Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within...Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.展开更多
Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing t...Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.展开更多
Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complicati...Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.展开更多
Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in dev...Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.展开更多
Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The ob...Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.展开更多
Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University ...Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University Teaching Hospitals in Yaoundé. Methodology: A case-control study was conducted for 5 months, from February 25th to July 25th 2015, at the Gynecology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH) and the Medical Oncology unit of the Yaoundé General Hospital (YGH). One hundred and five patients with breast cancer (cases) were compared to 210 women who did not have breast cancer (controls). SPSS Version 18.0.0 software was used to analyze the data with a statistical significance considered at P-value 50 years (P three times per week (P = 0.002;OR = 2.14;CI = [1.33 - 3.45]), palm oil consumption > two times per week (P = 0.001;OR = 2.38;CI = [1.4 - 4.1]). After multivariate analysis, age > 50 years (aOR = 41.48;CI = [2.46 - 69.9]) and consumption of red meat > three times per week [aOR = 7.33;(1.49 - 36)] were the risk factors considered significant for breast cancer. Conclusion: Age > 50 years and red meat consumption are independent risk factors for breast cancer at the Yaoundé General Hospital and at the Yaoundé Gyneco-Obstetric and Pediatric Hospital.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due ...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> considered to be statistically significant. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 105 patients were </span><span style="font-family:Verdana;">recruited, including 104 women and 1 man. The median age was 46 years</span><span style="font-family:Verdana;"> with extremes of 25 and 77 years. Most patients (71%) had a monthly income </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">less than 175 USD. Patients in this study had opted for: contemporary</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> medi</span><span style="font-family:Verdana;">cine (49.5%), therapeutic abstention (38.1%), naturopathy (1.9%), </span><span style="font-family:Verdana;">self-me</span><span style="font-family:Verdana;">dication (9.5%) and traditional medicine (1%). The factors significantly associ</span><span style="font-family:Verdana;">ated with the choice of contemporary medicine as a first diagnostic option</span><span style="font-family:Verdana;"> were monthly income above 175 USD (OR = 0.37, 95% CI: 0.15 - 0.89, p = 0.028), good level of education (OR = 0.37, 95% CI: 0.16 - 0.82, p = 0.034) and </span><span style="font-family:Verdana;">good knowledge about breast cancer (OR = 0.28, 95% CI: 0.08 - 0.89, p = </span><span style="font-family:Verdana;">0.005). The majority of patients (65.7%) sought contemporary medicine as</span> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">first therapeutic option after a diagnosis of breast cancer was confirmed,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> while about a third </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of them </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">had chosen alternative treatment options including na</span><span style="font-family:Verdana;">turopathy (15.2%), traditional medicine (9.5%), religious practices (4.8%), </span><span style="font-family:Verdana;">thera</span><span><span style="font-family:Verdana;">peutic abstention (2.9%) and self-medication (1.9%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The firs</span></span><span style="font-family:Verdana;">t diagnostic and therapeutic choices of breast cancer patients in </span><span style="font-family:Verdana;">our setting are </span><span style="font-family:Verdana;">numerous and intricate, including contemporary medicine, therapeutic ab</span><span style="font-family:Verdana;">stention, self-medication, traditional medicine, naturopathy and religious </span><span style="font-family:Verdana;">practices. There is a need to promote breast cancer awareness in our population.</span></span></span></span>展开更多
The pain experienced during labour varies from one person to another. The objective of this study is to evaluate the experience of analgesia during labour in three maternity hospitals in Cameroon. Methodology: This wa...The pain experienced during labour varies from one person to another. The objective of this study is to evaluate the experience of analgesia during labour in three maternity hospitals in Cameroon. Methodology: This was a cross-sectional analytical study conducted over 4 months, from 1 December 2019 to 31 March 2020, at the Yaoundé Gynaecological-Obstetric Hospital, the Yaoundé Central Hospital and the Douala General Hospital. We compared 35 parturients who delivered vaginally under analgesia and 79 parturients who delivered without analgesia. The data collected were compared using Chi 2 and Fischer tests with a significance level of P Results: Parturients aged 30 - 40 years (P = 0.03), public sector employees (P = 0.002) and private sector employees (P Conclusion: Analgesia delivery offers a better birth experience, however it may have negligible side effects.展开更多
