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Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 967-978页

作者： Jeffrey-Lewis Nzang Cliford Ebontane Ebong Simon Manga florence Manjuh félix essiben Isidore Tompeen Judith Seungue Serge Robert Nyada Jeanne Hortence fouedjio Ymele fouelifack Julius Sama Dohbit Kloukanmey Zonal Hospital Mdecins Sans Frontires Kloukanmey Benin faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Gynecology and Obstetrics Unit Central Hospital of Yaound Yaound Cameroon Womens Health Program Cameroon Baptist Convention Health Services Yaound Cameroon Department of Obstetrics and Gynaecology Gyneco-Obstetric and Pediatric Hospital of Yaound Yaound Cameroon Expanded Program of Immunization Ministry of Health Yaound Cameroon Department of Obstetrics and Gynaecology Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaounde Cameroon Department of Obstetrics and Gynaecology University of Dschang Dschang Cameroon Higher Institute of Medical Technology Nkolondom Yaound Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between february 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a

关键词： High-Risk Human Papillomavirus Precancerous Digital Cervicography VIA/VILI Serotype

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Maternal and foetal Outcomes Associated with Caesarean Deliveries in Patients with Severe Preeclampsia in Two Teaching Hospitals, Yaoundé

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1271-1281页

作者： essiben félix Ngo Um Meka Esther Mve Koh Valère Gwos Laurentine Ojong Samuel foumane Pascal faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Yaoundé Central Hospital Yaounde Cameroon Yaounde Gynaeco-Obstetric and Paediatric Hospital Yaounde Cameroon Yaounde Teaching Hospital Centre Yaounde Cameroon

Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p f adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p f high blood pressure (RR = 4.51, p first-line analgesics (RR = 3, p f postoperative complications.

关键词： Preeclampsia Postoperative Complications Caesarean Section Yaoundé

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Predictive factors for Pre-Eclampsia: A Case-Control Study in Two Hospitals in Yaounde

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 565-574页

作者： Junie Annick Metogo Ntsama Ines Winnie Gouanfo Claude Hector Mbia Wilfried Loic Tatsipie Pascal Mpono Madye Ngo Dingom felix essiben Claude Cyrille Noa Ndoua 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 major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from february 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm f pre-eclampsia and maternal history of pre-eclampsia. Recognition of these predictor factors would improve the ability to diagnose and monitor women likely to develop pre-eclampsia before the onset of disease for timely interventions.

关键词： Pre-Eclampsia Predictive factors Yaoundé

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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

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Histopathological Aspects of Placental Lesions in Mild and Severe Pre-Eclampsia in a Population of Cameroonian Women

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 154-168页

作者： félix essiben Ayissi Gregory Belinga Etienne Ndolo Kondo Astrid Ngo Dingom Madye Ange Ebong Cliford Ebontane Ojong Samuel Atomveng foumane Pascal Yaoundé Central Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Central Maternity Yaoundé Central Hospital Yaoundé Cameroon Yaounde Gyneco-Obstetric and Pediatric Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon

Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated with PE in a population of Cameroonian women. Methods: We conducted a cross-sectional, analytical study in three university teaching hospitals in Yaounde namely, the Yaounde Central Hospital, the pathology laboratory of the Yaounde University Hospital Centre, and the Yaounde Gynaeco-Obstetric and Paediatric Hospital. The study spanned 8 months from January 1st to September 1st, 2021. Placental analysis was carried out as per standard protocol. The study included 101 parturients with pre-eclampsia. These were divided into two groups, with groups 1 and 2 being made of patients with mild pre-eclampsia (n = 40), and severe pre-eclampsia (n = 61), respectively. Results: The mean ages of the two groups were 29.93 ± 7.36 versus 28.28 ± 7.18 (p = 0.267) for patients with mild and severe pre-eclampsia respectively. Low socioeconomic status was the most frequently identified risk factor in both groups (59%). Patients’ history revealed that the women with severe pre-eclampsia tended to have poor pregnancy follow-up compared to those with mild pre-eclampsia (p f patients with severe pre-eclampsia weighed significantly less than those of patients with mild pre-eclampsia (454.4 ± 122 vs. 511.7 ± 125;p ficantly greater in patients with severe disease (p Conclusion: PE-related placental lesions in our context are multiple and diverse especially in severe disease, and these arise as a result of defective maternal vascular perfusion.

关键词： Preeclampsia Placental Lesions Histological Aspects Placental Dysfunction Cameroon

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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

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Materno-foetal Morbidity in the Second Stage of Labour: A Cohort Study in Primiparous Women in Yaounde

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Open Journal of Obstetrics and Gynecology 2021年第12期11卷 1725-1734页

作者： félix essiben Khadidja Bayero Hapsatou Ahmadou Djoulatou Maye Ange Ngo Dingom Julius Sama Dohbit Cliford Ebontane Ebong Pascal foumane faculty of Medicine and Biomedical Sciences the University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences Yaoundé Central Hospital Yaoundé Cameroon Central Maternity Yaoundé Central Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Yaounde Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon

Introduction: Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. Methods: It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software. Results: Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%;28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%;18/120) and perinatal asphyxia (7.5%;9/120). Maternal complications were significantly increased in women with an SSL lasting 1 - 2 hours (44.9% versus 22.7%;p 0.001) and >2 hours (42.9% versus 22.7%;p = 0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1 -

关键词： Second Stage of Labour Duration Primiparas Morbidity Yaounde

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female fertility following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 166-178页

作者： félix essiben Ngowa Jean Dupont Kemfang Aline Nganso Meka Juliette Esther Ngo Um Etienne Atenguena Samuel Ojong Paul Ndom Emile Telesphore Mboudou Yaoundé Central Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaounde Gyneco-Obstetric and Pediatric Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaounde General Hospital Yaoundé Cameroon Yaoundé General Hospital Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Douala Gyneco-Obstetric and Pediatric Hospital Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the fAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment. More than half of these women (51.3%) complained of a drop in libido and 6.4% achieved pregnancy within 13 months following cessation of chemotherapy. Conclusion: following chemotherapy for BC, menstrual cycle disorders are more frequent and this can affect the patients’ reproductive potential. fertility consultations should be integrated into the management plan of such patients.

