TITLE:
Obstetrical Emergencies in Teenagers at the Reference Health Centre of Commune VI, District of Bamako, Mali
AUTHORS:
Mamadou Keita, Fanta Coulibaly, Aminata Cisse, Dramane Haidara, Alou Samake, Seydou Diallo, Saoudatou Tall, Niagalé Sylla, Brahima Cisse, Djeneba Coulibaly, Mamadou Diallo, Moussa Konate, Sidiki Doumbia, Mariam Maiga, Nema Poudiougou, Bocari Sidy Koné, Mahamoud Coulibaly, Mahamadou Keita, Yacouba Sylla, Abdourahmane Dicko, Kadidia Ba, Amadou Boucoum
KEYWORDS:
Obstetrical Emergencies, Adolescent, Bamako, Mali
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.8,
August
29,
2025
ABSTRACT: Introduction: In Mali, the adolescence is characterized by a precocious sexuality, early marriages, immature pregnancies and/or some unwanted pregnancies, and some clandestine abortions. We have undertaken this study in order to study the obstetrical emergencies in the admitted teenagers in the gynecological-obstetrical service of the reference health centre of Commune VI, district of Bamako. Material and Methods: It is a descriptive transversal study with prospective data collection in a period of six months. The studied variables were socio-demographic, admission, taking care, morbidity, and maternal-perinatal mortality. Results: Our study has recorded 300 obstetrical emergency cases in teenagers in a total number of 884 teenagers admitted for emergency in the service, or a frequency of 33.9%. 96.7% of adolescents were older than 16 years old and 3.3% were less than 15 years old. The teenagers who are not at school represent 123 of 3000, or a rate of 41%, followed by those who are in primary school with 96 teenagers, or 31%. The teenagers were married in 88.3% of cases, single in 11%, and widowed in 0.3% of cases. Housewives were 70.3% and pupils or students in 25% of cases. Those who had any medical antecedents were 99% of cases (267/300). On the other hand, 3.3% had a previous caesarean (100/300) and 0.3% a previous laparotomy (1/300). They were primigenous (75.5%), primiparous (75.7%), had a past abortion in 4% of cases, and had used contraceptive methods, either 7.7%. The dystocies were the obstetrical emergencies the most represented with 32.3% (97 cases), with 4 cases of uterine breaking, followed by acute fetal pains 21% (63 cases). Pre-eclampsia and eclampsia 20.7% (62 cases), HPP 9.7% (29 cases), and HRP 8% (24 cases). The adolescents who had caesarean birth were 58.7% and natural birth 41.3%; the caesarean indications were dominated by the dystocy (66%) followed by acute foetal pain (13.2%). The maternal prognosis was marked by 14.7 complications, with immediate post-partum haemorrhage (45 cases) at a frequency of 15%, and we recorded 5 death cases, i.e., 1.7%. The causes of death were eclampsia (2), uterine breaking (1), uterine inversion (1) and retro-placenta hematoma (1). The carried-out surgical gestures were the suture of weak parts (50%), the Caesarean (41%), historiography (3 cases) and hysterectomy (2 cases). For prenatal prognosis, the Apgar score was less than or equal to 7 in the first minute in 13.1%. Newborn babies with low birth weight represented 23.6%. The low weight was due either to prematurity or hypotrophy. Our reference rate was 38.7%; the motives of references were such as: prenatal asphyxia with a rate of 56% of referred newborn babies, 21.6% for hypotrophy, 15.5% for prematurity, 4.3% for neonatal infection, 1.7% for macrosomia, and 0.9% for malformation (omphalocele). We must note that 89.5% of newborn babies were alive at birth, while 10.5% were stillborn. We have recorded 23 cases of neonatal death, or 8.6%, all precocious, by perinatal asphyxia (18), prematurity (4), and omphalocele (1). Conclusion: Obstetrical emergencies among teenagers were frequent in the gynecological-obstetric service of the CSREF of Commune VI. They were dominated by dystocia and pre-eclampsia/eclampsia. The maternal prognosis was dark, with a high lethality (1.7%); the prenatal prognosis was marked by strong mortality.