Objective: To identify the risk factors of intrapartal fetal death in a tertiary hospital in Yaoundé. Methods: It was a case-control study comparing 53 women who delivered with intrapartal fetal death to 106 wome...Objective: To identify the risk factors of intrapartal fetal death in a tertiary hospital in Yaoundé. Methods: It was a case-control study comparing 53 women who delivered with intrapartal fetal death to 106 women who delivered without intrapartal fetal death, carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. Results: The risk factors of intrapartal fetal death identified at bivariate analysis were: maternal age <20 years (OR = 3.1;CI = 1.1 - 8.3), absence of regular income (OR = 2.4;CI = 1.2 - 4.7), single motherhood (OR = 2.9;CI = 1.5 - 5.7), illiteracy and primary level of education (OR = 4.7;CI = 1.9 - 11.5), referral (OR = 5.0;CI = 2.5 - 9.9), parity 0 and 1 (OR = 2.3;CI = 1.1 - 4.5), no antenatal care (OR = 9.2;CI = 2.4 - 35.6), number of antenatal visits <4 (OR = 4.2;CI = 2.1 - 8.6), antenatal care in a health center (OR = 3.8;CI = 1.9 - 7.5), antenatal care by a midwife (OR = 2.5;CI = 1.3 - 4.9) or a nurse (OR = 5.2;CI = 1.4 - 18.7), absence of malaria prophylaxis (OR = 10.6;CI = 2.9 - 39.5), absence of obstetrical ultrasound (OR = 4.7;CI = 1.9 - 10.9), prematurity (OR = 3.4;CI = 1.5 - 7.3), abnormal presentation (OR = 2.6;CI = 1.1 - 5.9), ruptured membranes at admission (OR = 2.7;CI = 1.3 - 5.4), ruptured membranes >12 hours at admission (OR = 5.1;CI = 2.5 - 10.3), stained amniotic fluid (OR = 4.8;CI = 2.4 - 9.7), labor lasting more than 12 hours (OR = 18.1;CI = 8.0 - 41.0), presence of maternal complications (OR = 4.7;CI = 2.2 - 10.3), and presence of fetal complications (OR = 48.6;CI = 18.3 - 129), particularly acute fetal distress (OR = 52.3;CI = (14.6 - 186), cord prolapse (OR = 12.1;CI = 3.3 - 43.4), and birth weight <2500 g (OR = 2.8;CI = 1.2 - 6.6). Conclusion: Close attention should be offered to pregnant women, so as to identify these risk factors and promptly provide an appropriate management.展开更多
The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics D...The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.展开更多
Introduction: Postpartum Depression is one of the commonest complications of the postpartum period. In Cameroon, little is known about this condition. Our objective was to determine the prevalence and identify the ris...Introduction: Postpartum Depression is one of the commonest complications of the postpartum period. In Cameroon, little is known about this condition. Our objective was to determine the prevalence and identify the risk factors for postpartum depression. Methodology: The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, from November 4th 2013 to April 4th 2014. All the women between the 4th and 6th week after birth who gave their consent were included. A pretested questionnaire including demographic, psychosocial, maternal and infant variables as well as the Edinburgh Postnatal Depression Scale (EPDS) was filled. A woman with an EPDS score ≥12 was considered having postpartum depression, while a score < 12 ruled out a postpartum depression. Results: We recruited 214 women, among whom 50 had an EPDS score ≥ 12, giving a prevalence of 23.4% of postpartum depression. After multivariate analysis, the risk factors of postpartum depression were: lack of satisfaction in the marital relationship, recent financial problems, recent conflicts with the partner, baby blues, difficulties in feeding the baby and problems with the baby’s sleep. Conclusion: Postpartum depression is common and associated to specific risk factors in our setting.展开更多
The objective of this study was to assess the effects of excessive weight gain during pregnancy on the outcome of cesarean delivery. It was a cohort study comparing the outcome of cesarean delivery between 56 pregnant...The objective of this study was to assess the effects of excessive weight gain during pregnancy on the outcome of cesarean delivery. It was a cohort study comparing the outcome of cesarean delivery between 56 pregnant women with excessive weight gain during pregnancy and 75 pregnant women with no excessive weight gain during pregnancy, consecutively recruited at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. In women delivered by cesarean section, excessive weight gain during pregnancy was found to predispose to: time interval from parietal incision to fetal extraction of more than five minutes, duration of cesarean section more than 60 minutes, blood loss more than 1000 ml during surgery, post-operative maternal complications, especially sepsis, fetal weight >3.5 kg and macrosomia. A systematic screening of excessive weight gain should be offered to all pregnant women, so as to prevent the adverse effects of excessive gestational weight gain on cesarean outcome.展开更多
