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Factors Associated with Postpartum Haemorrhage amongst Primigravidae Women;the Case of Two Hospitals within the Bamenda Health District

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 793-813页

作者： william ako takang Foueliefack Ymele Florent Egbe Thomas Obichemti Obande Valery Fukara Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Bamenda Regional Hospital North West Region Bamenda Cameroon

Background: Approximately 830 women die from pregnancy-related conditions daily with 99% of these maternal deaths occurring in low resource countries. Primary postpartum haemorrhage (PPH) accounts for 25.7% of maternal deaths in Africa. In Cameroon, postpartum hemorrhage remains the leading cause of maternal death, with little information on the primigravidae population compared to multigravida or multiparity. Objective: The aim of this study was to assess the factors associated with postpartum haemorrhage amongst primigravidae women giving birth in two hospitals within the Bamenda Health District. Methods: This study was a multicentric, non-randomized cross-sectional descriptive and analytic study. Of the 221 women interviewed regarding their willingness to participate in the study, 197 consented. Quantification of blood loss was done by visual estimate and with the assistance of the pathfinder international wall chart for visual estimation of blood loss. Data was collected using a structured questionnaire and analyzed using SPSS version 23. A P-value of <0.05 used to determine association between variables was considered statistically significant. Results: The prevalence of postpartum hemorrhage in primigravidae was 7.1%. The risk factors of postpartum hemorrhage were: induction of labour (P-value < 0.01), duration of labour (P-value < 0.01), augmentation (P-value < 0.05), mode of delivery (P-value < 0.01), and macrosomia (P-value < 0.01). The main causes of PPH were uterine atony and obstetrical lacerations (P value < 0.01). Management was mostly by the use of non-pharmacological and pharmacological measures. The main adverse outcomes were shock and severe anaemia, with one case of nearmiss recorded. No maternal death was recorded. Conclusion: The prevalence of postpartum hemorrhage amongst primigravidae was high. The main causes of post-partum hemorrhage were uterine atony and obstetric lacerations. PPH was associated with uterine hypotonia, retained products an

关键词： Postpartum Hemorrhage Primigravidae VEBL Maternal Death BHD

Perception of Condoms and Emergency Contraceptive Pill Use among Students in the University of Bamenda

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 589-608页

作者： william ako takang Arnold Agwe Tanah Walters Dobgima Pisoh Mary Bi Shu Atanga Department of Clinical Sciences Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Public Health Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Nursing and Midwifery Faculty of Health Sciences University of Bamenda Cameroon

Background: Globally, university students fall in the youth group prone to unattended sexual risks which may lead to unwanted pregnancy and STI/HIV. In Cameroon, more than a third of maternal deaths occur among adolescent girls and young mothers. Unwanted pregnancies results from the infrequent use of modern contraceptive methods and is one of the main causes of death in this population. Condoms are barrier contraceptive that have a beauty of dual protection-against pregnancy and transmission of STI/HIV, meanwhile emergency contraceptives has just one function which is protection against unwanted pregnancy. Aim: To assess the perception of condoms and emergency contraceptive pill use among students in the university of Bamenda, Cameroon. Materials and Methods: A university-based cross-sectional study was conducted among students in the University of Bamenda, North West Region of Cameroon, a cosmopolitan area approximately about 19 km from Bamenda main town (Commercial Avenue). The study was carried out over a period of three months. Data were collected using a structured interviewer questionnaire administered through Google form. Data collected were extracted into excel sheet and analysed with SPSSv23. Results: The study included 719 students (318 males and 401 females). The rate of male and female condom use was 28.5% and 8.1% respectively. The mean age of our study populations was 24.5 ± 4.97 years with 52.7% of population between 20 to 24 years of age. Knowledge about condoms was high at 98.3%, however, 91.9% of participants have never used the female condoms before. Highest factor recorded for non-utilisation of the male and females condoms were reduction in sexual pleasure (47.4%) and lack of knowledge on usage (44.1%) respectively. 95% of students have knowledge on Emergency Contraceptive Pills (ECPs) but just an average (52.4%) have used it before. Fear of side effects (47.4%) was the main reason for not using ECPs. Conclusion: There is a very high knowledge

关键词： Contraceptive Unwanted Pregnancy STI/HIV

Maternal and Foetal Outcome among Pregnant Women Infected with COVID-19 in Three Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 625-641页

