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• W2865948265 abstract "RESUMEObjectif. Etudier les aspects epidemiocliniques et le pronostic maternel de l’hysterectomie d’hemostase (HH) a Bamako. Patientes et methodes. Il s’agit d’une etude transversale mixte (retrospective 1er janvier 2007  et prospective au 31 decembre 2016), sur une periode de 10 ans portant sur les cas d’HH realisees au bloc operatoire du centre de sante de reference de la commune V de Bamako. N’ont pas inclues, les cas d’HH referes dans un centre hospitalier universitaire. Les variables etudiees etaient les donnees sociodemographiques et cliniques, l’importance du saignement, les gestes effectues avant l’hysterectomie et le pronostic postoperatoire. L’analyse statistique  a ete realisee avec SPSS. Le test de Chi2 a ete utilise pour les comparaisons avec un seuil de significativite de 0,05. Resultats. Nous avons collige 101 cas d’HH sur 90 872 accouchements (0,11%). L’âge moyen des patientes etait de 32,35±6,16 ans avec des extremes de 16 et 46 ans ; une notion de grande multiparite etait retrouvee chez 53,47% des patientes. A l’admission, 76,24% des patientes presentaient une instabilite hemodynamique, necessitant une transfusion de produits sanguins dans 94,06% des cas. Les principales indications de l’HH ont ete l’atonie uterine (47,53%) et la rupture uterine (42,57%). La morbidite postoperatoire etait dominee par la suppuration parietale (7,92%), l’oligurie a la 24eme (9%  dont 2% persistante a la 48eme heure). Il y a eu trois deces (2,97%). Conclusion. L’HH est l’ultime element de prise en charge de l’hemorragie du postpartum liee a l’atonie uterine, la rupture uterine ou les troubles de la coagulation. Elle est envisagee en cas d’echec ou d’absence des therapeutiques et procedures conservatrices. La precocite de la prise en charge permet d’ameliorer la morbimortalite postoperatoire. ABSTRACTObjective. The aim of the study was to report epidemiological, clinical aspects and the maternal prognostic of emergency obstetrical hysterectomy (EOH). Patients and methods. This was a ten years cross sectional descriptive retrospective study (from January 2007 to December 2016) concerning all the EOH performed in the « Centre de sante de reference de la commune V » in the Bamako district (Mali). Patients referred to Teaching Hospitals were not included. The main study variables were sociodemographic and clinical status, severity of hemorrhage, treatment before hysterectomy and clinical outcome. Statistical analysis has been performed with SPSS 21.0, using the Pearson Chi-square test for comparisons for 0.05 as an alpha error. Results. 101 EOH were found out of 90 872 deliveries (0.11%). The average age of patients was 32.35±6 (range: 16 to 46 years). Grand multiparity was found in 53.47% of patients. On admission, 76.24% of patients were hemodynamically unstable, requiring blood transfusion in 94.06% of cases. Uterine atony (47.53%) and uterine rupture (42.57%) were the most frequent indications of EOH procedures. The main postoperative morbidities were oliguria (9%) and superficial surgical site infections (7.92%). The mortality rate was 2.97% (3 patients). Conclusion. EOH is a rare and ultimate treatment of postpartum hemorrhage induced by uterine atony, uterine rupture or coagulation disorders. It is considered in failure or absence of conservatives procedures. An early management of such cases may positively impact postoperative morbidity and mortality." @default.
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• W2865948265 date "2018-07-01" @default.
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• W2865948265 title "Hystérectomies d’Hémostase à Bamako: Aspects Épidémiocliniques et Pronostic Maternel" @default.
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