关键词： Chemotherapy fertility Women of Childbearing Age Breast Cancer Yaounde

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Maternal and Perinatal Outcomes of Pregnant Women with Heart Disease in Three YaoundéReferral Hospitals

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Open Journal of Obstetrics and Gynecology 2022年第1期12卷 93-103页

作者： Jean Dupont Kemfang Ngowa Calixte Galilée fotsing Kengne Christiane Nsahlai Boombhi Jérôme felix essiben Wilfried Loic Tatsipie Jovanny Tsuala fouogue Pascal foumane Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaoundé Cameroon Department of Internal Medicine/Cardiology Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaoundé Cameroon Department of Obstetrics Gynaecology and Maternal Health Faculty of Medicine and Pharmaceutical Sciences of the University of Dschang Dschang Cameroon

Heart disease in pregnancy is the cause of significant maternal and perinatal morbidity. We wanted to evaluate the maternal and perinatal outcomes of pregnant women with heart disease in Yaoundé, Cameroon. This was a cross sectional study with retrospective data collection of 45 pregnancies in 42 women with heart disease followed at three Yaoundé referral hospitals in Yaoundé, Cameroon from January 1st 2015 to December 31st 2020. We collected data on maternal obstetrical and perinatal outcomes. The frequency of pregnancies with heart diseases was 0.1%. The mean maternal age was 29.05 ± 6.5 years. At first antenatal visit, all patients were in class I (84.4%) and II (15.6%) of the New-York Heart Association (NYHA) functional class. Valvular heart disease (51.1%) was the most common type followed by cardiomyopathy (37.7%). Over half of the deliveries were vaginal (51.1%). A cesarean section was generally indicated for the usual obstetrical reasons (54.5%) and for heart disease (31.8%). Complications included 17 (37.7%) cases of heart failure, 6 (13.3%) cases of pulmonary edema, 2 (04.4%) cases of pulmonary embolism, 3 (06.6%) maternal deaths and 3 (06.3%) perinatal deaths, 14 (29.7%) premature births and 3 cases of (6.3%) intrauterine growth retardation. The maternal deaths were cases complicated by pulmonary edema and all had dilated cardiomyopathy. The maternal and perinatal outcomes of pregnant women with heart disease are marked in our environment by increasedfont-family:Verdan

关键词： Heart Disease Pregnancy Perinatal Delivery Cesarean Section

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The Value of Clinical Breast Examination, Imaging, and fine Needle Aspiration and the Challenge of Diagnosing Breast Cancer in a Low Resource Setting: A Hospital-Based Analytical Study in Yaounde

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Advances in Breast Cancer Research 2022年第3期11卷 173-182页

作者： C. E. Ebong N. J. D. Kemfang E. Atenguena f. essiben J. H. fouedjio A. Ngassam S. Nyada N. f. Mangala A. N. Ngalame J. T. fouogue S. Dohbit faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon General Hospital of Yaoundé Yaoundé Cameroon Gynecological Endoscopic Surgery and Human Reproduction Teaching Hospital of Yaoundé Yaoundé Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Gyneco-Obstetric and Pediatric Hospital of Douala Douala Cameroon faculty of Medicine and Pharmaceutical Sciences of the University of Dschang Dschang Cameroon faculty of Health Sciences University of Buea Buea Cameroon

Background: Breast cancer is the most common cancer in the world, as well as in Cameroon, where it represents about 20.1% of all cancers recorded in 2020. The number of pathologists in the country is as few as seven for a population of about 26 million. The diagnostic performances of diagnostic modalities other than histology—clinical breast examination (CBE), imaging and fine needle aspiration and cytology (fNA)—in our context are not known. Study Objectives: Our objectives were to estimate the proportions of cases managed with mammography, breast ultrasound and fNA and to estimate the sensitivity, specificity, positive and negative predictive values, and accuracy of CBE, mammography, breast ultrasound and fNA;using histology as reference. Study Methodology: The study was cross-sectional and analytical, and was carried out at the Yaoundé General Hospital. It lasted twelve months, April 2015 through March 2016 and covered the period January 2010 to february 2016. Using histology as reference, we calculated measures of diagnostic accuracy for all four modalities using the statistical methods of Galen and Gambino. Results: We recruited 107 cases, 105 females (98.1%) and 02 males. We had 112 breast lumps, 106 malignant (94.6%) and 6 benign. The mean lump size was 61.1 mm. The most frequently used diagnostic tool after CBE was fNA (49.1%), while the diagnostic accuracies were 76.8%, 79.1%, 82.9%, and 82.0% for CBE, breast US, mammography and fNA. Conclusion: The four baseline diagnostic modalities for breast cancer are used sub-optimally and fNA appears to be the most commonly used in our setting after CBE. We recommend that fNA should be considered for diagnosis as appropriate but a negative result should not stop the quest for histological elimination of presence of malignancy.

关键词： Breast Cancer Lump Clinical Breast Examination Breast Ultrasound Mam-mography fine Needle Aspiration Accuracy Cameroon

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