ABSTRACT
The aim was to evaluate antenatal consultations at the maternity ward of the hospital in Gao (Mali). Materials and methods: This was a cross-sectional descriptive evaluative study that involved a randomly selected sample of 122 cases of antenatal consultations carried out over a period of (6 months). Results: In our study, the 21 to 30 age group was the most represented with a rate of 67%; 23% of pregnant women were between 14 and 20 years old and 10% were over 30 years old. The Sonrhaïs were mostly represented. In fact, more than one in two pregnant women belonged to this socio-cultural group, 53.2%. The majority of our pregnant women were out of school or in high school, i.e. 55% respectively; 38%. The household profession was the most represented in our study, accounting for 60% of cases. During this study, most pregnancies were seen in the third trimester with a rate of 72%, less than % of pregnancies had had 4 PNCs. The objective of comparing the quality index of so-called high-risk pregnancies with others could not be explored due to the very limited number of these pregnancies in our sample.

ABSTRACT
The delivery of a macrosomic baby remains a concern for obstetricians and neonatologists, especially when the delivery is vaginal, because of the risk of maternal and perinatal complications. The aim of this article is to study macrosomic deliveries in the gynaecology and obstetrics department of the Kati reference health center. Method: This was a prospective, cross-sectional study which ran from 1 November 2020 to 31 October 2022, a period of 24 months. It concerned all deliveries in which the birth weight of the newborn was greater than or equal to 4000 grams, excluding cases of foetal malformations. Results: Out of a total of 4676 deliveries, we recorded 127 cases of macrosomia, a frequency of 2.7%. The average age of the women was 28.5 years, ranging from 16 to 47 years. The main risk factors identified were high multiparity (29.1%), maternal obesity (28.4%), overdue delivery (19.7%), previous delivery with the presentation was cephalic in 93.7% of cases, and delivery was by vaginal route in 63.8% of cases, compared with caesarean section in 36.2%. Maternal complications were dominated by perineal tears in thirteen cases (10.2%), cervical tears in two cases (1.6%), endometritis in two cases (1.6%), vaginal tears in one case (0.8) and haemorrhage during delivery in one case (0.8%). However, no complications were found in 108 out of 127 deliveries (85%). The Apgar score was less than eight at 1 minute in 12.6% of newborns. We observed serosanguineous hump (8.7%), brachial plexus paralysis (4.7%), clavicle fracture (1.6%) and early neonatal death (2.4%) due to neonatal distress. Conclusion: Macrosomic delivery carries very real risks, and the indications for vaginal delivery must be restricted in order to improve maternal and foetal prognosis.