Background The therapeutic pathway options of people living with epilepsy (PWE) in Sub-Saharan Africa (SSA), especially in Mali are influenced by sociocultural, anthropological, and economic factors. Our study aimed to analyze the determinants of healthcare-seeking behavior and therapeutic choices after an inaugural epileptic seizure. Methods We focused on analyzing the choice of care pathway after an inaugural epileptic seizure in an environment characterized by the coexistence of conventional medicine (CM) and traditional medicine (TM). We hypothesized that a mixed approach, combining classical biomedical methods (qualitative and quantitative) with constructivist approaches, would allow for a deeper understanding of the issue. This study was conducted in urban and rural referral centers for the management of PWE. Patients with clinically and EEG-confirmed epilepsy were consecutively enrolled in outpatient consultations at the two sites during the study period, and data were collected through direct and semi-structured interviews. Descriptive statistics and linear regressions were used to analyze the generated data. Results A total of 87 patients met the inclusion criteria and participated in the interviews (patients or caregivers). The mean age was 20 ± 14 years, and were predominantly men (50/87, 57%). Epilepsy was mainly symptomatic, linked to complications from abnormal childbirth, head trauma, stroke, and cerebral malaria. Following the inaugural seizure, patients consulted conventional healthcare facilities (48%), traditional practitioners (49%) and pastor (2%). The high cost of antiepileptic drugs in conventional medicine emerged as a limiting factor. The multivariate model showed that male sex and higher levels of education were associated with significantly more robust odds ratios for consulting a physician. Conversely, a greater distance from a healthcare facility was associated with a significantly lower likelihood of consulting a physician. Conclusion The diagnosis and treatment of epilepsy remain major public health challenges in sub-Saharan Africa, particularly in Mali. This study highlights the central role of traditional medicine as a primary therapeutic option following an inaugural seizure, often favored due to the high cost of medication and, significantly, the challenges surrounding the accessibility and availability of conventional healthcare facilities. In this context, the implementation of the Universal Health Insurance Plan (RAMU) is essential to mitigate the prohibitive cost of anti-seizure medications and ensure financial accessibility for the most vulnerable populations. Researchers and policymakers must implement innovative strategies aimed at: (1) improving access to healthcare facilities, especially in rural areas; (2) promoting collaboration between traditional and conventional medicines; and (3) developing information and education campaigns to foster positive behavioral changes. Our work represents an initial step toward adapting epilepsy care to local sociocultural and economic realities—a prerequisite for reducing the burden of this pathology in Mali and throughout sub-Saharan Africa.

Subtalar dislocation is a rare traumatic injury to the foot in which the calcaneus and the navicular bone are displaced relative to the talus which maintains its normal relationship within the tibiotalar mortise. It must be considered a therapeutic emergency, and no treatment is specific to this lesion. We report a case of pure open internal subtalar dislocation stage 2 of Gustillo and Anderson following a domestic accident falling from the height of a Baobab tree of approximately 3 m: The patient benefited from an urgent reduction followed by a stabilization with arthrosis by two calcaneo-talo-tibial pins, and cast immobilization for six weeks. After a 12-month follow-up, the functional results were satisfactory.

Fibroadenomas are the most common benign breast disorders. The aim of this study was to identify the clinical and therapeutic aspects of fibroadenoma in the obstetric gynecology department and General Surgery of Teaching hospital Gabriel TOURE in Bamako Mali. PATIENTS AND METHODS:The study was descriptive with retrospective data collection from July 1, 2018 to July 31, 2021. The records of patients treated for fibroadenoma were included in accordance with ethical principles guaranteeing anonymity and confidentiality of data. RESULTS:A total of 112 patients were selected for the study period, representing 15. 9% of all breast pathologies. We recorded 642 cases of breast mass, with fibroadenoma accounting for 16.72% of these breast tumors. Among all 154 benign breast tumors, fibroadenoma accounted for 72%. The mean age was 27 years, with a standard deviation of 14.8 years (13 years and 62 years). The 20-35 age group was the most represented, at 44%. The frequency of fibroadenoma decreased with increasing gestational age and parity. Over 60% of patients were overweight. The main reason for consultation was the presence of breast swelling. Unilateral left breast swelling was predominant in 46% of cases, and location in the upper-outer quadrant accounted for 50%. Surgical excision was the most frequent management modality, accounting for 56,2% of cases. CONCLUSION:fibroadenoma of the breast are a fairly common benign condition. Diagnosis requires surveillance. Surgical treatment should be discussed according to age, size and the presence of risk factors for malignancy.