作者： william ako takang Cho Joseline Nyuykighan Dobgima Walters Pisoh Dobgima Walters Pisoh Robinson Enow Mbu Faculty of Health Sciences University of Bamenda Bamenda Cameroon Maternity Department Regional Hospital Bamenda Bamenda Cameroon Gynaeco-Obstetric and Pediatric Hospital Yaoundé Yaoundé Cameroon

Introduction: Pregnancy is generally known to be an immune compromised state, thus placing pregnant women at risk of SARS-COV-2 infection. We therefore carried out this study to assess the maternal and foetal outcomes among pregnant women infected with COVID-19 in three referral hospitals in Cameroon. Methodology: This was a hospital-based retrospective case control study covering a two-year period. Data collection was done over a duration of four months at the Yaoundé Central Hospital, Douala Gynaeco-Obstetric and Paediatric Hospital and the Bamenda Regional Hospital. Cases were pregnant women who gave birth after a confirmed COVID-19 infection, matched 1:2 by age (±1 year) and parity (±1) to pregnant women not infected by COVID-19, who gave birth at the three hospitals within the same period. Results: The rate of caesarean section delivery among our cases was 52.4% as compared to 44.3% among controls (OR, 1.38, 95% CI, 0.74 - 2.60, P = 0.296). Maternal mortality rate in our cases was at 8.2% as compared to 6.6% in controls (OR, 1.60, 95% CI, 0.50 - 5.12, P = 0.422). The rate of preterm delivery in our cases was 24.6% as compared to 11.5% in the control group (OR, 2.39, 95% CI, 1.05 - 5.42, P = 0.025). Perinatal death rate in our study was recorded at 8.2% as compared to 3.4% in the controls (OR, 2.63, 95% CI, 0.68 - 10.18, PS = 0.162) Conclusion: Pregnant women infected with COVID-19 were found to have higher risks of preterm delivery and acute foetal distress as compared to pregnant women who were not infected. Caesarean section deliveries, maternal and foetal mortality were higher in COVID-19 infected pregnant women as compared to those not though these findings were not statistically significant.

关键词： COVID-19 Pregnancy Maternal Foetal Outcome

Epidemiologic and Therapeutic Aspect of Urogenital Fistula Following Obstetric and Gynecologic Surgeries Repaired at the Nkwen Baptist Hospital

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 427-443页

作者： william ako takang Mangoue Moubeariane Landry Ngwa Tangang Ebogo Titus Julius Sama Dohbit Faculty of Health Sciences University of Bamenda Bamenda Cameroon Cameroon Baptist Convention Health Services Nkwen Bamenda Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Urogenital fistula is an abnormal communication between the urinary and the genital systems. It may occur following vaginal deliveries or following pelvic surgeries. Data concerning urogenital fistula post-surgery is limited and we have noticed in recent years in Sub-Saharan Africa, an increase in the burden of iatrogenic urogenital fistula. Objective: The aim of this study was to assess the epidemiology, clinical profiles and therapeutic aspects of urogenital fistula following obstetric and gynaecologic surgeries repaired at the Nkwen Baptist Hospital Bamenda. Materials/Methods: This was a longitudinal descriptive study with a retrospective and prospective phase carried out at the Nkwen Baptist Hospital for 5 months. However the complete duration of the study was about 17 months. Data was collected using a pretested questionnaire containing socio-demographic information, clinical features, and therapeutic methods used. We used the statistical software SPSS (Social Package for Statistical Sciences) V 26.0 for data analysis. Results: The number of participants in the study was 40. The mean age was 43.5 years (+/- 13.3) ranging from 16 - 74 years. The prevalence of urogenital fistula post obstetric and gynecologic surgeries at the Nkwen Baptist hospital was 64.6%. The most common symptom was urine leakage and the most common surgery that exposed the patient to the urogenital fistula was total abdominal hysterectomy (60%) followed by caesarean section (35%). The different indications for these surgeries were mostly symptomatic leiomyoma (70.8 %) and prolonged labor (64.2%) respectively. The different types of fistula encountered were Vesicovaginal fistula (55%), Ureterovaginal fistula 40% and Vesicoutetrine fistula 5%. The different treatment modalities used were trans abdominal (77.5%) and transvaginal repair (22.5%). The overall repair success rate after one month was 85%. Conclusion: There is high burden of urogenital fistula post surgeries in our sett

