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Ultrasound Study of First Trimester Bleeding

Open Journal of Radiology 2019年第1期9卷 58-68页

作者： Mathurin Neossi Guena Florent Zilbinkai Alapha Doris Christelle Maleu Kemegne achille nkigoum nana Odile Fernande Zeh Joseph Gonsu Fotsing Department of Biomedical Sciences Faculty of Sciences University of Ngaoundéré Ngaoundéré Cameroon Imaging Service Ngaoundéré Regional Hospital Ngaoundéré Cameroon Gyneacology and Obstetrical Service Ngaoundéré Regional Hospital Ngaoundéré Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde Gynaecology Obstetrics and Pediatrics Hospital Yaounde Cameroon

Objective: Bleeding during the first trimester of pregnancy is common and can be a sign of complication that often necessitates obstetric ultrasound for the assessment of the haemorrhage, and of fetal well being. The aim of this study was to determine the causes of first trimester bleeding on obstetrical ultrasound in our area. Method: It was a cross-sectional descriptive study during a six-month period from May to October 2017. All women who referred to the Regional center of medical imaging of Ngaoundere who agreed to participate in the study with first trimester bleeding were evaluated with clinical history and ultrasonography (US). Ultrasonographic exam was done via transabdominal or endovaginal approaches using GE LOGIQ 7 scanner brand. Microsoft Office Excel 2010 and SPHINX V 4.0 were used for data analysis. Results: A total of 121 of pregnant women who presented vaginal bleeding during the first trimester were enrolled into the study. These Ultrasound examinations represented 37.93% of all obstetric ultrasounds in the first trimester. The patients in this study ranged in age from 16 to 47 years with an average of 30 years. 50 (41.32%) were pregnant for the first time and 24 (19.83%) were primiparous. Mean gestational age was 9 weeks with the extremes of 5 and 12 weeks. 97 (80.2%) reported spontaneous bleeding while in 24 (18.8%) bleeding was mostly caused by sexual intercourse 11 (45.8%). Pelvic pain 91 (75.2%) was the most associated sign. 36 (29.8%) patients were diagnosed as threatened abortions. 27 (22.3%) were diagnosed with incomplete abortions. 4 (3.3%) cases showed an ectopic gestation. 9 (7.4%) cases showed complete abortions. Concordance between clinical diagnosis and ultrasound results was 84%. Conclusions: Bleeding in the first trimester of pregnancy is common in our area. Ultrasonography occupies a prominent place in the etiological diagnosis of bleeding in the first trimester of pregnancy;it is easy to find in most cases a responsible abnormality of bleeding.

关键词： Bleeding of the First Trimester Pregnancy Ultrasound Etiological Diagnosis

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Non-Laboring Uterine Rupture of an Unscared Uterus before Term Discover during Obstetric Ultrasound

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Case Reports in Clinical Medicine 2018年第1期7卷 47-54页

作者： Mathurin Neossi Guena Florent Alapha Solène Keutcha Tiodjio Irène Piaple Nganyou Carine Nelie Nde Houmtie achille nkigoum nana Department of Biomedical Sciences Faculty of Sciences University of Ngaoundere Ngaoundere Cameroon Imaging Service Ngaoundere Regional Hospital Ngaoundere Cameroon Gyneacology and Obstetrical Service Ngaoundere Regional Hospital Ngaoundere Cameroon