BACKGROUND:Few studies have been conducted on breast cancer despite its high burden in our context. Therefore, this study aimed to: (1) specify the sociodemographic and clinical characteristics of breast cancer; and (2) determine the factors associated with breast cancer survival at Gabriel Touré University Hospital (CHU). METHODS:This was a retrospective cohort study conducted at CHU Gabriel Touré between January 1st2018 and 31st, December 2022. Histologically confirmed cases of breast cancer were included and divided into three anatomoclinical groups (non-T4 tumor [NT4], locally advanced cancer [LAC] and inflammatory breast cancer [IBC]). We used Pearson's Chi-square or Fisher's Exact tests to compare proportions. The frequency distributions using density plots were constructed for the three breast types. They were compared using the Kruskal Wallis statistic. Kaplan-Meier curves were estimated for the survival analysis and Cox regression was used to identify factors associated with breast cancer survival. Adjusted hazard ratios (AHRs) and their 95% confidence intervals (95% CIs) were computed. RESULTS:A total of 255 cases of breast cancer were included in this study. The mean age was 46.9 years old. Whatever the anatomoclinical type, the density plot curve peaked before the age 40. NT4 and LAC were more frequently observed on the right breast, while IBC occurred on the left breast (p < 0.001). Comorbidity rates were comparable between the three groups. The median survival time was 9 months, and the overall 5-year survival rate was < 40%. Infertility history and IBC had a significant influence on survival, with AHRs of 1,63 [1,01 - 2,63] and 1,52 [1,04 - 2,22] respectively. CONCLUSION:Breast cancer at Gabriel Touré University Hospital is characterized by an early onset and a poor prognosis, suggesting that particular emphasis should be placed on early diagnosis and the quality of management.

Introduction : La tuberculose et le VIH constituent un couple mortel, qui représente un problème majeur de santé publique. Chez les personnes vivant avec le VIH, la tuberculose augmente la réplication du VIH et l'hétérogénéité virale. L’objectif de ce travail était d’identifier les facteurs liés aux décès chez les patients coinfectés par la tuberculose et le VIH, hospitalisés dans le service des maladies infectieuses et tropicales du CHU du Point G. Méthodologie : Il s’agissait d’une étude descriptive et analytique à collecte rétrospective réalisée dans le service des maladies infectieuses et tropicales sur une période de 3 ans allant de 2020-2022. Les dossiers de tous les patients infectés par le VIH hospitalisés dans le service atteints de tuberculose confirmée bactériologiquement, répondant aux critères d’inclusion ont été inclus. Les données ont été saisies et analysées sur le logiciel SPSS IBM statistique version 22. Le test statistique de Khi2 a été utilisé pour la comparaison des facteurs avec un seuil de significativité p≤0,05. Résultats : La prévalence hospitalière de la coïnfection VIH/TB était de 7,5 %. A l’issue du séjour hospitalier, 28 patients étaient survivants (35 %) et 52 décédés (65%). En analyse bivariée, les facteurs prédictifs de létalité étaient l’IMC < 16kg/m2 ; la PAM < 65 mmHg ; le stade clinique IV OMS ; le taux Hb < 7 g/dl ; le taux CD4 ≤ 200 c/mm3 ; la présence de pathologies infectieuses associées et le délai de décès court en hospitalisation <7 jours. Conclusion : La tuberculose est la première cause de mortalité chez les PvVIH. Mots-clés : VIH, Tuberculose, Décès, Bamako, Mali.

