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Causes of Infertility of Couples Residing in Libreville

Advances in Reproductive Sciences 2024年第1期12卷 75-82页

作者： Opheelia Makoyo Komba Ulysse Minkobame Pamphile Assoumou Reteno Retno Elsy Ntsame Anouchka Mewi jacques albert bang ntamack Jean François Meye Département de gynécologie obstétrique Université des sciences de la santé d’Owendo Libreville Gabon

Introduction: According to the World Health Organization, globally one in six people experience infertility in their lifetime. Infertility is considered as a major and global public health issue. In most cases, women bear the burden of infertility to protect the male ego. Although men and women are equally likely to have fertility problems. The aim of this study was to identify the causes of infertility of couples residing in Libreville. Patients and Methods: This was a retrospective descriptive study performed over 2 years, from 1st January 2021 to 31st December 2022. Data was obtained from 162 couples attending the assisted reproduction department of the mother and child hospitals in Libreville. Statistical analysis was done using IBM SPSS Statistics version 22.0 software. Results: During the study period, 28.5% of couples could afford IVF treatment. The average for woman age was 39.1 ± 4.06 while the average age for male patients was 41.53 ± 7.08 years with minimum and maximum age of 34 et 66 years. More than half (58.6%) of female partners were employed in the public sector. Half of the male partners (50%) were employed in the private sector. The median duration of infertility was 6 years. Approximately 49.4% of couples were diagnosed with primary infertility. The most common causes of infertility in female patients were Fallopian tubes obstruction (53.2%), uterine factors (24.2%) and hormonal problems (19.6%). With regards to male factors infertility, testicular causes were predominant (53.6%). Oligoasthenoteratozoospermia were the major semen abnormalities (55.7%) found after semen evaluation. Both male and female partners were sub-fertile in 47.5% of cases. Unexplained infertility was found in 11% of couples. Conclusion: This study showed that the diagnostic of infertility faced by couples residing in Libreville should involve both male and female partner.

关键词： Epidemiology Gabon Infertility

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Epidemiological Aspects of Stillbirth and Neonatal Deaths in the Delivery Room at the Libreville Mother-Child University Hospital from 2019 to 2022

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Open Journal of Pediatrics 2024年第1期14卷 1-10页

作者： Eliane Kuissi Kamgaing jacques albert bang ntamack Opheelia Makoyo Komba Raïssa Koumba Maniaga Steeve Minto’o Rogombe Pascal Loulouga Badinga Aude Lembet Mikolo Simon Ategbo Department of Neonatal Medicine Jeanne Ebori Foundation Mother-Child University Hospital (JEFMCUH) of Libreville Libreville Gabon Department of Gynaecology and Obstetrics Jeanne Ebori Foundation (JEFMCUH) of Libreville Libreville Gabon Department of Paediatrics University of Health Sciences Libreville Gabon

Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.

关键词： Stillbirth Neonatal Death Delivery Room Epidemiology Libreville-Gabon

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End-of-Pregnancy Monitoring at CHUMEFJE through the Functional Investigation Centre (FIC) in 2022

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 186-192页

作者： Ulysse Pascal Minkobame Zaga Minko Opheelia Makoyo Komba Pamphile Assoumou Obiang Anouchka Mewie Lendzinga Elsy Ntsame Mezui Irenee Edzo Mvono jacques albert bang ntamack Jean François Meye Department of Obstetrics and Gynaecology University of Health Sciences Libreville Gabon

Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery.

关键词： Follow-Up End of Pregnancy Scheduled Caesarean Section Prognosis

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Influence of Prenatal Surveillance on Maternal and Perinatal Prognosis: A Prospective Study over 6 Months at the Maternity Ward of the Owendo University Hospital (Gabon)

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 301-311页

作者： Boniface Sima Ole Sidy Gérard Mba Edou Ulysse Minkobam Désire Assoume Ophélie Makoyo Komba Nathalie Ambounda Pamphile Assoumou jacques albert bang ntamack Sosthène Mayi Tsonga Jean François Meye Department of Obstetrics and Gynaecology Owendo University Hospital Owendo Gabon Department of Obstetrics and Gynecology Faculty of Medicine of Libreville Libreville Gabon

Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.

