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Open Journal of Obstetrics and Gynecology 2022年第1期12卷 25-32页

作者： Mosman Anyimbi Ofeh Charles Regent Kenne Nodem Department of Obstetrics and Gynecology Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Internal Medicine Gynecology and Obstetrics Unit Monatele District Hospital Monatele Cameroon

Epilepsy is a leading neurological condition characterized by recurrent seizures and affecting more than 50 million people worldwide. Status epilepticus (SE) is a neurological emergency associated with a high mortality rate and long-term cognitive sequelae. In pregnancy, status epilepticus poses a tremendous threat to both mother and fetus. We report a case of status epilepticus in pregnancy complicated by coma, where obstetrical ultrasound revealed fetal demise in utero followed by rapid maternal deterioration and demise later. There was management challenge of a comatose pregnant mother in very poor and deteriorating hemodynamic state with fetal demise in a low economic and limited resource setting.

关键词： Status Epilepticus Pregnancy Coma Fetal Demise Epilepsy

Unmet Needs for Family Planning among Adolescent Girls Giving Birth in Three Teaching Hospitals in Yaoundé

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 849-862页

作者： Florent Ymele Fouelifack Christiane Catherine Ticki Mengue Mosman Anyimbi Ofeh Loic Dongmo Fouelifa Jeanne Hortence Fouedjio Department of Surgery and Specialties Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Obstetrics and Gynecology Unit of the Yaoundé Central Hospital Yaoundé Cameroon Research Education and Health Development Group “GARES-Falaise” Dschang Yaoundé Cameroon Faculty of Health Sciences University of Lomé Lomé Togo School of Armies Health Services of Lomé Lomé Togo Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences of University of Yaoundé I Yaoundé Cameroon

Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.

关键词： Adolescent Girls Unmet Need Family Planning

Circadian Rhythm of Childbirths and Maternal and Neonatal Prognosis at the YaoundéCentral Hospital

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Advances in Reproductive Sciences 2023年第1期11卷 11-22页

作者： Florent Ymele Fouelifack Jufo Donkeng William Takang Edmond Mesumbe Loic Dongmo Fouelifa Mosman Anyimbi Ofeh Jackson Ndenkeh Jeanne Hortence Fouedjio Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Obstetrics and Gynecology Unit of Yaoundé Central Hospital Yaoundé Cameroon Research Education and Health Associative Group Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Faculty of Medicine University of Bamenda Bamenda Cameroon Bamenda Regional Hospital Bamenda Cameroon Faculty of Health Sciences University of Lomé Lomé Togo School of Armies Health Services of Lomé Lomé Togo Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Background: The circadian variation of childbirths has been described by several authors around the globe. De Graaf showed that hospital childbirths at night were associated with increased perinatal mortality and adverse perinatal outcome. To improve obstetric care, we carried out this study to evaluate the circadian rhythm of childbirths and to assess the outcome following variations in the time of childbirths during the day. Methods: It was a cross-sectional descriptive study at the Yaoundé Central Hospital (YCH), over a two years period. We collected data from files of women who delivered from the 1st of January 2017 to 31st December 2018. We included files of women who delivered at least at 28 weeks of pregnancy. We excluded files of those who delivered by elective caesarean section, those whose hour of delivery was not noted and those who delivered before reaching the hospital. Sociodemographic, obstetrical characteristics, and immediate prognosis were recorded. Data were entered into excel, then analysed with SPSS v23 software. Tools used to appreciate our results were means, median, number, percentage, P, and OR with its 95% confidence interval. The difference in p is significant if p is less than 5%. Results: We analyzed 6041 files bearing the time of birth. Childbirths took place at all hours of the day, but the times of the day where the highest numbers of births were recorded were 10, 11, 12, 13 (that’s 1pm), 14 (that’s 2 pm), 15 (that’s 3 pm), 16 (that’s 4 pm), 17 (that’s 5 pm) and 23 (that’s 11 pm) hours, with respectively 224 (3.7%), 277 (4.6%), 256 (4.2%), 265 (4.4%), 207 (3.4%), 255 (4.2%), 228 (3.8%), 216 (3.6%) and 226 (3.7%) births. The peak of births was at 11 am while the time of day where the lowest number of births was recorded was 6 pm, with 175 (2.9%) births. The mean age of participants was 27.34 ± 6.03 years with extremes of 13 and 49, with 87.6% between 20 to 39 years. Sociodemographic characteristics of participants, prematurity and bleeding during delivery, had no dependence on the t

关键词： Circadian Rhythm Childbirth Maternal Neonatal Prognosis

Morbidity and Mortality Linked to Unsafe Abortions in Cameroon—Difficulties in Accessing Safe Abortions: Systematic Review and Meta-Analysis. A Study Proposal

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1102-1112页

作者： Florent Ymele Fouelifack Ako William Takang Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Guy Sadeu Wafeu Christophe Lontsi Saha Department of Surgery and Specialties Higher Institute of Medical Technology of Nkolondom-Yaoundé Yaoundé Cameroon Gynecology and Obstetrics Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Monatélé District Hospital Monatélé Cameroon Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Human Rights and Humanitarian Action National Coordinator of CIVITAS Cameroon Yaoundé Cameroon Systematic Reviews and Meta-Analysis Coordinator of Cochrane Cameroon Yaoundé Cameroon Public Health Option Epidemiology Faculty of Health Sciences Catholic University of Central Africa Yaoundé Cameroon

Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I2 and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.