Abstract Introduction Long-term exposure to high-risk human papillomavirus (Hr-HPV) is a well-known necessary condition for development of cervical cancer. The aim of this study is to screen for Hr-HPV using vaginal self-sampling, which is a more effective approach to improve women’s adherence and increase screening rates. Methods This pilot study included a total of 100 Women living with HIV (WLWHIV), recruited from the Center for Listening, Care, Animation, and Counseling of People Living with HIV in Bamako. Hr-HPV genotyping was performed on Self-collected samples using the Cepheid GeneXpert instrument. Results The median age of WLWHIV was 44 (interquartile range [IQR], 37–50) years. Approximately 92% of the study participants preferred self-sampling at the clinic, and 90% opted to receive result notifications via mobile phone contact. The overall prevalence of Hr-HPV among study participants was 42.6%, and the most frequent Hr-HPV sub-types observed were HPV18/45 (19.1%), HPV31/35/33/52/58 (13.8%), and HPV39/68/56/66 (12.8%), followed by HPV16 (5.3%), and HPV51/59 (5.3%). WLWHIV under 35 years of age had a higher frequency of Hr-HPV compared to their older counterparts, with rates of 30% versus 11.1% (p = 0.03). The duration of antiretroviral treatment showed an inverse association with Hr-HPV negativity, with patients on treatment for 15 (IQR, 10–18) years versus 12 (IQR = 7–14) years for Hr-HPV positive patients (95% CI [1.2–5.8], t = 3.04, p = 0.003). WLWHIV with baseline CD4 T-Cell counts below 200 exhibited a higher frequency of Hr-HPV compared to those with baseline CD4 T-Cell counts above 200 (17.9% versus 1.9%, p = 0.009). However, other demographics and clinical factors, such as marital status, age of sexual debut, parity, education, history of abortion, history of preeclampsia, and cesarean delivery, did not influence the distribution of Hr-HPV genotypes. Conclusion Our findings indicate that WLWHIV under the age of 35 years old exhibited the highest prevalence of Hr-HPV infection, with HPV18/45 being the most prevalent subtype. Additionally, WLWHIV with baseline CD4 T-Cell counts below 200 showed the highest infection rates.

Cervical cancer (CC) remains a real public health problem in low- and middle-income countries, where technical resources and competent personnel are insufficient. Persistent cervix infection by high-risk human papillomavirus (Hr-HPV) is the main cause of CC development. In the current study, we examined the distribution of Hr-HPV in the general healthy Malian population using cervicovaginal self- sampling. A total of 354 women were recruited, with a median age of 34 ± 11.37 years, IQR (27–43). We found that 100

Neurological disorders (ND) have a high incidence in sub-Saharan Africa (SSA). In this region, systemic challenges of conventional medicine (CM) and cultural beliefs have contributed to a large utilization of traditional medicine (TM). Yet, data on TM and those who use it in the treatment of ND in SSA are scarce. Here, we systematically analyze its role as a therapy modality for ND in Mali, the socio-demographic characteristics of its users, and propose next steps to optimize the dual usages of TM and CM for patients with ND. We conducted a questionnaire study in two phases. In phase one, patients with ND answered questions on their usage of and attitudes towards TM. In phase two, the TM therapists who provided care to the patients in phase one answered questions regarding their own practices for treating ND. Patients were recruited from the country's two university neurology departments. 3,534 of the 4,532 patients seen in the Departments of Neurology in 2019 met the inclusion criteria. Among these 3,534 patients, 2,430 (68.8

Breast cancer is the leading cancer in women worldwide. A better understanding of this pathology by women can contribute to significantly reducing its morbidity and mortality. AIM:It was to evaluate women's knowledge about breast cancer in the obstetrics and gynecology department of the district hospital of commune II of Bamako. PATIENTS AND METHODS:We carried out a descriptive and analytical cross-sectional study with prospective collection of data from July 1 to August 31, 2021. It concerned women admitted to gynecological consultation without notion of emergency, who agreed to participate in this study. RESULTS:In 2 months, 390 women agreed to participate in this study, of which almost half of the women (45.1%) had no knowledge of the risk factors, clinical signs and means of screening for breast cancer. breast. Women's knowledge of breast cancer was influenced by age, education level, profession, religion and marital status (p<0.001). CONCLUSION:Breast cancer remains poorly understood by women. Intensifying awareness campaigns can help increase women's understanding of this scourge.