Objective:The importance of a“second look”laparoscopy for adhesion formation after myomectomy by laparotomy in improving fertility is not clearly defined in our context.The aim of this study was to compare spontaneo...Objective:The importance of a“second look”laparoscopy for adhesion formation after myomectomy by laparotomy in improving fertility is not clearly defined in our context.The aim of this study was to compare spontaneous fertility after myomectomy by laparotomy between women who underwent a“second look”laparoscopy and those who did not.Methods:We conducted an analytical cross-sectional study with retrospective data collection from January 1,2008 to December 31,2015,comparing spontaneous fertility between patients who underwent“second-look”laparoscopy after myomectomy by laparotomy to those who did not.Firstly,data was collected from the records of patients included in the study.Secondly,through phone calls,informed consent for each participant was obtained after which inquiries were made regarding their fertility status.Results:After a period of 24 months,23 patients(47.9%)with“second look”laparoscopy conceived,compared to 37 patients(35.2%)without“second look”laparoscopy(p=0.136);and 24 patients(50.0%)with“second look”had term pregnancies compared to 39 patients(37.1%)without“second look”laparoscopy(p=0.134).Conclusion:Spontaneous fertility rates seemed to be improved after a“second look”laparoscopy,however,there was no statistically significant difference between spontaneous fertility rates obtained after myomectomy by laparotomy,irrespective of the fact that the patient had undergone a“second look”laparoscopy or not at Yaounde Gyneco-Obstetric and Pediatric Hospital.展开更多
Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-co...Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.展开更多
Objective: To describe the clinical and therapeutic aspects of rape against females in a tertiary level hospital, Yaoundé, Cameroon. Methods: This was a cross-sectional study with a retrolective collection of dat...Objective: To describe the clinical and therapeutic aspects of rape against females in a tertiary level hospital, Yaoundé, Cameroon. Methods: This was a cross-sectional study with a retrolective collection of data, concerning the female patients with a clinical diagnosis of rape received from January 1st 2008 to December 31st 2012. Results: Rape was confirmed at physical examination in 131 cases. The rape victim survivals were mostly aged less than 20 years (85/131;64.9%), unmarried (127/131;97.0%), with no income (95/131;72.5%) and had no university education level (110/131;83.9%). The aggression commonly took place during the night (68/131;51.9%), at the victim’s or aggressor’s home (70/131;53.4%), with physical constraint (73/131;55.8%), by an unknown aggressor (88/131;67.2%). A vaginal penetration was reported by 97.0% of the victims (127/131) while 12.2% of them (16/122) had an anal ingress. Condom usage was uncommon during rape (3/131;2.3%). Vulvar and vaginal lesions were encountered in 32.8% of the cases (43/131). Only 27.5% (36/131) of the victims were prescribed an emergency contraception, while antiretroviral prophylaxis was administered to 46.6% (61/131) of them. Conclusion: These data might be useful for prevention of rape. The clinical management of survival victims of rape needs to be improved.展开更多
Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It ...Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1st 2012 to March 31st 2013 giving total study duration of 07 months. Laboratory analyses were carried out at the National Obesity Centre(NOC)of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years;p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS). Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman’s correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.展开更多
Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to ...Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.展开更多
Introduction: The substantial changes that occur in adolescence may lead to sexual behaviors that adversely affect their health. We have described sexual patterns in adolescents in various neighborhoods of Yaounde in ...Introduction: The substantial changes that occur in adolescence may lead to sexual behaviors that adversely affect their health. We have described sexual patterns in adolescents in various neighborhoods of Yaounde in order to underscore the sexual challenges that they face. Methods: We carried out a cross-sectional descriptive study in District number V of Yaounde from August 1st to 31st 2018. To characterize their sexual lives, we surveyed 1800 adolescents between 10 and 19, and analyzed the data using SPSS version 25.0. Results: In our study, 1023 (56.8%) adolescents were female, and 777 (43.2%) were male. Most of the adolescents were between ages 18 and 19 years (25.4%), unmarried (93.1%), had a secondary level of education (81.9%) and lived with their families (87.3%). One-third of the adolescents (30.7%) were sexually active and 41.1% had multiple sexual partners. The average age of coitarche was 15.1 years. Among the females, 17.1% reported one prior pregnancy and 30.8% had one abortion. Most of the sexual encounters were heterosexual (82.6%) and 30.2% regularly used male condoms. 