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Spontaneous Abortions in the Second Trimester of Pregnancy: Research and Analysis of Factors Associated at Laquintinie Hospital in Douala

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1130-1143页

作者： Henri Essome moustapha bilkissou Merlin Boten Bounyom Sandrine Ngoumi Ingrid Doriane Ofakem Ilick Astrid Ndolo Kondo Fulbert Mangala Nkwele Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Pascal Foumane Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences of Bamenda University of Bamenda Bamenda Cameroon Institute of Health Sciences of the University of the Mountains of Bangant Bangant Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of Yaound University of Yaound 1 Yaound Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmlima University of Ebolowa Ebolowa Cameroon

Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.

关键词： Spontaneous Abortion Second Trimester Associated Factors Laquintinie

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Pregnancy Preferences in Females of Reproductive Age with Sickle Cell Disease at Laquintinie Hospital: A Cross-Sectional Analysis

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 744-757页

作者： Eposse Ekoube Charlotte Jeannette Disso Massako Mangala Fulbert Nkwele Mandeng Ma Linwa Edgar Puepi Djike Yolande Merlin Boten Bounyom Erero F. Njiengwe Épée Patricia Hassanatou Iyawa Dora Mbonjo Bitsie Emmanuel Heles Nsang Soumaiyatou Abba Ngo Linwa Esther Eleonore Ndolo Kondo Astrid Grâce Tocki Toutou moustapha bilkissou Essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Females with sickle cell disease (SCD), despite having a delayed pubertal development, are subject to many worries relating to their abilities to conceive, their capacity to maintain a maternofetal-risk-free pregnancy till term and give birth to healthy children without sickle cell disease. Knowing that unplanned pregnancies are more likely to increase maternofetal morbidity and mortality, we sought out to explore the pregnancy preferences in female patients with sickle cell disease to promote healthy conception and childbirth in this vulnerable population. Methodology: We conducted a cross-sectional study involving female patients of child-bearing age with sickle cell disease followed at Laquintinie Hospital Douala or who were members of a local sickle cell association. Pregnancy preferences were determined using the Desire to Avoid Pregnancy (DAP) scale. Factors associated with pregnancy preferences were determined using multivariable linear regression model. Threshold for significance was set at p Results: Seventy-seven patients were included with a mean age of 24.71 ± 5.53 years. Forty patients (51.95%) had one sexual partner and thirteen women (32.5%) used contraceptive methods. Most patients (46.0%) responded “Strongly Agree” or “Agree” to the statement “it would be a good thing for me if I became pregnant in the next 3 months”. The mean DAP score was 1.63 ± 0.91 [1.28 ± 0.82 in those who had a sexual partner and 1.99 ± 0.86 in those who had no sexual partner]. Factors that were positively associated with DAP score were students (b = 0.32, 95% CI [0.21, 0.95], p = 0.003), monthly income ≥ 100,000 FCFA (b = 0.24, 95% CI [0.07, 0.81], p = 0.022), and not having a sexual partner (b = 0.26, 95% CI [0.11, 0.85], p = 0.012). Conclusion: Most female patients with SCD have a low desire to avoid pregnancy. This is especially true for patients who are not students, have a partner and have a low monthly income.

关键词： Pregnancy Preferences Sickle Cell Disease Laquintinie Hospital Cameroun

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Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 705-720页

作者： Henri Essome Merlin Boten Bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Fulbert Mangala Nkwele Irène Cyrielle Edjoa Mboe Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou moustapha bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmelima University of Ebolowa Ebolowa Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

关键词： Profile Delivery Term Malaria Douala

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Draft of an Anthropometric Reference System for Full-Term Cameroonian Newborns: Prospective Study with Analytical Aim in the Maternity Wards of Douala

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 435-450页

作者： Henri Essome Charlotte Epossè Ekoube Fulbert Mangala Nkwele Rita Carole Mbono Betoko Irène Cyrielle Edjoa Mboe Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Ingrid Doriane Ofakem Ilick Hassanatou Iyawa moustapha bilkissou Astrid Ndolo Kondo Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Nelly Noubi Valère Mve Koh Théophile Nana Njamen Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Laquintinie Hospital Douala Cameroon Department of Pediatrics Laquintinie Hospital Douala Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Pluridisciplinary Department Laquintinie Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th

关键词： Anthropometry Full-Term Newborn Douala

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Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 758-778页

作者： Henri Essome Merlin Boten Bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Charlotte Epossè Ekoube Rita Bono Betoko Hassanatou Iyawa Fulbert Mangala Nkwele Théophile Nana Njamen Robert Tchounzou Alphonse Ngalame Nyong Charlotte Irène Cyrielle Edjoa Mboe moustapha bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Michel Roger Ekono Nelly Noubi Pascal Foumane Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Ebolowa Ebolowa Cameroon