Abstract Background Our recent studies have shown headache disorders to be very common in the central and western sub-Saharan countries of Benin and Cameroon. Here we report headache in nearby Mali, a strife-torn country that differs topographically, culturally, politically and economically. The purposes were to estimate headache-attributed burden and need for headache care. Methods We used cluster-random sampling in seven of Mali’s eleven regions to obtain a nationally representative sample. During unannounced household visits by trained interviewers, one randomly selected adult member (18–65 years) from each household was interviewed using the structured HARDSHIP questionnaire, with enquiries into headache in the last year and, additionally, headache yesterday (HY). Headache on ≥ 15 days/month (H15+) was diagnosed as probable medication-overuse headache (pMOH) when associated with acute medication use on ≥ 15 days/month, and as “other H15+” when not. Episodic headache (on < 15 days/month) was recorded as such and not further diagnosed. Burden was assessed as impaired participation (days lost from paid and household work, and from leisure activity). Need for headache care was defined by criteria for expectation of benefit. Results Data collection coincided with the SARS-CoV-2 pandemic. The participating proportion was nonetheless extremely high (99.4%). The observed 1-year prevalence of any headache was 90.9%. Age- and gender-adjusted estimates were 86.3% for episodic headache, 1.4% for pMOH and 3.1% for other H15+. HY was reported by 16.8% with a mean duration of 8.7 h. Overall mean headache frequency was 3.5 days/month. Participants with pMOH lost more days from paid (8.8 days/3 months) and household work (10.3 days/3 months) than those with other H15+ (3.1 and 2.8 days/3 months) or episodic headache (1.2 and 0.9 days/3 months). At population level, 3.6–5.8% of all time was spent with headache, which led to a 3.6% decrease in all activity (impaired participation). Almost a quarter (23.4%) of Mali’s adult population need headache care. Conclusion Headache is very common in Mali, as in its near neighbours, Benin and Cameroon, and associated with substantial losses of health and productivity. Need for headache care is high – a challenge for a low-income country – but lost productivity probably translates into lost gross domestic product.

•Psychosocial burden related to epilepsy is highly significant in developing countries.•Stigmatization is one of the most common psychosocial burden in people living with epilepsy.•Epileptic patients often suffer from the stigmatization of their parents.•There is a huge gap in knowledge about epilepsy in the Malian population.

Background The objective of this study was to evaluate the effect of CYP2B6 and CYP3A4 polymorphisms on the virological and immunologic responses of patients receiving an efavirenz-containing regimen. A total of 153 HIV-positive patients were enlisted for the current study. Methods Viral load and median CD4 T cell counts were evaluated at baseline and month 6 (M6). Single nucleotide polymorphisms (SNPs) in CYP2B6 and CYP3A4 genes were genotyped using TaqMan genotyping assays. Results Interestingly, the AG genotype in CYP2B6 rs2279343 was associated with viral load suppression (VLS) compared to the homozygous AA (OR 2.6; 95% CI 1.3–5.3). Moreover, in the overdominant model, the AG genotype was associated with VLS compared to AA/GG (OR 2.05; 95% CI 1.3–2.9). The AG genotype in CYP2B6 rs2279343 was associated with an increase in CD4 cell count between baseline and M6 (p = 0.01). In CYP2B6 rs3745274, CD4 cell count at M6 was higher than that of baseline for GG carriers (p = 0.04) and for GT carriers (p = 0.013). In contrast, the TT mutant displayed no difference in CD4 cell count at M6 and baseline (p = 0.3). In CYP3A4 rs2740574, the TC carriers showed a higher median CD4 count at M6 compared to that of the baseline count (p = 0.024), similar trend was noted for CC carriers (p = 0.004). In contrast, the TT genotype showed no trend (p = 0.8). The best genotypes combination associated with CD4 cell count improvement were AA/AG in SNP rs2279343 (p = 0.003) and GG/GT in SNP rs3745274 (p = 0.002). Conclusion Our findings support the fact that CYP2B6 rs2279343 could help in the prediction of VLS and both SNPs rs3745274 and rs2279343 in CYP2B6 and CYP3A4 rs2740574 were associated with immune recovery in Malian HIV-positive patients.