66.0% and 47.7% obtained information about sexuality primarily from social media and mass media, respectively. Conclusion: Sexual encounters in adolescents of District V of Yaounde were premature, mostly heterosexual and often unprotected. The consequences were an increased incidence of early pregnancies and abortions.展开更多
Objective: To describe the practice of laparoscopic surgery in the treatment of infertility at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital. Materials and Methods: This was an observational study with ret...Objective: To describe the practice of laparoscopic surgery in the treatment of infertility at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital. Materials and Methods: This was an observational study with retrolective data collection. All patients who underwent laparoscopy for infertility with a complete file were recruited. Data were collected on a pre-established form and analyzed with Microsoft Excel 2007 software. Results: Six hundred and thirty-three women, representing 6.9% of gynecologic operations, underwent laparoscopic surgery during the study period. Infertility accounted for 69.8% (442 cases) of the indications. Four hundred and fifteen files were analyzed. The commonest intraoperative findings were: tubo-peritoneal adhesions (71.6%), hydrosalpinx with distal tubal occlusion (41.5%), peri-hepatic adhesions (22.4%), uterine fibroids (20.2%) and tubal phimosis (14.0%). Adhesiolysis, neosalpingostomy and fimbrioplasty were the commonest surgical gestures. At the end of the procedure, the best tube was staged as favorable in 57.6% of our patients. A complication rate of 4.3% was observed. Conclusion: Infertility is the main indication for laparoscopic surgery in our setting. The main operative findings are tubo-peritoneal adhesions and hydrosalpinx. The most practiced tubal surgical gesture is neosalpingostomy. Half of the recruited women have a favorable stage for the best tube. The complication rate is low.展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Preeclampsia is one of the major causes of maternal and neonatal</span><span style="font-family:""&...<strong>Introduction:</strong><span style="font-family:Verdana;"> Preeclampsia is one of the major causes of maternal and neonatal</span><span style="font-family:""><span style="font-family:Verdana;"> morbidity and mortality in the world. The complexity of its </span><span style="font-family:Verdana;">etio-pathogenesis</span><span style="font-family:Verdana;"> involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> We carried out an analytical cross-sectional case-control study from November 01</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 to May 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> body mass index, prothrombin level (PL) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">> 100%, ACT</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">25</span><span style="font-family:""> </span><span style="font-family:Verdana;">seconds. Statistical tests were considered significant for a p-value </span><span style="font-family:Verdana;"><</span><span style="font-family:Verdana;"> 0.05.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We recruited 150 pregnant women including 50 preeclampsia matched</span><span style="font-family:Verdana;"> with 100 non-preeclampsia. The majority age group in both groups was 25</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">30 years (32% versus 37%). We found a high PL in 58% of preeclampsia versus 22% of non-preeclampsia patients (p = <0.001), a low PL in 8% of preeclampsia versus 0% in non-preeclampsia patients (p = 0.004). The ACT was prolonged in 12% of the preeclampsia versus 0% in the non-preeclampsia patients (p = <0.001). Pregnant women with preeclampsia were 4.89 times more likely to develop hypercoagulability than pregnant women without preeclampsia (OR 4.89;CI 2.34</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.20;p = <0.001). In linear regression, preeclampsia was significantly associated with PL (correlation coefficient 0.07;p = 0.008). We did not find risk factors associated with hypercoagulability in preeclampsia.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Our study confirms the existence of hypercoagulability associated with preeclampsia, in particular </span><span style="font-family:Verdana;">in relation to</span><span style="font-family:Verdana;"> an increase in the level of prothrombin.</span></span>展开更多
文摘Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.
