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Obstetrical and Perinatal Outcomes of Adolescent Pregnancies in Cameroon: A Retrospective Cohort Study at the YaoundéGeneral Hospital

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Open Journal of Obstetrics and Gynecology 2015年第2期5卷 88-93页

作者： Jean Dupont Kemfang Ngowa jean Marie Kasia Walter Dobgima Pisoh Anny Ngassam Cyrille Noa Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Adolescent pregnancy is a serious health and social problem worldwide as well as in Cameroon. The aim of this study was to determine the obstetrical and perinatal outcomes of nulliparous adolescent pregnancies in a reference hospital in Cameroon. Methods: A retrospective cohort study to compare the outcomes of nulliparous adolescent pregnancies to those of nulliparous women aged 20 to 25 years was carried out at the Yaoundé General Hospital between January 1993 and December 2012. Results: Adolescent deliveries represented 2.84% (331 deliveries) of all deliveries registered during the study period. The adolescent mothers had a significantly higher incidence of preeclampsia/eclampsia, preterm delivery and low birth weight babies (<2500 g) when compared to the control group (OR, 3.46;CI 95%, 1.46 - 8.18;OR, 1.94 CI 95%, 1.34 - 2.79;OR, 1.98, CI 95%, 1.39 - 2.46, respectively). However, placenta previa, abruptio placenta, episiotomy, cesarean section, vaginal instrumental delivery, perineal tears and post partum hemorrhage were not significantly different in the two groups. Furthermore, there was no statistically significant difference between the two groups regarding fetal distress, low Apgar score (st and 5th minutes), the rate of admission in the neonatal intensive care unit, stillbirth and neonatal death. Conclusion: Adolescent pregnancy is associated with an increased risk of preeclampsia/ eclampsia, preterm birth and low birth weight.

关键词： Adolescent Pregnancy Perinatal and Obstetrical Outcome Preterm Birth Low Birth Weight

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Voluntary Induced Abortion in Cameroon: Prevalence, Reasons, and Complications

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Open Journal of Obstetrics and Gynecology 2015年第9期5卷 475-480页

作者： Jean Dupont Kemfang Ngowa Humphry Tatah Neng Joel Fokom Domgue Christiane Jivir Nsahlai jean Marie Kasia Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Ya-oundé Cameroon

In Cameroon, induced abortion is permitted when a woman’s life is at risk, to preserve her physical and mental health and on the grounds of rape or incest. Objectives: The aim of this study was to determine the prevalence, reasons and complications of voluntary induced abortion among women attending the obstetrics and gynecology services in an urban area, Yaoundé and in a rural area, Wum in Cameroon. Methods: We carried out a cross sectional study, with 509 women recruited between August 1, 2011 and December 31, 2011 in three health facilities in Cameroon. We appreciated the frequency, complications and reasons for Voluntary induced abortions. Results: The prevalence of voluntary induced abortion was 26.3% (134/509) globally;25.6% (65/254) in urban area and 27.1% (69/255) in rural area. One hundred and eleven (83%) cases of induced abortions were carried out in a health structure and 23 (17%) cases in private homes. Medical doctors and nurses were the most frequent abortion providers in both urban (84.7%) as well as rural setting (77.2%). The three main reasons for induced abortion were to pursue their studies (34.3%), not yet married (22.6%) and fear of parents (13.9%). Complications were reported by 20% (27/134) of respondents who had carried out voluntary induced abortion. Excessive bleeding was the most reported complication (70.4%). Conclusion: Despite its illegality in Cameroon, the prevalence of voluntary induced abortion was high in this study.

关键词： Induced Abortion Unsafe Abortion Voluntary Abortion Voluntary Induced Abortion

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Maternal and Perinatal Complications of Severe Preeclampsia in Three Referral Hospitals in Yaoundé, Cameroon

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 723-730页

作者： Jean Dupont Kemfang Ngowa jean Marie Kasia jean Alima Joel Fokom Domgue Anny Ngassam jean Baptiste Bogne Sebastien Mba Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Anesthesia and Intensive Care Unit Yaoundé General Hospital Yaoundé Cameroon

Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.