Summary: Introduction: Sexual violence is an all-encompassing term that refers to "any sexual act, attempt to obtain a sexual act, comment or advance of a sexual nature directed against a person's sexuality using coercion" according to the WHO. Objective: Study sexual violence based on gender at the level of the care unit << One Stop Center >> the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a descriptive and analytical cross-sectional retrospective study from January 1, 2019 to December 31, 2020. We included in this study, all survivors of sexual violence at least 10 years old admitted to the "One Stop Center" care unit of the Reference Health Center of Commune V of the District of Bamako. Results: The prevalence of sexual violence was 54.62% in relation to all cases of gender-based violence and 3.36% in relation to all gynaecological emergencies. The age group less than or equal to 19 years accounted for 54.18% of survivors, 69.68% of survivors were single. In 39.95% of the cases the incident took place in the home of the alleged perpetrator of the sexual assault. The survivors had presented a state of fear and panic in 23.92% of cases. Penetration was << penis-vagina >> in 37.1% of survivors. Survivors received psychiatric assistance in 12.87% of cases. Conclusion: Sexual violence is relatively common in our care unit << One Stop Center >>. They had constituted the majority of cases of gender-based violence. The care was holistic.

Methylenetetrahydrofolate reductase (MTHFR) plays a major role in the metabolism of folates and homocysteine, which in turn can affect gene expression and ultimately promote the development of breast cancer. Thus, mutations in the MTHFR gene could influence homocysteine, methionine, and S-adenosylmethionine levels and, indirectly, nucleotide levels. Imbalance in methionine and S-adenosylmethionine synthesis affects protein synthesis and methylation. These changes, which affect gene expression, may ultimately promote the development of breast cancer. We therefore hypothesized that such mutations could also play an important role in the occurrence and pathogenesis of breast cancer in a Malian population. In this study, we used the PCR-RFLP technique to identify the different genotypic profiles of the C677T MTHFR polymorphism in 127 breast cancer women and 160 healthy controls. The genotypic distribution of the C677T polymorphism in breast cancer cases was 88.2% for CC, 11.0% for CT, and 0.8% for TT. Healthy controls showed a similar distribution with 90.6% for CC, 8.8% for CT, and 0.6% for TT. We found no statistical association between the C677T polymorphism and breast cancer risk for the codominant models CT and TT (p > 0.05). The same trend was observed when the analysis was extended to other genetic models, including dominant (p = 0.50), recessive (p = 0.87), and additive (p = 0.50) models. The C677T polymorphism of MTHFR gene did not influence the risk of breast cancer in the Malian samples.

The Duke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown prevalence, globally. To date, <100 cases have been reported worldwide. We report the case of an 18-year-old patient admitted for status epilepticus seizure, and who presented a right hemiparesis, body asymmetry, joints ankylosis, and mental retardation. Brain CT-scan revealed left hemisphere atrophy, skull bone thickening, and hyperpneumatization of the frontal sinuses; all consistent with DDMS. Seizures improved remarkably on Levetiracetam and Valproate. This is the first report of an unusual DDMS in Mali, and the diagnosis delay highlights the challenges for the management of these diseases in resource-limited settings.