文摘Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.
文摘Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.
文摘Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.
文摘Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
文摘Introduction: Breast cancer is the most common cancer and the first cause of cancer-related deaths among women in Cameroon. The aim of the study was to investigate its risk factors for breast cancer at two University Teaching Hospitals in Yaoundé. Methodology: A case-control study was conducted for 5 months, from February 25th to July 25th 2015, at the Gynecology unit of the Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH) and the Medical Oncology unit of the Yaoundé General Hospital (YGH). One hundred and five patients with breast cancer (cases) were compared to 210 women who did not have breast cancer (controls). SPSS Version 18.0.0 software was used to analyze the data with a statistical significance considered at P-value 50 years (P three times per week (P = 0.002;OR = 2.14;CI = [1.33 - 3.45]), palm oil consumption > two times per week (P = 0.001;OR = 2.38;CI = [1.4 - 4.1]). After multivariate analysis, age > 50 years (aOR = 41.48;CI = [2.46 - 69.9]) and consumption of red meat > three times per week [aOR = 7.33;(1.49 - 36)] were the risk factors considered significant for breast cancer. Conclusion: Age > 50 years and red meat consumption are independent risk factors for breast cancer at the Yaoundé General Hospital and at the Yaoundé Gyneco-Obstetric and Pediatric Hospital.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> considered to be statistically significant. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 105 patients were </span><span style="font-family:Verdana;">recruited, including 104 women and 1 man. The median age was 46 years</span><span style="font-family:Verdana;"> with extremes of 25 and 77 years. Most patients (71%) had a monthly income </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">less than 175 USD. Patients in this study had opted for: contemporary</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> medi</span><span style="font-family:Verdana;">cine (49.5%), therapeutic abstention (38.1%), naturopathy (1.9%), </span><span style="font-family:Verdana;">self-me</span><span style="font-family:Verdana;">dication (9.5%) and traditional medicine (1%). The factors significantly associ</span><span style="font-family:Verdana;">ated with the choice of contemporary medicine as a first diagnostic option</span><span style="font-family:Verdana;"> were monthly income above 175 USD (OR = 0.37, 95% CI: 0.15 - 0.89, p = 0.028), good level of education (OR = 0.37, 95% CI: 0.16 - 0.82, p = 0.034) and </span><span style="font-family:Verdana;">good knowledge about breast cancer (OR = 0.28, 95% CI: 0.08 - 0.89, p = </span><span style="font-family:Verdana;">0.005). The majority of patients (65.7%) sought contemporary medicine as</span> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">first therapeutic option after a diagnosis of breast cancer was confirmed,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> while about a third </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of them </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">had chosen alternative treatment options including na</span><span style="font-family:Verdana;">turopathy (15.2%), traditional medicine (9.5%), religious practices (4.8%), </span><span style="font-family:Verdana;">thera</span><span><span style="font-family:Verdana;">peutic abstention (2.9%) and self-medication (1.9%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The firs</span></span><span style="font-family:Verdana;">t diagnostic and therapeutic choices of breast cancer patients in </span><span style="font-family:Verdana;">our setting are </span><span style="font-family:Verdana;">numerous and intricate, including contemporary medicine, therapeutic ab</span><span style="font-family:Verdana;">stention, self-medication, traditional medicine, naturopathy and religious </span><span style="font-family:Verdana;">practices. There is a need to promote breast cancer awareness in our population.</span></span></span></span>
文摘The pain experienced during labour varies from one person to another. The objective of this study is to evaluate the experience of analgesia during labour in three maternity hospitals in Cameroon. Methodology: This was a cross-sectional analytical study conducted over 4 months, from 1 December 2019 to 31 March 2020, at the Yaoundé Gynaecological-Obstetric Hospital, the Yaoundé Central Hospital and the Douala General Hospital. We compared 35 parturients who delivered vaginally under analgesia and 79 parturients who delivered without analgesia. The data collected were compared using Chi 2 and Fischer tests with a significance level of P Results: Parturients aged 30 - 40 years (P = 0.03), public sector employees (P = 0.002) and private sector employees (P Conclusion: Analgesia delivery offers a better birth experience, however it may have negligible side effects.