关键词： Pregnancy Hypertension Severe Preeclampsia Maternal and Perinatal Complications Cameroon

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Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the YaoundéGeneral Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2015年第9期5卷 481-486页

作者： Jean Dupont Kemfang Ngowa Anny Ngassam Jovanny Fouogue Tsuala Juny Metogo Zacharie Sando Angèle Kabeyene jean Marie Kasia Obstetrics and Gynecology Unit Yaoundé General Hospital Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.

关键词： Cervical Cancer Cervical Intraepithelial Neoplasia LEEP Screening Cervical Cancer Low Resource Country

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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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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 disproportion was the predominant indication in groups 3

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

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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 increased morbidity and mortality. Therefore, it is n

关键词： Heart Disease Pregnancy Perinatal Delivery Cesarean Section

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Contribution of Laparoscopy in the Management of Female Infertility in Low Resource Countries: A Review of 208 Cases at the YaoundéGeneral Hospital, Cameroon

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International Journal of Clinical Medicine 2015年第12期6卷 934-939页

作者： Jean Dupont Kemfang Ngowa jean Marie Kasia Victorine Nkongo Anny Ngassam Jovanny Fouogue Tsuala Philemon Nsem Alexis Medou Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaoundé Cameroon Anesthesia Unit Yaoundé General Hospital Yaoundé Cameroon

Background: Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Methods: A descriptive review of complete medical records of 208 women who underwent laparoscopy at the Gynaecology Unit of Yaoundé General Hospital from December 2007 to December 2012. Results: Two hundred and eight women were enrolled in this study. Mean age was 32.6 ± 11.25 years. Infertility was secondary in 71.6% of cases;125 (60.1%) women were married and 116 (55.8%) had a positive serology of Chlamydia trachomatis infection. The most frequent findings during diagnostic laparoscopy were: pelvic adhesions (83.7%), hydrosalpinx (21.6%), pyosalpinx (4.8%), perihepatic adhesions (25.5%), uterine fibromas (22.6%), pelvic endometriosis (13%) and ovarian abnormalities (10.1%). The surgical procedures during laparoscopy were: adhesiolysis (79.7%), tuboplasty (35.0%), salpingectomy (8.2%), ovarian cystectomy (5.8%) and myomectomy (1.9%). Three (1.4%) cases of uterine perforation and 1 (0.5%) case of laparoscopy conversion to laparotomy were observed. Conclusion: Diagnostic laparoscopy revealed that tubal lesions and pelvic adhesions were still the major causes of female infertility in developing countries. Adhesiolysis and tuboplasty were the most frequently performed surgical procedures during laparoscopy. Therefore, training in endoscopic surgery should be regarded as an important issue in developing countries.

关键词： Laparoscopy Infertility Pelvic Adhesions Adhesiolysis Tuboplasty Myomectomy

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Diagnostic and Therapeutic Options of Breast Cancer Patients in Yaounde, Cameroon

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Advances in Breast Cancer Research 2022年第1期11卷 50-62页

作者： Jean Dupont Kemfang Ngowa Hortense jeanne Fouedjio Annaïk Morelle Tchami Julienne Louise Ngo Likeng Christelle Domngang Noche Brigitte Wandji Djouonang Florent Fouelifack Ymele Pascal Foumane Emile Telesphore Mboudou Pierre Marie Tebeu Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon University of Montagnes Bangangté Cameroon Catholic University of Central Africa Yaounde Cameroon Higher Institute of Medical Technology Nkolondom Cameroon

Introduction: Breast cancer remains a public health problem due to its severity and because it is the leading cause of death from cancers in women worldwide as well as in Cameroon. Our objective was to study the diagnostic and therapeutic options that patients followed for breast cancer choose in Yaounde. Method: This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaounde from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0., p values

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Consultation, Diagnosis and Treatment Delays for Breast Cancer among Patients Followed up at the YaoundéGeneral Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1580-1589页

作者： Jean Dupont Kemfang Ngowa Angèle Kabeyene Richard Ngarvounsia Etienne Atenguena Yvan Sinclair Ngaha Tchawe Anny Ngassam Christiane Nsahlai Junie Metogo Jovanny Fouogue Tsuala Pierre Marie Tebeu Department of Obstetrics/Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Obstetrics/Gynecology Unit Yaoundé Cameroon Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Medical Oncology Unit Yaoundé Cameroon Department of Obstetrics/Gynecology Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. Materials and Methods: This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the initial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). Results:

关键词： Breast Cancer Delay in Consultation Delay in Diagnosis Delay in Treatment

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