INTRODUCTION:Emergency obstetrical treatment influences maternal and neonatal mortality and so the government of the republic of Mali decided on June 23, 2005 to establish a free caesarean policy in public health establishments. After 3 years and half, we evaluated the impact of the policy on maternal and neonatal mortality.METHOD:A comparative transversal study was conducted. The data of women who had a caesarean performed in the Segou regional hospital covering the span of 5 years (18 months before the policy and 42 following the new law) was collected. The data was analyzed using the Info 6.4 software. We employed a Pearson's Chi-2 with significance set at p<0.05.RESULTS:Frequency of the caesarean increased following the policy to 25.48 % in 2008 versus 9.33 % in 2004 (p=0.0067). Maternal mortality rate was improved: 3.85 % in 2004 versus 0.23 % in 2008. The rate of neonatal mortality in the same period dropped from 25.39 % to 9.36 % (p=0.021).CONCLUSION:It is noted that the free caesarean policy enabled an increase in the number of caesareans performed and a significant reduction in maternal and neonatal mortality rates.

One of the obstetric interventions introduced to address this issue is the cesarean – delivery. Cesarean delivery is defined as the birth of a fetus through incisions in the abdominal wall (laparotomy) and the uterine wall (hysterotomy) [Cunningham, 2001]. Historically, cesarean delivery was associated with a high complication rate, sometimes causing maternal death. In the era of modern medicine, however, cesarean section has become safe and is widely endorsed throughout the world as a strategy to improve pregnancy outcomes [Weil & Fernandez, 1999].

AIM:Pregnant women HIV infection has main risk the contamination of newborn. MTCT actions permit to reduce that risk.MATERIAL AND METHODS:Our survey has been realized in Gabriel Touré teaching hospital gynecology and obstetrics and pediatric departments. It is about an observational prospective and descriptive survey that spreads on a period from January 2005 to December 2008. Has been included in the study all the HIV positive pregnant women followed in our service and their babies that had received ARV prophylaxis and 18 months of life serology.RESULTS:We recorded 211 HIV positive pregnant women on a total of 9291 childbirths (2.27%). We noted 90.52% of HIV-1 vs 7.11% of type 2. The mother treatment consisted in a tri therapy in 77.25 vs 0.47% of bi anti retroviral and 22.28% of mono anti retro viral therapy. Maternal viral load was undetectable at the moment of delivery in 78.20% of cases. We noted vaginal delivery in 84.36% vs 15.64% of caesarean section. Newborns respectively received 67.32%; 4.88% and 22.92% of bi, tri and mono therapy. They formula-fed in 98.98%. The mother to child HIV transmission rate was 1.98%.CONCLUSION:HIV prevalence in pregnant patients is relatively height. HARRT in HIV positive mothers associated to bi therapy and formula feeding to their infants permit to obtain low vertical HIV transmission rate.

AIM:The sexual aggressions pose an important medico - legal problem. The implication of several services is often indispensable to determine the future of this aggression. Our survey objectives were to determine epidemiological and clinical characteristics of sexual aggressions and to specify the judicial continuations.MATERIAL AND METHODS:We did historical cohort survey while recruiting all cases of consultation in the service for sexual aggressions. This survey spreads on a period of 60 months going from January 2004 to December 2008. A systematic health evaluation (HIV test, vaginal screeming, lever inflammatory deseases) is asked to every sexual abuse patients.Data have been recorded from patients' clinical files, cards of requisition and accounts returned of verbal suit of auditions and police custodies. khi 2 test has been used to appreciate relationship between variables, significativity doorstep P value < 5%.RESULTS:The sexual aggression frequency in relation to admissions to emergencies is 3.12%. The age group <15 years were the more represented with 59.18%. The police authority referred the patients with a requisition in 65.17% of cases (p<0,005). Presumed aggressor was known by the patient in 63.67% of cases (p<5%) and in 72.28% of cases the aggression has been made by night (p=0,001) It was about one aggressor in 65.54% of cases; they were 2 and 3 numbers in 17.23%. (p=0,002). We noted a sexual penetration notion in 80.52% of cases against 19.48% of sexual attouchements. The threat has been noted in any case: 40.82% by weapon and 30.71% by stroke of point. More of the half of the patients (60.30%) had had sexual intercourse before the aggression. The clinic exam was normal in 76.40% of cases (P<5%). The main types of lesions were: hymeneal injuries (13.48%), vulva injuries (7.87%). The judicial continuations have been marked by 10.48% of condemnations, 46.06% of acquittal and 40.06% of friendly regulation (P<5%).CONCLUSION:The number of sexual aggressions, although under valued, is raised in our country. The collaboration between the judicial, police and medical services should permit to reduce the frequency of these aggressions.

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S724-S724 Poster presentations P1113 Cervical cancer screening in Mali: Eight years experience and perspectives I. Teguete, Search for more papers by this authorY. Traore, Search for more papers by this authorN. Mounkoro, Search for more papers by this authorT. Dolo, Search for more papers by this authorM. Djire, Search for more papers by this authorM. Traore, Search for more papers by this authorC. Traore, Search for more papers by this authorA. Dolo, Search for more papers by this author I. Teguete, Search for more papers by this authorY. Traore, Search for more papers by this authorN. Mounkoro, Search for more papers by this authorT. Dolo, Search for more papers by this authorM. Djire, Search for more papers by this authorM. Traore, Search for more papers by this authorC. Traore, Search for more papers by this authorA. Dolo, Search for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)62597-2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S724-S724 RelatedInformation

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S357-S357 Free communication (oral) presentations O928 Malaria and pregnancy at the Gabriel Toure teaching hospital in Bamako (Mali) between 2003 and 2007 I. Teguete, I. TegueteSearch for more papers by this authorN. Mounkoro, N. MounkoroSearch for more papers by this authorY. Traore, Y. TraoreSearch for more papers by this authorT. Dolo, T. DoloSearch for more papers by this authorK. Kayentao, K. KayentaoSearch for more papers by this authorA. Sissoko, A. SissokoSearch for more papers by this authorM. Traore, M. TraoreSearch for more papers by this authorA. Dolo, A. DoloSearch for more papers by this author I. Teguete, I. TegueteSearch for more papers by this authorN. Mounkoro, N. MounkoroSearch for more papers by this authorY. Traore, Y. TraoreSearch for more papers by this authorT. Dolo, T. DoloSearch for more papers by this authorK. Kayentao, K. KayentaoSearch for more papers by this authorA. Sissoko, A. SissokoSearch for more papers by this authorM. Traore, M. TraoreSearch for more papers by this authorA. Dolo, A. DoloSearch for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)61301-1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S357-S357 RelatedInformation