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Experience of Analgesia during Labour in a Sub-Saharan Hospital Setting

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Open Journal of Anesthesiology 2022年第4期12卷 135-145页

作者： junie Annick Ntsama metogo Junette Arlette Mbengono metogo Felix Essiben Clinton Kamga Albet Ludovic Amengle Ferdinand Ndom Ntock Wilfried Loïc Tatsipie Pascal Foumane Jacqueline Ze Minkande Department of Obstetrics and Gynaecology Yaounde Hospital Centre for Research and Application in Endoscopic Surgery and Human Reproduction Faculty of Medicine and Biomedical Sciences University of Yaound&eacute I Yaound&eacute Cameroon Department of Anaesthesiology and Intensive Care Douala General Hospital Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynaecology Central Hospital of Yaound&eacute Faculty of Medicine and Biomedical Sciences University of Yaound&eacute I Yaound&eacute Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&eacute I Yaound&eacute Cameroon Department of Anaesthesiology nd Intensive Care Yaound&eacute Gyneaco-Obstetric and Paediatric Hospital Faculty of Medicine and Biomedical Sciences University of Yaound&eacute I Yaound&eacute Cameroon Department of Obstetrics and Gynaecology Gynaeco-Obstetric and Paediatric Hospital of Yaoundé Faculty of Medicine and Biomedical Sciences University of Yaound&eacute I Yaound&eacute Cameroon

The pain experienced during labour varies from one person to another. The objective of this study is to evaluate the experience of analgesia during labour in three maternity hospitals in Cameroon. Methodology: This was a cross-sectional analytical study conducted over 4 months, from 1 December 2019 to 31 March 2020, at the Yaoundé Gynaecological-Obstetric Hospital, the Yaoundé Central Hospital and the Douala General Hospital. We compared 35 parturients who delivered vaginally under analgesia and 79 parturients who delivered without analgesia. The data collected were compared using Chi 2 and Fischer tests with a significance level of P Results: Parturients aged 30 - 40 years (P = 0.03), public sector employees (P = 0.002) and private sector employees (P Conclusion: Analgesia delivery offers a better birth experience, however it may have negligible side effects.

关键词： Experience Analgesia Labour Pain

Histopathological and Ultrasound Correlation in Women Presenting with Breast Lumps in Yaoundé, Cameroon

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Open Journal of Radiology 2023年第4期13卷 218-231页

作者： Yann Chris Mannel Eng Ambroise Merci Seme Engoumou Armel Philippe Awana Sandrine Prisca Ndongo Onembele junie Annick metogo Ntsama Odile Fernande Zeh Faculty of Medicine and Biomedical Sciences The University of Yaounde I Yaounde Cameroon Yaoundé Gyneco-Obstetrical and Pediatric Hospital Yaounde Cameroon Radiology Unit Yaoundé University Teaching Hospital Yaounde Cameroon Radiology Unit Jamot Hospital Yaounde Cameroon Department of Biomedical Sciences University of Ngaoundere Ngaoundere Cameroon

Context: Breast cancer is very deadly among women with higher rates in the developing world. Imaging tools such as ultrasound, can be used to differentiate between the types of breast lumps. This study aimed to determine the value of ultrasound as a first-line examination in the diagnosis of breast masses. Methods: This was a retrospective cross-sectional study of women presenting with breast lumps from November 2022 to June 2023 at the Yaounde General Hospital, which lasted seven months, from November 2022 to June 2023. The sampling was exhaustive and consecutive. Association between variables was studied using the x2 test and concordance between ultrasound and histopathological findings was assessed using the Kappa correlation coefficient. Results: 234 women were included in the study. Their mean age was 46.3 ± 11.4 years. Overall, 15 (6.4%) lumps were benign while 219 (93.6%) were malignant. Triple negative (5.6%) was the most recurrent genomic classification. The correlation between the ultrasound and histopathological findings was significant, with an observed concordance rate at 85.1%, kappa = 0.322 and a p-value Conclusion: The performance of ultrasound in differentiating benign and malignant lesion was high. However, the discordant cases highlight the need for a diagnosis system which blends histopathological and radiological findings for an improved management of patients with breast lumps.

关键词： Ultrasound Histopathological Diagnosis Breast Lumps Yaoundé

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 < 3 months, personal history of 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

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

The Delivery of Grand Multiparas in a Semi-Rural Setting: A Cross-Sectional Descriptive Study at the Ayos Locality of Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 74-81页

作者： Serge Robert Nyada Cliford E. Ebong Véronique Mboua Christiane Nsahlai Pascale Mpono Emenguele Michelle Mendoua junie metogo Isidore Tompeen Cyrile Claude Noa Ndoua Centre Hospitalier de Recherche et d’Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya (CHRACERH) Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon University Teaching Hospital Yaoundé Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Gynaeco-Obstetric and Pediatric Hospital Yaoundé Yaoundé Cameroon