关键词： ANC Insufficiency Maternal Pathologies Perinatal Death Gabon

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Factors Determining the Postponement of Schedule Gyneaco-Obstetric Surgery at CHUMEFJE in Libreville (Gabon)

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1699-1710页

作者： Pamphile Assoumou Obiang jacques albert bang ntamack Ophélia Makoyo Ulysse Minkobame Jean Pierre Malanda Anouchka Mewie Juvette Elsy Ntsame Robert Eya’ama Ernest Junior Minto’o Jean François Meye Department of Obstetrics and Gynaecology Faculty of Medicine Libreville University of Health Sciences (USS) Libreville Gabon

The study aimed to identify factors causing delays in scheduled gynaeco-obstetric surgeries at CHUMEFJE in Libreville from January 2019 to July 2020. Through a 16-month observational survey, it was found that out of 346 scheduled procedures, 128 (36.4%) were postponed. Organizational issues in the operating theatre were responsible for 80.3% of these delays, with 95.3% being preventable. To enhance efficiency, improvements in operating theatre organization are recommended.

关键词： Scheduled Gynaeco Obstetric Surgery Postponement Determining Factors

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SHER Grade IIIb Placenta Abruptio Complicating Severe Superimposed Pre-Eclampsia at 19 WA: A Case Report

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1516-1522页

作者： Ulysse Minkobame Zaga Minko Opheelia Makoyo Komba Pamphile Assoumou Obiang Irenée Edzo Mvono Elsy Ntsame Mezui Junior Minto’o jacques albert bang ntamack Jean François Meye Department of Gynecology Obstetrics Health Science’s University Libreville Gabon

The placenta abruptio is an extremely serious pathology which involves the maternal-fetal prognosis. We report the case of a 19-year-old patient who consulted for abdominopelvic pain associated with heavy vaginal bleeding on 19SA in a context of arterial hypertension. The symptomatology suddenly worsened with the onset of hemorrhagic shock, which prompted an emergency hysterotomy. The diagnosis of placenta abruptio grade III b of SHER was evoked. Uterine atony was objectified intraoperatively and uterine compression by the B-Lynch technique was performed. The evolution of the patient was favorable after a stay of 5 days in intensive care.

关键词： Added Preeclampsia Placenta Abruptio 19 Weeks Uterine Plication

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LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

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Open Journal of Obstetrics and Gynecology 2014年第1期4卷 23-27页

作者： Sosthène Mayi-Tsonga jacques bang ntamack Boniface Sima-Ole Pamphile Assoumou Obiang Ulysse Minkobame Doris Ngouafo Department of Obstetrics and Gynecology of University Hospital of Libreville Gabon Africa Faculty of Health Sciences of Libreville Gabon Africa

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

关键词： Unsafe Abortion Contraception LARC Period for the Insertion of LARCs Gabon

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Conservative Treatment of Breast Cancer and Oncoplasty at the Teaching Hospital Mother and Child of Jeanne Ebori Foundation in Libreville (Gabon)

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1747-1758页

作者： Assoumou Obiang Pamphile Minkobame Ulysse Makoyo Opheelia Eya’Ama Robert Dikongo Wilson Mewie Anouchka Ntsame Elsy Juvette Minto’o Junior bang jacques albert Meye Jean François Department of Obstetrics Gynecology Faculty of Medicine of Libreville University of Health Sciences (USS) Libreville Gabon

Introduction: Breast cancer is currently the most common malignant tumour in women worldwide. Objective: To evaluate conservative treatment of breast cancer and oncoplasty at the teaching hospital Mother and Child of Jeanne Ebori Foundation (CHUMEFJE). Patients and methods: This is an observational, descriptive study, which took place from August 2019 to December 2021 at CHUMEFJE. Data were collected using patients’ medical records, and operative and pathological anatomy reports. Results: Conservative treatment and oncoplasty were performed in 12 (34.2%) patients. Of these patients, 8 (66.7%) benefited from an external technique and 2 (16.7%) from a pamectomy. Post-operative complications were dominated by lymphocele in 5 (41.6%) patients. Ten (83.3%) patients were satisfied with the post-operative aesthetic result. At the time of updating the records, 1 (8.3%) patient had died and 11 (91.7%) were alive. Conclusion: Conservative treatment and oncoplasty are giving satisfactory results at the CHUMEFJE in Libreville.

关键词： Breast Cancer Conservative Treatment Oncoplasty Aesthetics Satisfaction

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