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potenti

关键词： Newborn Low Birth Weight Gestational Age Douala

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Clinical, Psychological and Socio-Economic Profile of Women Consulting for Couple Infertility in the Yaounde Gynaeco-Obstetric and Paediatric Hospital

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 490-498页

作者： Junie Ngaha Isidore Tompeen bilkissou moustapha Claudia Toukem Anabelle Ako Brigitte Wandji Laure Menguene Pascal Foumane Gynaeco-Obstetric Unit Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Department of Gynaecology and Obstetrics Higher Institute of Medical Technology University of Douala Douala Cameroon

Introduction: Infertility is defined as the inability to achieve a pregnancy after at least 12 months or more of regular unprotected sexual intercourse. Our main objective was to describe the clinical, psychological and socio-economic profile of women consulting for infertility in the Yaounde Gyneco-Obstetric and Pediatric Hospital. Methodology: This was a descriptive cross-sectional study with prospective data collection at the Yaounde Gyneco Obstetric and Pediatric Hospital over a period of 7 months from 1st December 2021 to 31st June 2022. Results: We included 171 patients. The mean age was 32.3 ± 5.5 years. The mean duration of infertility was 4.0 ± 3.7 years. Primary and secondary Infertility made up 31.6% and 68.4% of cases respectively. Past medical history was significant for Abortions (50%), Chlamydia and Mycoplasma infections (43.8%), chronic pelvic pain (49.7%) and endouterine manipulations (33.3%) of cases. Majority of our patients were stressed (76.6%). The most represented stress score was severe stress (66.1%). 51% of our patients were mentally depressed and 35.6% were anxious. Majority of them (74.9%) had low socio-economic status. Conclusion: Couple infertility is most often secondary. It triggers the onset of psychological problems like stress, mental depression and anxiety. Most of our patients had a low socio-economic status.

关键词： Psychological Profile Infertility Evaluation Scale Women

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Contribution of Colposcopy in the Diagnosis of Precancerous Lesions of the Uterine Cervix at the Douala Gynaeco-Obstetric and Pediatric Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1031-1041页

作者： Diane Estelle Modjo Kamdem Alphonse Nyong Ngalame Inna Rakya Robert Tchounzou Darolles Wekam Mwadjie Humphry Tatah Neng bilkissou moustapha Julie Batta Patricia Metouom Kamdem Charlotte Nguefack Tchente Emile Mboudou Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon University of Pittsburg Medical Center-Mckeesport Pittsburg USA Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: Cervical cancer is a public health problem in Cameroon, due to low screening and late diagnosis. We sought to assess practice of colposcopy at the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon and its contribution to the fight against cervical cancer in our context. Method: This is a retrospective cross-sectional study of 99 colposcopies after which 71 exploitable biopsies were retained at the Douala for a period of 1year (December 1, 2019-December 1, 2020). The nomenclature of the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV) was used. Results: Mean age of the participants was 44 years, mostly multiparous (80%). Cytological abnormalities were the main reference pattern. During the examination 22% of colposcopies were found to be normal, 37% of TAG 1-2A, 31% of TAG 2B-C, and 5% suspected of cancer. After histological analysis of biopsies guided by colposcopy, we found 42% (30/71) of Cervical Intraepithelial Neoplasia (CIN) 1, 15.5% (11/71) of CIN 2 - 3, and 24% (17/71) cancer. Upon analysis of the diagnosed CIN1/CIN2-3/Cancers, we noted a concordance with colposcopy in 62% (23/37), 37% (10/27) and 85% (6/7) respectively. Colposcopic performance in the detection of high-grade lesions and above was 36% (26/71), with a sensitivity of 92.86%, specificity 83.33%, PPV 78.79% and NPV 94.59%. Conclusion: Despite the difficult socioeconomic context, colposcopy retains all its importance in the diagnosis of precancerous lesions of the uterine cervix. With the imminent putting in place of a national health policy, the goals 90-70-90 by 2030 of the World Health Organization for the fight against cervical cancer can be achieved in our sub-Saharan African countries.

