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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

1.Introduction 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 cavity.However,in some cases,an ectopic implantation occurs as the embryo can enter the tube.Ectopic pregnancy(EP)is the location of the pregnancy outside the intrauterine cavity.The 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 ducts.Failures 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 septum.We reported a series of two cases of a woman with a septate uterus,cervical duplication and longitudinal vaginal septum undergoing an in vitro fertilization procedure.Septate uterus with double cervix and longitudinal vaginal septum is a rare anomaly.We reported its endoscopic management in two infertile women.Hysteroscopic 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

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

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

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

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

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

Association between the Different Phenotypes of Polycystic Ovary Syndrome and the Outcome in in Vitro Fertilization at Human Reproductive Center Paul et Chantal Biya-Yaoundé

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 18-28页

作者： Ngono Akam Vanina Ngah Minala Belinga Etienne Belinga Etienne Mpono Pascale Nyada Serges Onana Y. kasia Cho Joselyne kasia Florence Adjessa Abega kasia jean marie Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaoundé Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was to study the association between PCOS phenotypes and IVF/ICSI results in women admitted to Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital (CHRACERH). Material and Method: We carried out a cohort study with historical-prospective data collection over a period of seven years (January 2016 to March 2023) at Chracerh. PCOS patients were subdivided into 4 subgroups A, B, C and D. Results: We recruited 128 patients including 64 PCOS patients divided into four phenotypes and 64 non-PCOS patients constituting the control group. Phenotype D without hyperandrogenism had used the lowest dose of gonadotropins, i.e. 1939.7 ± 454.3 IU, and had produced a greater quantity of estradiol on the day ovulation was triggered (6529.8 ± 4324.8 ng/ml). The average number of punctured follicles and mature oocytes were higher in the phenotype D group. Ovarian hyperstimulation syndrome (OHSS) occurred mainly in phenotype D (3/35), with an estimated prevalence of 2.3%. The fertilization rate seemed lower in the hyperandrogenic phenotypes A, B, C compared to the group without hyperandrogenism without significant difference (p = 0.461). The biological pregnancy rate and live birth rate were comparable between the different groups. Conclusion: Phenotype D used less dose of gonadotropins. Biological pregnancy and live birth rates were comparable between the different phenotypes.

关键词： Phenotype Polycystic Ovarian Syndrome IVF/ICSI Prognosis CHRACERH

Epidemiological Profile and Location of Lesions According to #ENZIAN of Patients Operated on for Endometriosis in a Public Endoscopic Surgery Centre, Yaounde, Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1919-1927页

作者： Ngono Akam Marga Vanina Adjessa Abega Nyada Serge Mpono Pascale Nsahlai Christiane Mendoua Michelle Sharon Mbacham Ngwafor kasia Yves kasia Florence Soppo Blandine Belinga Etienne kasia jean marie Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaoundé Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Introduction: Endometriosis is a chronic disease affecting approximately 10% of women. Our aim was to describe the epidemiological profile, clinical presentation and location of lesions in patients operated on for endometriosis. Methodology: We conducted an analytical cross-sectional study with retrospective data collection over a period of 05 years from 1 January 2017 to 31 March 2022. Our study population consisted of women who had undergone laparoscopy for endometriosis. Data analysis was performed using SPSS software version 23.0. Results: In total we included 159 patients who had undergone laparoscopy for endometriosis. The mean age was 32.9 ± 5.9 years, most of whom were nuligravida 61.6% (n = 99). Infertility was the most frequent reason for consultation, accounting for 72.3% (n = 115), followed by dysmenorrhoea in 60.8% (n = 96) of cases and chronic pelvic pain in 37.7% (n = 60). In addition, 46 (28.9%) patients complained of deep dyspareunia, 17 (10.7%) of dyschezia and nine (5.7%) of dysuria. Magnetic Resonance Imaging (MRI) was used in one patient. Diagnostic laparoscopy was performed directly in 77 (48.4%) patients. The lesions were multifocal, according to the #ENZIAN classification nomenclature. Tubal lesions were most frequently found 107 (67.3%) on the left, followed by compartment B (uterosacral ligaments, cardinal ligaments and lateral pelvic wall) 49.7% (n = 79), and endometriomas 40.9% (n = 65). Conclusion: Women operated on for endometriosis were of a more advanced age, and predominantly nulliparous. Infertility was the most frequent reason for consultation and tubal location most frequently encountered for superficial lesions and compartiment B for deep lesions according to #ENZIA.

关键词： Epidemiology Clinical Manifestations Laparoscopy #ENZIA Endometriosis

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