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The Interest of Endoscopy in the Diagnosis of Fallopian Tubes Diseases at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (Ygoph)

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 767-774页

作者： cyrille Léger Abega claude cyrille noa ndoua Irène Nadine Kouna Tsala Arielle Fonkou Gladys Ngono Ateba Tobie Eric Ntsobe Jean Cédric Fouda Rosine Mafoma Pascal Foumane Mother and Child Center Douala General Hospital Douala Cameroon Department of Gyneco-Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon University of Yaoundé I Yaoundé Cameroon Faculty of Medecine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Garoua General Hospital Garoua Cameroon

Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathology. Among tools that are used to investigate such pathologies, we have ultrasound, hysterosalpingography and endoscopy. But, in many developing countries like Cameroon, the usage of endoscopy in gynecology is not yet known by many practicians. The objective of our study was to show the interest of endoscopy in the diagnosis of fallopian tube pathologies. Methodology: We conducted a cross-sectional and descriptive study from March 1st, 2017 to May 31st, 2017 at the Gyneco-Obstetrics and Pediatric department of our Hospital. We included all women who presented infertility and underwent ultrasound, hysterosalpingography (HSG) and endoscopy at the Yaoundé Gyneco-obstetrics Hospital. We analyzed epidemiological parameters, clinics, ultrasound, hysterosalpingography and endoscopic finding. We used Cohen’s Kappa test to determine the correlation between HSG/endoscopy and ultrasound/endoscopy in the diagnosis of fallopian tube pathologies. The threshold was significant for a K-value > 0.20. Results: We got a sample of 156 women;the mean age was 32.6 ± 4.5 years. The Secondary infertility dominated in 66.7% of cases;31.1% of women presented a past medical history of sexually transmitted infections and 41.7% did abortions before. Endoscopic lesions were dominated by a fallopian obstruction in 54.5% of cases, 8.3% of adhesions, 33.9% of women presented uterine myomas, 37.8% of ovarian cysts and 1.3% of pelvic endometriosis. The K-values between HSG and endoscopy for distal and proximal tube obstructions were significant with respective thresholds of 0.25 and 0.30. The K-value between ultrasound and endoscopy was not significant with a threshold of 0.015 for the tubal hydrosalpinx. Conclusion: Endoscopy assessment appears as the most efficien

关键词： Fallopian Tube Endoscopy Hysterosalpingography Ultrasound

Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 487-501页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi Marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena claude cyrille noa ndoua Robinson Enow Mbu Faculty of Medicine and Biomedical Sciences The University of Yaoundé 1 Yaoundé Cameroon Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartil

关键词： Determinants Early Survival Breast Cancer Yaoundé

Correlation between Hysterosonography and Hysteroscopy in the Diagnosis of Submucosal Fibroids in Women Attending the Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital (CHRACERH)

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1775-1785页

作者： Pascale Mpono Emenguele Henri Léonard Mol Vanina Ngono Akam Serge Robert Nyada Yves Bertrand Kasia claude Hector Mbia Roosevelt Dongmo Etienne Belinga claude cyrille noa ndoua Jean Marie Kasia Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Department of Obstetrics and Gynecology CHRACERH Yaound Cameroon

Background: Submucosal myomas can be responsible for abnormal bleeding, spontaneous abortions or even infertility. Objectives: This study aimed to study the correlation between the diagnosis and classification of submucosal fibroids at hysterosonography and at hysteroscopy at Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital (CHRACERH), Yaoundé, Cameroon. Methodology: We conducted a hospital-based cross-sectional study with retrospective data collection. Included were the files of patients in whom a hysteroscopy for uterine cavity evaluation was done from the 1st of January 2020 to the 31st of July 2022. The data collected were analysed using SPSS version 25 and Microsoft Excel 2013. Hysterosonographic findings were compared to those of hysteroscopy using Cohen’s kappa inter-observer agreement test. Results: A total of 104 women had available hysterosonography results prior to diagnostic hysteroscopy. The ages of the participants ranged from 26 to 65 years with a mean age of 39.92 ± 7.02 years. A total of 69 submucosal fibroids were identified at hysterosonography and 47 (68.1%) were found at hysteroscopy. There was agreement between the two methods in 13/17 (76.5%) cases of FIGO 0 fibroids, 21/30 (70.0%) of FIGO 1 fibroids and 13/22 (59.1%) of FIGO 2 fibroids. The overall agreement was moderate with a kappa coefficient of 0.478 (p Conclusion: The results present hysteroscopy as the gold standard for the diagnosis of submucosal myomas, but clinicians need to recognize utility of hysterosonography in certain situations.