文摘Objective: To identify the risk factors of intrapartal fetal death in a tertiary hospital in Yaoundé. Methods: It was a case-control study comparing 53 women who delivered with intrapartal fetal death to 106 women who delivered without intrapartal fetal death, carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. Results: The risk factors of intrapartal fetal death identified at bivariate analysis were: maternal age <20 years (OR = 3.1;CI = 1.1 - 8.3), absence of regular income (OR = 2.4;CI = 1.2 - 4.7), single motherhood (OR = 2.9;CI = 1.5 - 5.7), illiteracy and primary level of education (OR = 4.7;CI = 1.9 - 11.5), referral (OR = 5.0;CI = 2.5 - 9.9), parity 0 and 1 (OR = 2.3;CI = 1.1 - 4.5), no antenatal care (OR = 9.2;CI = 2.4 - 35.6), number of antenatal visits <4 (OR = 4.2;CI = 2.1 - 8.6), antenatal care in a health center (OR = 3.8;CI = 1.9 - 7.5), antenatal care by a midwife (OR = 2.5;CI = 1.3 - 4.9) or a nurse (OR = 5.2;CI = 1.4 - 18.7), absence of malaria prophylaxis (OR = 10.6;CI = 2.9 - 39.5), absence of obstetrical ultrasound (OR = 4.7;CI = 1.9 - 10.9), prematurity (OR = 3.4;CI = 1.5 - 7.3), abnormal presentation (OR = 2.6;CI = 1.1 - 5.9), ruptured membranes at admission (OR = 2.7;CI = 1.3 - 5.4), ruptured membranes >12 hours at admission (OR = 5.1;CI = 2.5 - 10.3), stained amniotic fluid (OR = 4.8;CI = 2.4 - 9.7), labor lasting more than 12 hours (OR = 18.1;CI = 8.0 - 41.0), presence of maternal complications (OR = 4.7;CI = 2.2 - 10.3), and presence of fetal complications (OR = 48.6;CI = 18.3 - 129), particularly acute fetal distress (OR = 52.3;CI = (14.6 - 186), cord prolapse (OR = 12.1;CI = 3.3 - 43.4), and birth weight <2500 g (OR = 2.8;CI = 1.2 - 6.6). Conclusion: Close attention should be offered to pregnant women, so as to identify these risk factors and promptly provide an appropriate management.
文摘The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.
文摘Introduction: Postpartum Depression is one of the commonest complications of the postpartum period. In Cameroon, little is known about this condition. Our objective was to determine the prevalence and identify the risk factors for postpartum depression. Methodology: The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, from November 4th 2013 to April 4th 2014. All the women between the 4th and 6th week after birth who gave their consent were included. A pretested questionnaire including demographic, psychosocial, maternal and infant variables as well as the Edinburgh Postnatal Depression Scale (EPDS) was filled. A woman with an EPDS score ≥12 was considered having postpartum depression, while a score < 12 ruled out a postpartum depression. Results: We recruited 214 women, among whom 50 had an EPDS score ≥ 12, giving a prevalence of 23.4% of postpartum depression. After multivariate analysis, the risk factors of postpartum depression were: lack of satisfaction in the marital relationship, recent financial problems, recent conflicts with the partner, baby blues, difficulties in feeding the baby and problems with the baby’s sleep. Conclusion: Postpartum depression is common and associated to specific risk factors in our setting.
