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Biomedical subjects

C T Cisse

Publications and source records attributed to C T Cisse.

28 records · Page 2Linked to original sources
PubMed1997

[Antibiotic prophylaxis à la carte in self-contaminated gynecologic and obstetric surgery: importance of cefotaxime].

Infections represents 5% of our post-operative morbidity and result in the use of expensive antibiotics and longer hospital stays. As a less expensive alternative to systematic antibiotherapy for all patients, the authors propose a prospective and descriptive study of the effectiveness of antibioprophylaxis by administering 1 g of Cefotaxime pre-operatively. The study concerns a continuous series of 103 cases in gynaecology and obstetrics operated in the Dakar University Teaching Hospital, during a 13 months period (April 95-April 96). The average age of the patients is 30 years, the major types of surgery was cesarean sections, laparotomy for extra-uterine pregnancy and myomectomies. The duration of the surgery varied between 40 to 105 minutes with an average of 60 minutes. There was no intolerance to Cefotaxime. No cases of post operative infections were observed. All surgical wounds healed in 6 to 8 days except 2 minor cases of non-union of 1 cm. Antibioprophylaxis with Cefotaxime can therefore be considered as an effective means of preventing post-operative infections in clean surgery. It is easy to administer and also has the advantage of lower cost (4050 Fcfa compared to 29,000 Fcfa for classic antibiotherapy).

Adolescent↗
PubMed1996

[Term abdominal pregnancy with delivery of a living child. Two case reports].

The lack of antenatal care and the growing number of genital infections make ectopic pregnancy a current unrecognized pathology in areas with few physicians. Such pregnancies exceptionally reach term but delivery of a live infant is rare. We report two cases in which echographic diagnosis of abdominal pregnancy was followed by the delivery of a live child. In both cases, fetal hypotrophy led to neonatal death. Maternal outcome was however favorable with surgery to reduce the risk of hemorrhage. Safe childbearing requires improved preventive measures and better maternal sanitary conditions and education, particularly important for subjects living in areas poorly provided with health facilities.

Adult↗
PubMed1996

[Cesarean section in a developing country. Profile and perspectives apropos of 21,743 deliveries between 1992 and 1995].

In three years and six month 21,743 delivered at the Maternity of Dakar University Hospital. Among them there were 2650 cesarean section. The cesarean rate is 16.93% of living birth. The principal indication was foeto-pelvic disproportion (32.5%) especially pelvic problem (27%). There was post operative mortality (1%) (especially hypertension) and morbidity (6%) (especially infection). Neonatal prognosis was also poor with a 10% early neonatal mortality. These findings show the important insufficiency and reflect major problems facing obstetric in Black Africa.

Apgar Score↗
PubMed1995

[Indications and prognosis of cesarean sections at the Dakar University Hospital Center].

From 1st January 1992 to 30 June 1994, 8489 delivered at the Dakar University Hospital. Among them, there were 953 cesarean sections, i.e. 11.2%. Epidemiological analysis revealed that mean parity was 2 for a mean age of 26 years. 22% of the women had a clinically perceptible pelvic problem. The indications for cesarean section were divided into 3 groups: mandatory operations (feto-pelvic disproportion, haemorrhagic placenta praevia, dystocia): 41.4%; prudent operations (long-awaited infant, fetal suffering, breech presentation, cicatricial uterus): 50%; and necessary operations (maternal disease, especially hypertension): 8.6%. There was a high postoperative mortality (1.4%) and major morbidity, especially infection (10%). Neonatal prognosis was also poor with a 14% early neonatal mortality. These findings reflect the major problems facing obstetricians in Senegal and Subsaharian Africa. Improved prognosis necessarily will involve better organization of our health systems allowing easier access to life-saving cesarean section for our rural populations.

Adolescent↗
PubMed1995

[The role of hysteroscopy in the diagnosis and treatment of uterine adhesions. Apropos of 15 cases].

In this study, the authors raise the question of the morbidity related to Asherman's syndrome and demonstrate that hysterectomy is the best method for diagnosis and treatment. In a group of 15 patients, secondary sterility and secondary amenorrhea were the main reasons for consultation, 11 patients underwent surgical hysteroscopy and the other fourteen received conventional treatment. The main etiological factors identified were curettage and cesarian section. A normal cavity was successfully reconstructed in 12 cases (80%) after between one and three treatments. Normal menstruation was restored in all patients. In the obstetric field, there were 7 pregnancies, resulting in 6 deliveries and one miscarriage. Hysteroscopy therefore constitutes a real step forward in the diagnosis and treatment of Asherman's syndrome; it may be possible to extend its advantage to all forms of endouterine neoformations.