关键词： Submucosal Fibroids Hysterosonography Hysteroscopy Correlation

The Hidden Side of the Story between the Placenta and Preeclampsia: Preliminary Results of a Prospective Cohort of Pregnant Women in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 610-620页

作者： Junie Annick Metogo Ntsama Ambroise Merci Engounou Seme Urielle Julie Tchuente Sutchueng Wilfried Loic Tatsipie Christian Vagoda Henry-Leonard Chatelin Mol Madye Ngo Dingom Felix Essiben cyrille claude noa ndoua Yann chris Eng Odile Fernande Zeh Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was s

关键词： Pre-Eclampsia Doppler Ultrasound Placenta

Laparoscopic management of an ectopic pregnancy after in vitro fertilization and embryo transfer at CHRACERH:A case report

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Laparoscopic, Endoscopic and Robotic Surgery 2018年第3期1卷 70-73页

作者： Belinga Etienne noa ndoua claude cyrille Ayissi Gregory Kasia Onana Yves Bertrand Kasia Jean-Marie Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical ScienceUniversity of Yaounde IYaoundeCameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction YaoundeCameroon

*** Initially,in vitro fertilization and embryo transfer(IVF-ET)was designed to solve tubal factors infertility(TFI)by placing the embryo(s)within the uterine ***,in some cases,an ectopic implantation occurs as the embryo can enter the *** pregnancy(EP)is the location of the pregnancy outside the intrauterine *** prevalence of EP following assisted reproductive technology(ART)ranges between 2.1%and 8.6%of all pregnancies and it can reach up to 11%inwomen with tubal factors infertility history.

关键词： Ectopic pregnancy Laparoscopic management In vitro fertilization Embryo transfer

Septate uterus with cervical duplication and longitudinal vaginal septum:A two case series

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Laparoscopic, Endoscopic and Robotic Surgery 2019年第1期2卷 21-24页

作者： noa ndoua claude cyrille Ayissi Gregory Mendibi Sandrine Belinga Etienne Metogo Junie Kasia Onana Yves Bertrand Kasia Jean-Marie Departement of Gynecology and Obstetrics Faculty of Medicine and Biomedical ScienceUniversity of Yaounde IYaoundeCameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction YaoundeCameroon

Müllerian duct anomalies consist of a set of structural malformations resulting from abnormal development of the paramesonephric or Müllerian *** in lateral fusion may result in uterus didelphys,bicornuate uterus or arcuate uterus while,reabsorption failure results in a uterus with a partial or complete *** reported a series of two cases of a woman with a septate uterus,cervical duplication and longitudinal vaginal septum undergoing an in vitro fertilization *** uterus with double cervix and longitudinal vaginal septum is a rare *** reported its endoscopic management in two infertile *** metroplasty which is a safe and simple approach for the removal of the uterine septum can improve reproductive outcomes but in vitro fertilization can be an alternative approach for these patients.

关键词： Septate uterus Cervical duplication Metroplasty Hysteroscopy

Epidemiological Profile of Abnormal Uterine Bleeding at the Gyneco-Obstetric and Pediatric Hospital of Yaounde

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Open Journal of Obstetrics and Gynecology 2020年第2期10卷 237-242页

作者： Kasia Jean Marie noa ndoua claude cyrille Belinga Etienne Foumane Pascal Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Yaounde Cameroon Gyneco-Obstetric and Pediatric Hospital of Yaounde Yaounde Cameroon.

Introduction:?Abnormal uterine bleeding (AUB) is one of the most commonly encountered symptoms in gynecological consultations. The prognosis is rarely endangered but the impact on the quality of life is sometimes important. Objective:?Our objective was to assess the epidemiological profiles of patients consulting for AUB at the Yaounde Gyneco-Obstetrics and Pediatrics Hospital.?Methodology:?We carried out a descriptive cross-sectional study at the Yaounde Gyneco-Obstetrics and Pediatrics Hospital. We included all women with acute or chronic per vaginal bleeding and we excluded all cases of bleeding in pregnancy, bleeding due to infection, pre pubertal bleeding and the incomplete files. Data were?collected from January to May 2019, using a questionnaire, and analyzed using Epi Info version 3.5.4 and SPSS version 7. softwares. Results:?A total of 163 patient files were exploited and analyzed. The frequency of AUB in outpatient gynaecology clinics was 3.7%. AUB patients had a mean age of 36 ± 12.27 years and the most represented age group was 30 to 35 years, with 17.1% cases. Sixty-seven representing 41.1% patients were married, 23.9% were civil servants, 23.1% were tertiary employees, and 40.3% had secondary level of education. Almost 44.1% were nulliparous and 53.9% had unknown HIV status an 83.4% have never used contraception. Conclusion:?The frequency of AUB during gynecological consultations is 3.7%. Those women have an average age of 36 years, most of them are nulliparous and have never use contraception.