关键词： Colposcopy Cervix Dysplasia Cancer DGOPH

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Covid-19 in Pregnancy: Cases of Women Managed in the City of Douala-Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1019-1030页

作者： bilkissou moustapha Alphonse Nyong Ngalame Charlotte Nguefack Tchente Frederic Victor Okala Kingsley Ombaku Humphry Tatah Neng Diane Kamdem Ngo Batta Julie Nkendo Sandrine Darolles Mwadjie Emile Telesphore Mboudou Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: The SARS-COV-2 virus has been responsible for a health crisis in pregnancy, causing severe acute respiratory distress syndrome. Materno-foetal complications can be observed. Taking into account the materno-foetal risks associated with COVID-19 infection in pregnant women and the low sample size of the first publication in Cameroon, we considered it necessary to conduct an in-depth study on the maternal and foetal prognosis of this condition in pregnant women in three hospitals in Douala. Materials and Methods: We conducted a cross-sectional survey with retrospective data collection in the three state tertiary and reference hospitals in Douala (DGOPH, DGH and DLH) from November 1, 2021 to April 30 2022 after obtaining ethical and administrative clearances. All records of COVID-19 pregnant women confirmed by reverse transcription polymerase chain reaction (RT PCR) or COVID-19 rapid diagnostic test (COVID RDT) were included. The survey form contained socio-demographic data, clinical and para-clinical characteristics, management and materno-foetal outcome. SPSS.26 and Microsoft Excel 2016 software were used to analyze the data, and a logistic regression model was used to look for associations between the variables. Results: We found in total 96 files that met our inclusion criteria. The most represented sector of activity was the unemployed (44.46%). Patients with a secondary level of education constituted the majority with 47% (45). The main comorbidity found was diabetes (27.2%). The most frequent symptom was fever, found in 87 patients (90.1%). In our series, a chest CT scan was performed in 50 patients. Caesarean section was the most common mode of delivery (58.3%). We recorded 15.6% of maternal deaths, mainly in patients admitted to intensive care. Factors associated with maternal death were: Maternal diabetes, high LDH and D-dimer levels, and 75% lung involvement on chest CT scan. Oxygen saturation > 94% on admission was a protective factor. Regardin

关键词： COVID-19 Clinical Para-Clinical Materno-Foetal Outcomes Pregnant Women

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Management of Obstetric Emergencies in a Tertiary Hospital in Cameroon: A Milestone for End of Preventable Maternal Deaths

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1749-1762页

作者： Robert Tchounzou Theophile Nana Njamen Alphonse Nyong Ngalame Vanessa Baleba Inna Rakya Darolles Mwadjie Wekam André Gaetan Simo Wambo Humphry Neng Tatah Diane Estelle Kamdem moustapha bilkissou Félix Adolphe Elong Dominique Djomo Tamchom Julie Ngo Batta Emile T. Mboudou Douala Gynaeco-Obstetric and Paediatric Hospital Douala Cameroon Faculty of Health Sciences University Buea Buea Cameroon Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences of Ngaoundere Garoua Cameroon Regional Hospital Limbe Limbe Cameroon Regional Hospital Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Background: Maternal mortality was insufficiently reduced in Cameroon in 2015 despite the adoption of Millennium development goals. To tackle the situation and meet the sustainable Millennium goals target of 140/100,000 live births by 2030, the Government adopted the strategies of building reference hospitals where high quality obstetric care, timely and optimal management of obstetric emergencies will be offered. The objective of this study was to describe the patterns of obstetric emergencies in Douala Gynaeco-obstetric and Paediatric Hospital, evaluate the outcomes of their management and the contribution to maternal mortality. Patients and Methods: 418 patients with obstetric emergencies were included in a two-phase cross-sectional study. Data were retrieved from patients’ case notes during the retrospective phase and a questionnaire filled for each case received during the prospective phase. Patterns of obstetric emergencies were determined and for each, the following were analysed: patient managed in this hospital or referred from other hospitals, management according to hospital guidelines, timi

关键词： Obstetric Emergencies Tertiary Hospital Maternal Outcome Maternal Death

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Improving Post Abortion Care (PAC) Delivery in Sub-Saharan Africa: A Literature Review

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1295-1306页

作者： Alphonse Nyong Ngalame Robert Tchounzou Humphry Tatah Neng Fulbert George Nkwele Mangala Rakya Inna Diane Modjo Kamdem bilkissou moustapha Julius Sama Dohbit Eugene Justine Kongnyuy Claude Ndoua Noa Benova Lenka Gregory Ekane Halle Darolles Wekam Mwadjie Therese Delvaux Emile Telesphore Mboudou Gynecology & Obstetrics Unit Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) Douala Cameroon Faculty of Health Sciences (FHS) University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) University of Ngaoundere Ngaoundere Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaounde I Yaounde Cameroon United Nations Population Fund (UNFPA) Bamako Mali Institute of Tropical Medicine (ITM) Antwerpen Belgium

Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published during 2000-2018. The following databases were searched: MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.

关键词： Post Abortion Care (PAC) Misoprostol Contraception Midlevel Cadres Sub-Saharan Africa

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