Uterine rupture is defined as the occurrence of communication between the abdominal and uterine cavity and may be complete or incomplete depending on the degree of involvement of the different layers of the uterus and surrounding organs. It is a rare complication whose consequences often involve the maternal and fetal prognosis. The majority of uterine rupture occurs on the scarred uterus, its incidence in France is estimated according to the series between 1/1000 and 1/2000 births, it represents 30% of causes of maternal death in the developing countries. The authors report here a case of uterine rupture outside of labor at 33 weeks of age in 32 years old woman, gravida 9 para 8, with no history of uterine surgery discovered during obstetric ultrasound for abdominal pain. During the interrogation, she was alarge multipara and had a child of 15 months. The abdominal ultrasound showed a right lateral corporeal rupture with hemoperitoneum of medium sized and a dead fetus. The emergency laparotomy revealed a right lateral uterine wound approximately 15 cm long with intra-abdominal placenta and a haemoperitoneum of medium sized of about 600 cc and a bladder lesion. After opening the amniotic sac, there was extraction of a dead fetus. The uterine and bladder lesions were repaired followed by bilateral tubal ligation. The patient received 500 cc of whole blood during and 500 cc after the procedure. The postoperative follow-up was simple. This case contributes to the knowledge of this rare and atypical event, and emphasizes the importance of maintaining a suspicion.

关键词： Uterine Rupture Multiparity Obstetrical Ultrasound Unscarred Uterus Short Interval between Pregnancies Outside of Labor Term

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Breast Cancer Survival in Cameroon: Analysis of a Cohort of 404 Patients at the YaoundéGeneral Hospital

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Advances in Breast Cancer Research 2015年第2期4卷 44-52页

作者： Jean Dupont Kemfang Ngowa Jean Marie Kasia Jean Yomi achille nkigoum nana Anny Ngassam Irenée Domkam Zacharie Sando Paul Ndom Department of Gynecology and Obstetrics Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaoundé Cameroon Department of Radiation Therapy Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management Yaoundé Cameroon Department of Morphological Sciences Yaoundé General Hospital Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Oncology Division Yaoundé General Hospital Yaoundé Cameroon

This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.

关键词： Survival Breast Cancer Developing Countries

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Results of Adults Laparoscopic Varicocelectomy in a Limited Setting: A Study in Yaoundé(Cameroon)

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Open Journal of Urology 2021年第12期11卷 443-451页

作者： Landry Oriole Mbouché Guy Aristide Bang Axel Stéphane Nwaha Makon Frantz Guy Epoupa Ngallé Eric Patrick Savom Roland Metomo Junior Mekeme Mekeme achille Aurèle Mbassi Justin Kamga Blondel nana Oumarou Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon The National Insurance Fund Health Center of Essos Yaoundé Cameroon

Background: Varicocele is an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus veins draining the testicle. The principle of varicocele treatment is to block the reflux in the internal spermatic vein while preserving the internal spermatic artery, lymphatics and vas deferens. Treatment can be performed through percutaneous venous embolization or surgical correction, either open or laparoscopic approach. The purpose of the study was to review our experience in the management of laparoscopic varicocele repair and to assess the outcomes after operation. Methods: We retrospectively reviewed files of patients who underwent laparoscopic varicocelectomy from January 2010 to December 2009 in three health center of Yaoundé (Cameroon). Clinical and diagnosis features of varicocele, indication for surgery, operative procedure and outcomes, as well as long-term follow-up of were analyzed. Results: A total of 74 file of patients were collected. The average age of patients was 36.93 years old. Among them, 43 (58.11%) had varicocele grade 1, 21 (28.38%) grade 2, and 2 (2.70%) grade 3. Fifty-four (72.97%) cases had bilateral varicocele, 17 (22.97%) and 3 (4.05%) patients had left and right varicocele respectively. 42(56.7%) patients complained for fertility problem. Scrotal pain was found in 26 (35.13%) cases. The pneumoperitoneum was achieved in all cases through a supra-umbilical open coelioscopy with the insertion of a 10 mm-optic port. Two 5 mm working ports were used in all cases. Dilated veins were clipped without section simple in 56 cases (75.68%). the mean operative time was 31.9 min ± 8.6 min. With a mean follow-up period of 27 months, we recorded 4.05% of recurrence and hydrocele in 1 case (1.35%), symptoms’ regression in 87% of cases and pregnancy in 65.9% of cases of infertility. Conclusion: Laparoscopic varicocelectomy is feasible and safe in our setting, with good results. We e

关键词： Varicocele Laparoscopy Fertility Pain

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