Toxoplasmosis is defined as a cosmopolitan protozoan disease caused by an obligate intracellular coccidia, Toxoplasma gondii. The advent of HIV infection has made cerebral toxoplasmosis one of the most widespread neurological opportunistic infections.METHOD:We conducted a descriptive cross-sectional study with retrospective review of files of cerebral toxoplasmosis on HIV infected patients who had been hospitalized in the infectious diseases department of Point G University Hospital between January 1st, 2014 and September 30th, 2019.RESULTS:During the study period, the frequency of cerebral toxoplasmosis was 10.1% and in 46.4% of the patients, the diagnosis led to the discovery of HIV co-infection. The clinical features were characterized by fever, headaches, and motor deficit at 86.6%, 84.5% and 69.1% respectively. Roundel image on computed tomography was most represented and was found in 24.4% of patients. Anti-toxoplasma treatment based on trimethoprim /sulfamethoxazole (TMP/SMX) associated with folinic acid was initiated in 78 patients out of 90, but 19 patients had a contraindication or adverse effects to this combination and were treated with clindamycin. HAART was initiated in 31 patients out of 45 (68.9%) newly diagnosed. The overall prognosis was limited with a mortality rate of 42%.CONCLUSION:The prevalence of cerebral toxoplasmosis was high in our study, 10.1%. To reduce this prevalence, chemoprophylaxis should be initiated in all HIV-infected patients with a CD4 count below 200 cells/mm3.

Duke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown global prevalence. It typically manifests with body asymmetry, drugs resistant epilepsy, mental retardation, cerebral atrophy, skull bone thickening and hyperpneumatization of the frontal sinuses. In this report, we present an unusual case of DDMS revealed by status epilepticus.

OBJECTIVES:The main objective of this study was to evaluate the effect of CYP2B6 and CYP3A4 polymorphisms on the virological and immunologic responses of HIV patients. A total of 153 HIV-positive patients were enlisted for the study. PATIENTS AND METHODS:Viral load and median CD4 T cell counts were evaluated at baseline and month 6 (M6). Samples were identified using TaqMan genotyping assays. RESULTS:The AG in CYP2B6 rs2279343 was associated with VLS compared to homozygous AA. In the dominant model, the AG/GG genotypes were associated with VLS compared to the AA genotype. Moreover, in overdominant model, the AG genotype was associated with VLS compared to AA/GG. Regarding immunological response, only the AG in SNP rs2279343 CYP2B6 was associated with an increase in CD4 cell count between baseline and M6. In CYP2B6 rs3745274, the CD4 cell count at M6 was higher than that of baseline for GG carriers and for GT carriers. In CYP3A4 rs2740574, the TC carriers showed a higher median CD4 count at M6 compared to that of the baseline count, as well as for CC carriers. The best genotypes combination associated with CD4 cell count improvement were AA/AG in SNP rs2279343 and GG/GT in SNP rs3745274. CONCLUSION:Our findings support the fact that CYP2B6 rs2279343 could help in the prediction of VLS and both SNPs rs3745274 and rs2279343 in CYP2B6 and CYP3A4 rs2740574 were associated with immune recovery in Malian HIV-positive patients.

Le syndrome d'encéphalopathie postérieure réversible (PRES) est un syndrome neurologique aigu ou subaigu réversible. Compte tenu de l'intérêt diagnostique, thérapeutique et évolutif de ce syndrome, rare dans la pratique courante, nous rapportons l'observation d'un cas au Mali. Patiente âgée de 42 ans, mariée mère deux enfants, césarisée deux fois, aux antécédents d'hyperplasie endométriale et d'hypertension artérielle de découverte récente (4 jours) sous amlodipine 10 mg. Elle a été admise pour céphalée, trouble de la vision à type de cécité bilatérale en neurologie. Avant son admission en neurologie elle avait été vu aux urgences de l'hôpital pour céphalée aiguë inhabituelle accompagnée de vomissements (4 fois) avec une tension systolique à 223 mmHg 4 jours avant puis un médecin interniste qui retrouvait une TA à 20/14 cmHg. Elle était admise pour perte de la vision. L'examen neurologique d'entrée retrouvait une cécité bilatérale avec une parésie à 4/5 aux 4 membres (NIHSS à 7). L'IRM réalisée en urgence mettait en évidence plus de dix lésions lacunaires en hypersignal sur T2 diffusion sur en sus- et sous-tentoriel de façon bilatérale (hémisphères cérébelleux, lobes occipitaux, temporaux, pariétale droite). La goutte épaisse trouvait 32 trophozoïtes, Sur le plan thérapeutique elle recevait une association amlodipine 10 mg et valsartan 160 mg, l'artesunate injectable, et du paracétamol injectable. L'évolution a été marquée par la disparition complète des signes et symptômes le 3e jour de son hospitalisation (NIHSS à 0). L'IRM de contrôle réalisée 6 semaines après était revenu strictement normal. Le diagnostic de PRES syndrome a été retenu devant l'évolution clinique favorable et la disparition des signes d'imageries à l'IRM de contrôle. Le PRES est un syndrome clinicoradiologique associant un tableau neurologique à des images radiologiques bilatérales et symétriques localisées aux lobes pariéto-occipitaux, et dont l'évolution est classiquement réversible. Dans notre observation la régression des signes cliniques et imagériques était très rapide. Maladie rare d'évolution favorable, l'IRM diffusion est capitale dans le diagnostic.