关键词： Mortality Morbidity Difficulties Access Unsafe Abortion Cameroon

Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 342-359页

作者： Florent Ymele Fouelifack Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu Robinson Enow Mbu Department of Surgery and Specialties at the Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Gynecology and Obstetrics Unit of the Yaoundé Central Hospital Yaoundé Cameroon Maga District Hospital Maga Cameroon Public Health of Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon CIVITAS Cameroon Human Rights and Humanitarian Action Yaoundé Cameroon Public Health Option Epidemiology Yaoundé Cameroon Information Communication and Technology American University Yaoundé Cameroon Centre for the Development of Best Practices in Health (CDBPSH) National Coordinator of Building Medical Research in Africa (BMR Africa) Yaoundé Cameroon Family Health Ministry of Public Health Yaoundé Cameroon

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I2 and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider b

关键词： Morbi-Mortality Unsafe Difficulties Access Safe Abortion Cameroon

Longitudinal Epigastric Incision for Caesarean Section in a Morbidly Obese Patient in a Low-Resource Setting (Cameroon): A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第8期11卷 929-934页

作者： Florent Ymele Fouelifack Wilfried Loic Tatsipie Armand Kamga Talom anyimbi ofeh mosman Hortence Fouedjio Department of Surgery and Specialties Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Obstetrics and Gynecology Unit Yaounde Central Hospital Yaounde Cameroon Research Education and Health Associative Group GARES-Falaise Dschang Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Obesity is a metabolic condition associated with a significant morbidity and mortality rate. In the pregnant context, this risk is even higher because of the contingent of metabolic and haemodynamic complications present in the ante-, intra- and post-partum periods. In these people, the recommended delivery method is caesarean section, which is not easy to perform. Our aim is to explain the particularities and advantages of epigastric incision in obese women during a caesarean section. The authors report the case of a patient who was admitted to the maternity ward of the Yaounde Central Hospital for management of a post-date, and in whom an elective caesarean section was indicated with an epigastric approach. The vertical supra umbilical incision should be recommended because it is subject to fewer complications and reduces the operating time and hospital stay.

关键词： Obesity Caesarean Section Epigastric Incision

Knowledge, Attitude and Practice of Breast Self-Examination amongst Women in Two Communities of Cameroon

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 773-793页

作者： Florent Ymele Fouelifack Rene Pierre Binyom anyimbi mosman ofeh Jeanne Hortence Fouedjio Robinson Enow Mbu Department of Obstetrics and Gynecology of Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Obstetrics and Gynecology Unit of Yaounde Central Hospital Yaounde Cameroon Research Education and Health Associative Group GARES-Falaise Dschang Cameroon Department of Surgery Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Breast cancer is a major health problem in the world. It is the most common cancer in women and is equally the leading cause of cancer death in women. Though in controversy Breast self-examination (BSE) remains a useful tool in early diagnosis of breast cancer. The aim of this study was to evaluate the knowledge, attitude and practice of BSE amongst women in Yaoundé and Monatele. We carried out a cross sectional study in two communities of Cameron over a period of eight months, targeting females older than 15 years. After obtaining authorization, we randomly interviewed 402 consenting participants, using a pretested questionnaire. Data were entered using CS Pro 7.3 and analysed using SPSS 23. Of a total of 402 participants, 256 (63.7%) in Monatele and 146 (36.3%) in Yaoundé VI, the mean age was 26.55 ± 9.57 years. Exactly 50% (201) had earlier heard of BSE. Health personnel and media represented the main sources of information on BSE. Of the total, 46 (11.4%) knew BSE should be done monthly. Fifty-three percent had poor knowledge and 51.0% had a generally low attitude towards BSE. Out of 402 participants, 65.2% reported not practicing BSE. For those practicing, 71.6% had poor practices. The main reason for not practicing was lack of knowledge. Poor knowledge increased poor practice. In conclusion half of the women had heard about BSE even though the majority had a poor knowledge on BSE and very low overall attitude and practice. Health personnel and media played a key role in passing of information. Increasing the number of health campaigns, multiplying TV shows and health talks about breast self-examination will improve knowledge and hence attitude and practice.

关键词： Knowledge Attitude Practice Breast Self-Examination