgical repair to restore proper anatomical appearance and to limit blood loss. Subtotal hysterectomy is commun. Management of retroperitoneal Hematoma depends on the clinical situation. It can be managed conservatively, surgically, or through use of angiographic embolization. We report a case of a 28 years old woman who presents a uterine rupture complicated with retroperitoneal hematoma after vaginal delivery.

Described for the first time by Wade and Kopf in 1978, The Bowenoid papulosis is a vulvar intraepithelial neoplasia of high grade, due to an infection of oncogenic HPV. This affection affects essentially the young adult with a mean age of 30 years. The classic clinical aspect is a pigmented or pinkish papule, but it can also be polymorphic, often multifocal, which could affect the perineal and perianal areas.The evolution is often mild with a possibility of spontaneous regression, but there is a probability of a transformation into an invasive carcinoma especially by the immunosuppressed. The treatment is essentially conservative by local destruction of the lesions.We report the case of a female patient of 31 years, without pathological individual history, and who presented papular isolated vulvar lesions for which she presented for consultation of Maternity Souissi, University Hospital Ibn Sina, Rabat.

The cervical cancer is the most common gynecological malignancy in the world, its incidence is greatly reduced thanks to screening methods. The Pelvic organ prolapse increases with age, obesity, and parity. The Cervical cancer complicating uterine procidence is a rare event and requires a multidisciplinary approach

Pregnancy causes an altered immune response which predispose pregnant women to increased severity of infections. Management of septic shock requires prompt resuscitation with volume expansion, inotropic therapy and empiric antibiotic therapy. Toxic shock syndrome can be caused by Staphylococcus aureus or Clostridium sordellii. It may occur unexpectedly after an uncomplicated pregnancy and delivery. Management includes antibiotic therapy with penicillin and clindamycin and early surgical intervention. Immunoglobulins may be beneficial. We report the case of a 22 years-old primagravida who represents a septic shock during labor caused by staphylococcus aureus which the point of departure was a urinary tract infection.

Mother's milk is ideal for infants, it is safe and contains all the necessary nutrients, antibodies that protect the baby from common children illnesses. Exclusively breastfeeding of infants and continuing the breastfeeding until the second year of life provides the child with quality nutrition and can prevent the lack of nutrients, malnutrition and their consequences. We can see the need for education on breastfeeding and promotion of breastfeeding, which gives importance to healthcare workers for education and prevention of early stopping of breastfeeding. The study included 100 respondents in the Canton, 50 primiparea (pregnant women expecting the first child) and 50 respondents who were multiparas. The study was designed as an observation – transient study and lasted from April to July 2016. It was done using a CDC questionnaire. The research was conducted in the Public Health Institute for the Health Protection of Women and Maternity of Sarajevo Canton at Vogosca. There is a statistically significant difference in the knowledge of primipara and multiparas about the length of breastfeeding according to WHO recommendations, ?2=13,827; p=0.001. Multipare have better knowledge. The most frequent sources of information about breastfeeding in both examined groups were the experiences of other mothers, ?2=0.186; p=0.666. After the research we have found that there is a certain number of subjects who do not have enough breastfeeding education. The fact that the majority of respondents considered the most reliable source of information on breastfeeding the experience of other mothers and family members emphasized the need to create new promotional projects on the importance of breastfeeding by health professionals.

Leadership development is a new initiative that has no precedents upon which to draw. While leadership has been recognized for centuries as essential prerequisite to society’s development, there is no “school” for leadership development. Head nurse/ ward- in – charge have been an established part of the nursing structure and are expected to facilitate staff nurses in their roles as patient caregivers. Nurse leaders have a responsibility to create effective properly functioning units to support the work of nurses. This paper presents an initiative in this direction, by developing the leadership practices of head nurses using a leadership development package. A quasi experimental pretest- post test control group design was used. The findings of the study revealed that the leadership development package could bring in significant improvement in the leadership practices of the head nurses.

Abdominal pregnancy is a very rare obstetric complication which is extremely dangerious to the mother as well as the fetus. The diagnose can be difficult using ultrasounds beyond the first trimester,even then a high index of suspicion remains necessary. In this report, we present a primigravida woman accounted for pelvic pain and late periods into the Emergency room.