RESUMEIntroduction. La grossesse sur cardiopathie operee demeure une association a haut risque. Le but de cette etude etait d’evaluer l’issue maternelle et fœtale de la grossesse chez les femmes operees du cœur avec ou sans traitement anticoagulant. Patients et methodes. Nous avons realise une etude transversale retrospective et descriptive dans les services de cardiologie du CHU Gabriel Toure et du CHU Mere-Enfant de Bamako de 2017 au 2018. Nous avons inclus dans l’etude toutes les femmes suivies pour grossesse et ayant beneficie d’une chirurgie cardiaque ou d’un catheterisme interventionnel. Resultats. Sur un total de 29 parturientes, l’âge moyen etait de 26.41±7,3. Le rhumatisme articulaire aigu (62.07%) etait l’antecedent medical le plus frequent. Les valvulopathies rhumatismales ont constitue 82.76% de lesions cardiaques operees contre 17.24% pour les cardiopathies congenitales. L’annuloplastie mitrale (48.28%) etait la chirurgie la plus frequente suivi des protheses mecaniques (31.03%). L’evolution de la grossesse a ete normale chez toutes les parturientes. L’accouchement etait normal chez 69% des patientes. Les complications en post partum ont ete surtout : l’insuffisance cardiaque (55.16 %) et les troubles du rythme (24.14%). Le traitement anticoagulant (la warfarine) a ete prescrit chez 79.31% des femmes. Ni avortement spontane, ni mort fœtale, ni hemorragie de la delivrance n’ont ete signales sous anticoagulant. L’echographie cardiaque en post partum a trouve une fonction systolique du ventricule gauche alteree chez 51.72%. Conclusion. Les mesures de surveillances et de suivis appropries sont necessaires afin d’eviter des complications fœto-maternelles de la grossesse sur cœur opere.ABSTRACTIntroduction. Pregnancy associated with operated heart is a high risk association. The aim of our study was to report the maternal and fetal outcome of pregnancy in women who have had heart surgery with or without anticoagulant therapy. Patients and methods. A retrospective and descriptive study was carried out in the cardiology departments of CHU Gabriel Toure and CHU Mere-Enfant de Bamako from 2017 to 2018. All the women followed for pregnancy and having benefited from a surgical treatment or interventional catheterization were included in the study. Results. In our study group of 29 women, the mean age was 26.41 ± 7.3. Rheumatic heart disease (62.07%) was the most common past medical history. Rheumatic valve disease constituted 82.76% of operated cardiac lesions against 17.24% for congenital heart disease. Mitral annuloplasty (48.28%) was the most common surgical repair modality followed by mechanical prostheses (31.03%). The course of the pregnancy was normal for all of the women. Delivery was normal in 69% of the pregnancies. The postpartum complications were mainly: heart failure (55.16%) and arrhythmias (24.14%). Anticoagulant therapy (warfarin) was prescribed in 79.31%. Neither spontaneous abortion, fetal death, nor delivery haemorrhage were encounteredwith anticoagulant therapy. Postpartum cardiac ultrasound found impaired systolic left ventricular function in 51.72% of patients. Conclusion. Appropriate monitoring and follow-up measures are necessary in order to avoid fetal-maternal complications of pregnancy on an operated heart.