文摘The objective of this study was to assess the effects of excessive weight gain during pregnancy on the outcome of cesarean delivery. It was a cohort study comparing the outcome of cesarean delivery between 56 pregnant women with excessive weight gain during pregnancy and 75 pregnant women with no excessive weight gain during pregnancy, consecutively recruited at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon. In women delivered by cesarean section, excessive weight gain during pregnancy was found to predispose to: time interval from parietal incision to fetal extraction of more than five minutes, duration of cesarean section more than 60 minutes, blood loss more than 1000 ml during surgery, post-operative maternal complications, especially sepsis, fetal weight >3.5 kg and macrosomia. A systematic screening of excessive weight gain should be offered to all pregnant women, so as to prevent the adverse effects of excessive gestational weight gain on cesarean outcome.
文摘Objective:The importance of a“second look”laparoscopy for adhesion formation after myomectomy by laparotomy in improving fertility is not clearly defined in our context.The aim of this study was to compare spontaneous fertility after myomectomy by laparotomy between women who underwent a“second look”laparoscopy and those who did not.Methods:We conducted an analytical cross-sectional study with retrospective data collection from January 1,2008 to December 31,2015,comparing spontaneous fertility between patients who underwent“second-look”laparoscopy after myomectomy by laparotomy to those who did not.Firstly,data was collected from the records of patients included in the study.Secondly,through phone calls,informed consent for each participant was obtained after which inquiries were made regarding their fertility status.Results:After a period of 24 months,23 patients(47.9%)with“second look”laparoscopy conceived,compared to 37 patients(35.2%)without“second look”laparoscopy(p=0.136);and 24 patients(50.0%)with“second look”had term pregnancies compared to 39 patients(37.1%)without“second look”laparoscopy(p=0.134).Conclusion:Spontaneous fertility rates seemed to be improved after a“second look”laparoscopy,however,there was no statistically significant difference between spontaneous fertility rates obtained after myomectomy by laparotomy,irrespective of the fact that the patient had undergone a“second look”laparoscopy or not at Yaounde Gyneco-Obstetric and Pediatric Hospital.
文摘Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.
文摘Objective: To describe the clinical and therapeutic aspects of rape against females in a tertiary level hospital, Yaoundé, Cameroon. Methods: This was a cross-sectional study with a retrolective collection of data, concerning the female patients with a clinical diagnosis of rape received from January 1st 2008 to December 31st 2012. Results: Rape was confirmed at physical examination in 131 cases. The rape victim survivals were mostly aged less than 20 years (85/131;64.9%), unmarried (127/131;97.0%), with no income (95/131;72.5%) and had no university education level (110/131;83.9%). The aggression commonly took place during the night (68/131;51.9%), at the victim’s or aggressor’s home (70/131;53.4%), with physical constraint (73/131;55.8%), by an unknown aggressor (88/131;67.2%). A vaginal penetration was reported by 97.0% of the victims (127/131) while 12.2% of them (16/122) had an anal ingress. Condom usage was uncommon during rape (3/131;2.3%). Vulvar and vaginal lesions were encountered in 32.8% of the cases (43/131). Only 27.5% (36/131) of the victims were prescribed an emergency contraception, while antiretroviral prophylaxis was administered to 46.6% (61/131) of them. Conclusion: These data might be useful for prevention of rape. The clinical management of survival victims of rape needs to be improved.
文摘Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1st 2012 to March 31st 2013 giving total study duration of 07 months. Laboratory analyses were carried out at the National Obesity Centre(NOC)of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years;p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS). Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman’s correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.
文摘Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.