关键词： Morbidity Menstrual Cycle Abnormal Uterine Bleeding

Cesarean Sections according to the Robson’s Classification in Two University Hospitals of Yaoundé: Indications and Maternofetal Outcome

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Open Journal of Obstetrics and Gynecology 2023年第11期13卷 1791-1806页

作者： noa ndoua claude cyrille Ndongo Ivan Alfred Essiben Felix Toukam Louise Kemfang Ngowa Jean Dupont Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of YaoundéI Yaoundé Cameroon

Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health facility. For this reason, in 2015, the World Health Organization (WHO) recommended the use of Robson’s classification to evaluate the practice of cesarean sections in order to identify the groups of women who had abnormally high rates. The objective of our study was to evaluate cesarean sections using the Robson’s classification in CHRACERH and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a retrospective cross sectional and descriptive study in two (02) university hospitals in Yaoundé which took place from December 2017 to May 2018. We included in our study all women who gave birth over a period of two (02) years from January 2016 to December 2017 in these two health facilities. Our sampling was exhaustive over the study period. The parturients’ information was collected using an anonymous and pretested questionnaire. The Robson’s group of every parturient was determined. Descriptive parameters like mean and proportions were calculated. We compared the rates and indications of cesarean sections between the both hospitals using Chi2 test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections;hence, a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean section, hence a rate of 24.8%. The women who belonged to groups 1, 3 and 5 contributed to the highest rates of cesarean sections in both hospitals: in CHRACERH, group 5 (31.1%), group 3 (20%) and group 1 (15.6%), at YCH: group 3 (22.5%), group 1 (21.6%) and group 5 (17.3%). The indications of the cesarean sections varied depending on the Robson’s group and the hospital, the principal indication in group 1 was acute fetal distress (28.6%) in CHRACERH and cephalopelvic disproportion (36.7%) at YCH. Cephalopelvic dispropo

关键词： Robson’s Classification Indication for Cesarean Section Materno-Fetal Outcome

Laparoscopic versus Abdominal Myomectomy: Surgical and Post-Operative Outcomes in CHRACERH-Yaounde

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Open Journal of Obstetrics and Gynecology 2019年第12期9卷 1595-1603页

作者： noa ndoua claude cyrille Belinga Etienne Wirwah Tardzenyuy Festus Mangala Nkwele Fulbert Kasia Jean Marie Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaounde Cameroon Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Yaounde Cameroon General Hospital of Douala Douala Cameroon.

Introduction: Fibroid benign tumour of the uterus can be operated either by laparotomy or laparoscopy. Laparoscopy is not well vulgarised in our settings. Objective: The main objective was to compare the surgical and post-operative outcomes of laparoscopic versus abdominal myomectomy. Methods: We performed a comparative analytical cross sectional study from 1st January 2016 to 31st March 2018 consisted of two groups: group 1 of women who underwent laparoscopic myomectomy (LM) and group 2 of women who underwent abdominal myomectomy (AM). The data collected was entered in Epi Info 7.2 version and exported to IBM SPSS Statistics version 22 for analysis. We used alpha error margin of 5% and confidence interval of 95%. Results: We enrolled 50 cases of myomectomy consisted of 33 (66.0%) files for AM and 17 (34.0%) files for LM. The clinical presentation of fibroid was similar in both groups. The main operation time (H) was (1.27 ± 0.13) for laparoscopy which is much less than (2.05 ± 0.07) for laparotomy group (p = 0.006). In AM group we had 04 post-operatory complications against zero complications in LM group but the difference was not statistically significant (p = 0.387). In the second look laparoscopy, the types of adhesions were not statistically significant (p = 0.471). Conclusion: Laparoscopic offers advantages compared to abdominal myomectomy.

关键词： Laparoscopic Abdominal Myomectomy Surgical and Post-Operative Outcomes