Abortion, Spontaneous↗
PubMed1992

[Conjugal sterility at Dakar CHU: epidemiological profile and evaluation limits apropos of 429 cases].

The writers draw up the outcome of the medical management of infertiles couples at Dakar's teaching hospital over a period of 7 years (1983-1989). Restrictives factors (low rate incomes, social and psychological obstacles) make that médical management difficult. The responsibilities are shared among the couple with sex ratio of 1 man for 3 women. Among the women the etiologies dominated are the sterility of the Phaloppe tubes (81%) among men with the oligo and the azoospermy (32 and 27%). Sterility within married couples is a problem of public health that becomes more acute every day. A better handling of this problem through preventive medicine and elementary sanitary training is necessary.

Adult↗
PubMed1991

[Perinatal mortality and eclampsia at C.H.U. of Dakar. Apropos of 49 cases].

From 1/04/1985 to 12/02/1990 the authors have treated 49 pregnant women with eclampsia symptoms. Keeping in mind the foetal neonatal results, the following has been noted: 26 live births including on case involving twins, 20 still-births, two foetal abortion and two patients who had never returned. 90.47% of the deliveries were effected vaginally against 09.53% by means of cesarean; patients of whom we lost track are not accounted for, together with 05 foetuses who were extracted during the maternal autopsy. Among the live births, 52.84% weighed less than, 2500 grams and had an APGAR score lower than 07 during the first minute in 69.23% of the cases observed. Six newborns died during the neonatal period because of infection and/or premature birth. Perinatal mortality of this short sample is of 63.07%. This leads the authors to conclude that the improvement of the foetal prognosis of the eclampsia is necessary. This improvement will necessarily go through the broadening of the indication of cesarean.

Adolescent↗
PubMedDate not supplied

[Epidemiologic surveillance of early neonatal mortality at the university hospital center in Dakar (Sénégal)].

Neonatal precocious mortality (PNM) is a major public health problem in developing countries: the PNM rate is 57 per 1,000 live births, as compared to 11 per 1,000 in industrialized countries. In Senegal the rate is 35 per 1,000. A continuous epidemiological survey was started in 1987 in the Obstetrics and Gynecology Clinic of the Dakar University Teaching Hospital (Neonatology and Prematurity Unit) (Senegal). The aim was to identify the main risk factors for PNM, and thereby define the actions required to reduce the incidence. In 1995, there were 177 cases of PNM, which was 12.19% of admissions to the Neonatology and Prematurity Unit, and 41 per thousand live births. The most frequent causes were premature birth (62.71%) acute fetal suffering (27.20%) and neonatal infection (6.22%). The rate of PNM could be reduced by: improved organization of prenatal advice to identify pregnancies at risk (of premature delivery and obstetric disease); improved quality of neonatal resuscitation; improved practice for prevention of infectious disease.

Apgar Score↗
PubMedDate not supplied

[Cesarean sections in Senegal: coverage of needs and quality of services].

A prospective longitudinal study was carried out of all women undergoing Cesarean section in the surgical maternity hospitals of Senegal between January 1 and December 31 1996. The epidemiology and quality of Cesarean sections were investigated. For each case, the following data were recorded: marital status, prenatal monitoring, conditions of hospitalization, indications for and outcome of surgery, maternal and neonatal follow-up one month after the operation. 2,436 Cesarean sections were performed. Of these, 2,269 cases were indexed and filed and 1,612 received a postnatal checkup one month after the operation. The mean age of the women involved was 26 years. The referral system is not effective, with 58% of patients being rushed to a surgical maternity unit in medically unsuitable forms of transport. Cesarean section is not widely available either geographically or economically. The mean national rate of Cesarean section was 0.6% of expected births but there were differences between regions. The main indications for Cesarean section were the fetus being too large to pass through the pelvic girdle (30%) and fetal suffering (18%). The maternal mortality rate was 3% and one third of the women who died did so immediately after the operation. Maternal morbidity occurred in 10% of cases, mainly due to postoperative infection. The rate of perinatal stress was 25%, most deaths being caused by neonatal distress (33%) or infection (18%). Thus, overall, both the availability and quality of Cesarean section in Senegal are poor.

Adult↗