文摘Introduction: The substantial changes that occur in adolescence may lead to sexual behaviors that adversely affect their health. We have described sexual patterns in adolescents in various neighborhoods of Yaounde in order to underscore the sexual challenges that they face. Methods: We carried out a cross-sectional descriptive study in District number V of Yaounde from August 1st to 31st 2018. To characterize their sexual lives, we surveyed 1800 adolescents between 10 and 19, and analyzed the data using SPSS version 25.0. Results: In our study, 1023 (56.8%) adolescents were female, and 777 (43.2%) were male. Most of the adolescents were between ages 18 and 19 years (25.4%), unmarried (93.1%), had a secondary level of education (81.9%) and lived with their families (87.3%). One-third of the adolescents (30.7%) were sexually active and 41.1% had multiple sexual partners. The average age of coitarche was 15.1 years. Among the females, 17.1% reported one prior pregnancy and 30.8% had one abortion. Most of the sexual encounters were heterosexual (82.6%) and 30.2% regularly used male condoms. 66.0% and 47.7% obtained information about sexuality primarily from social media and mass media, respectively. Conclusion: Sexual encounters in adolescents of District V of Yaounde were premature, mostly heterosexual and often unprotected. The consequences were an increased incidence of early pregnancies and abortions.
文摘Objective: To describe the practice of laparoscopic surgery in the treatment of infertility at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital. Materials and Methods: This was an observational study with retrolective data collection. All patients who underwent laparoscopy for infertility with a complete file were recruited. Data were collected on a pre-established form and analyzed with Microsoft Excel 2007 software. Results: Six hundred and thirty-three women, representing 6.9% of gynecologic operations, underwent laparoscopic surgery during the study period. Infertility accounted for 69.8% (442 cases) of the indications. Four hundred and fifteen files were analyzed. The commonest intraoperative findings were: tubo-peritoneal adhesions (71.6%), hydrosalpinx with distal tubal occlusion (41.5%), peri-hepatic adhesions (22.4%), uterine fibroids (20.2%) and tubal phimosis (14.0%). Adhesiolysis, neosalpingostomy and fimbrioplasty were the commonest surgical gestures. At the end of the procedure, the best tube was staged as favorable in 57.6% of our patients. A complication rate of 4.3% was observed. Conclusion: Infertility is the main indication for laparoscopic surgery in our setting. The main operative findings are tubo-peritoneal adhesions and hydrosalpinx. The most practiced tubal surgical gesture is neosalpingostomy. Half of the recruited women have a favorable stage for the best tube. The complication rate is low.
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Preeclampsia is one of the major causes of maternal and neonatal</span><span style="font-family:""><span style="font-family:Verdana;"> morbidity and mortality in the world. The complexity of its </span><span style="font-family:Verdana;">etio-pathogenesis</span><span style="font-family:Verdana;"> involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> We carried out an analytical cross-sectional case-control study from November 01</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 to May 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> body mass index, prothrombin level (PL) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">> 100%, ACT</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">25</span><span style="font-family:""> </span><span style="font-family:Verdana;">seconds. Statistical tests were considered significant for a p-value </span><span style="font-family:Verdana;"><</span><span style="font-family:Verdana;"> 0.05.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We recruited 150 pregnant women including 50 preeclampsia matched</span><span style="font-family:Verdana;"> with 100 non-preeclampsia. The majority age group in both groups was 25</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">30 years (32% versus 37%). We found a high PL in 58% of preeclampsia versus 22% of non-preeclampsia patients (p = <0.001), a low PL in 8% of preeclampsia versus 0% in non-preeclampsia patients (p = 0.004). The ACT was prolonged in 12% of the preeclampsia versus 0% in the non-preeclampsia patients (p = <0.001). Pregnant women with preeclampsia were 4.89 times more likely to develop hypercoagulability than pregnant women without preeclampsia (OR 4.89;CI 2.34</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.20;p = <0.001). In linear regression, preeclampsia was significantly associated with PL (correlation coefficient 0.07;p = 0.008). We did not find risk factors associated with hypercoagulability in preeclampsia.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Our study confirms the existence of hypercoagulability associated with preeclampsia, in particular </span><span style="font-family:Verdana;">in relation to</span><span style="font-family:Verdana;"> an increase in the level of prothrombin.</span></span>