Introduction: Grand multiparity is a known risk factor for maternal and fetal complications. Materials and Methods: We carried out a cross-sectional descriptive study on the delivery of grand multiparas at the maternity of the regional hospital annex of Ayos, a semi-rural locality in the Center region of Cameroon. The study covered the period from January 2012 through December 2020, and the objective was to assess the frequency, the determinants and the outcome of delivery in grand multiparas. Results: We recorded 1384 deliveries and enrolled 137 cases of delivery of grand multiparas. This gives a frequency of grand multipara delivery of 9.89%. The mean age of the women was 34.96 ± 4.45 years. Married parturients accounted for 65% of the cases and 16.8% were HIV positive. Delivery occurred at term in 89.9%. In 35.8%, no antenatal consultation was done. The use of the partograph during labor was reported in 11.7%. Per vaginal delivery was noted in 88.3%, emergency cesarean in 10.2% and elective cesarean in 1.5%. The most frequent maternal complications included post-partum hemorrhage (19.9%), genital tract tears (12.4%), endometritis (9.5%) and surgical wound infection (8.7%). No maternal death was recorded. The mean birth weight of the newborns was 3336.8 ± 550 g. Fetal complications were mostly represented by neonatal infection (20.1%), perinatal death (7.9%) and neonatal asphyxia (9.5%). Conclusion: The frequency of grand multiparous delivery in the semi-rural locality of Ayos, Cameroon, was 9.89%. The mean age of parturients was 38.96 years and the proportion of vaginal delivery was 88.3%.

关键词： Grand Multipara Delivery Semi Rural Cameroon

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

Features and Patterns of Primipara Delivery in a Cameroon Semi-Rural Area: The Case of Ayos Locality

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 64-73页

作者： Serge Robert Nyada Cliford E. Ebong junie Annick metogo Ntsama Michelle Mendoua Christiane Nsahlai Véronique Mboua Pascale Mpono Emenguele Isidore Tompeen Etienne Belinga Cyrile Claude Noa Ndoua Centre Hospitalier de Recherche et d’Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya (CHRACERH) Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon The Central Hospital of Yaoundé Yaoundé Cameroon University Teaching Hospital of Yaoundé Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Gynaeco-Obstetric and Pediatric Hospital of Yaoundé Yaoundé Cameroon

Introduction: The delivery of a primipara, a woman giving birth for the first time, is challenging and may lead to complications and influence the obstetrical future of a woman. Materials and Methods: We carried out a cross-sectional and analytical study at the maternity of the regional hospital annex of Ayos, a semi-rural locality in Cameroon, for the period between January 2012 and December 2020. The objective was to determine the frequency and the determinants of primipara delivery. Results: We recruited 440 cases. The frequency of primipara delivery was 31.8%. The ages of the participants ranged from 12 to 35 years with a mean age of 18.01 ± 3.52 years. Single women contributed to 95.5% of cases while 97.5% were unemployed. The delivery occurred at term in 90.2% and 98.4% of pregnancies were singleton. The delivery was vaginal in 91.6%, while caesarean delivery was done in 8.4% (8% emergency and 0.4% elective). The most frequent maternal complications were genital tract tears (15.7%), post-partum hemorrhage (12.5%) and endometritis (2.7%). The birth weight of newborns ranged from 1070 to 4500 g with a mean of 3024.5 ± 511.4 g. The single marital status, a gestational age between 37 and 42 weeks and a birth weight between 1500 g and 2499 g were significantly associated with vaginal delivery. Conclusion: The frequency of primiparous delivery was relatively high (31.8%) in the Ayos semi-rural health district of Cameroon. Major complications associated with delivery included genital tract tears, post-partum hemorrhage, cesarean section and neo-natal infection.

关键词： Primipara Delivery Complication Semi-Rural Cameroon

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

Association between Placental Malaria and Severe Pre-Eclampsia in Two University Hospitals of Yaounde City

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1488-1511页

作者： Ayissi Gregory Astrid Ruth Ndolo Kondo Ndoumba Afouba Alice Noa Ndoua Claude Cyrille Essiben Félix Meka Esther Belinga Etienne metogo junie Engo Engo Samuel Désiré Bodo Edmond Lemaire Tchente Nguefack Charlotte Foumane Pascal Mboudou Emile Télésphore Department of Obstetrics and Gynecology Faculty of Medicine and Biomedicals Sciences University of Yaound I Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Department of Morphological and Anatomo-Pathological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon. Department of Morphological and Anatomo-Pathological Sciences Faculty of Medicine and Biomedicals Sciences University of Yaound I Yaounde Cameroon

Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: The objective of our study was to investigate the association between placental malaria lesions and severe pre-eclampsia. Methodology: We conducted a prospective analytical cross-sectional study in two University Hospitals in the city of Yaounde (Yaounde Central Hospital and the Gynaecological Obstetrics and Paediatrics Hospital), and in the laboratory of the Centre Pasteur in Yaounde over an eight-month period (1st January 2021 – 1st September 2021). All patients with pre-eclampsia diagnosed according to the criteria of the International Society for the Study of Hypertension (ISSHP) and free of chronic metabolic or infectious pathology were included in this study. The patients were divided into two groups: group 1 (mild pre-eclampsia) and group 2: severe pre-eclampsia. Socio-demographic, clinical and histopathological characteristics specific to pre-eclampsia and placental malaria were investigated. Statistical analysis was performed with SPSS 23.0 software, Chi 2 was used to compare categorical variables, Student t-test was used to compare means, and logistic regression was used to assess the association between placental malaria lesions and PES. Results: The mean age of our study population was 29.93 ± 7.36 years versus 28.28 ± 7.18 years in patients with mild and severe pre-eclampsia respectively. Pre-eclampsia placental lesions (accelerated villous maturation, infarction) were significantly greater in patients with severe pre-eclampsia (p Conclusion: Placental malaria lesions were significantly associated with severe pre-eclampsia and increased the risk of developing severe pre-eclampsia placental lesions by a factor of 10.

关键词： Mild Pre-Eclampsia Severe Pre-Eclampsia Malaria Placental Lesions Association