关键词： Urogenital Fistula Obstetric Surgery Gynecologic Surgery

Prevalence, Antimicrobial Susceptibility Pattern and Factors Associated with GBS Colonization in Pregnant Women at the Regional Hospital Bamenda (RHB)

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 887-906页

作者： william ako takang Egbe Thomas Obichemti Foueliefack Ymele Florent Ujambeng Valie Ujambeng Anouboweh Asaah Forlemu Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Bamenda Regional Hospital North West Region Bamenda Cameroon Department of Obstetric and Gynecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetric and Gynecology University of Douala Douala Cameroon

Introduction: Maternal asymptomatic colonization with GBS (Group-B Streptococcus) has become a major cause of sepsis, meningitis and encephalopathy in neonates alongside premature births, stillbirths and post-natal infections. Routine screening of pregnant women for GBS carriage and antimicrobial susceptibility are therefore necessary. This study was aimed at evaluating the prevalence, antimicrobial susceptibility pattern and factors associated with GBS colonization in pregnant women at the Regional Hospital Bamenda (RHB). Materials and Methods: Vaginal and rectal swab samples were collected from 121 pregnant women in the 3rd trimester at the RHB from December 2017 to May 2018. Sociodemographic, obstetric and neonatal history and some clinical parameters were obtained through a questionnaire approach. Cultures for the isolation and identification of GBS from the samples were done and grouping as well as susceptibility testing of GBS isolates was done. Results: The colonisation rates were 5.8% (7), 1.7% (2) and 5.8% (7) for rectal, vaginal and concomitant recto-vaginal carriage. GBS was isolated in the vagina/rectum of 16 participants (13.2% prevalence). Of the 16 GBS strains used for in vitro susceptibility test, no resistance to ampicillin, oxacillin, amoxicillin-clavulanate, ceftriaxone, erythromycin, imipenem, aztreonam and clindamycin was recorded. 6.3% (1) of the strains had intermediate susceptibility to ampicillin and amoxicillin-clavulanic acid. Of the isolates examined, 37.5% (6), and 12.5% (2) were respectively sensitive to gentamycin and levofloxacin. Maternal overweight, HIV positive status, history of PROM and spontaneous abortion, presence of Gardnerella vaginalis and Candida albicans had a high rate of GBS colonization but only HIV positive status had a statistical significance (p = 0.01). Other microbes isolated were Gardnerella vaginalis (55.4%, 67), Candida albicans (40.5%, 49), and Candida spp (12.4%, 15). Conclusion: GBS prevalence was

关键词： Group B Streptococcus (GBS) Prevalence Anti-Microbial Susceptibility Profiles Pregnant Women Carriage Colonization

Outcomes of Twin Delivery at the Bamenda Health District, North West Region Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第5期12卷 465-481页

作者： william ako takang Dobgima Walters Pisoh Tcheumbe Josiane Nyeumenou Enow Robinson Mbu Mary Bi Shu Atanga Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Bamenda Regional Hospital North West Region Bamenda Cameroon Programs and Academic Affairs Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Nursing and Midwifery Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Multiple gestations or multiple pregnancies occur when two or more fetuses are conceived at the same time in the same woman. Therefore, a twin pregnancy is defined as the simultaneous development of two fetuses in the same woman. It can either be a monozygotic or dizygotic pregnancy. Twin pregnancy is considered a high-risk pregnancy with variable incidence and outcomes worldwide. The adverse maternal and fetal outcomes of twin deliveries have not yet been investigated in our setting. Objectives: The main objective of this study was to evaluate the outcomes of twin deliveries at the Bamenda Health District. Methods: This was a hospital-based, cross-sectional analytic study done at the Bamenda Health District in three selected hospitals (Bamenda Regional Hospital, CMA Nkwen, and IHC Azire) from the 1st of January to the 10th of May 2018. 55 women with twin pregnancies and 55 women with singleton pregnancies at gestational ages of 28 completed weeks and above who came for delivery and who consented to the study were included. A face-to-face interview-administered questionnaire was used to obtain sociodemographic characteristics;a venous blood sample was collected from the mothers before and after delivery to determine the estimated blood loss based on haemoglobin level. The partogram was opened from 4 cm cervical dilatation for those who came in the first stage of labour and the mode of delivery was recorded. After delivery, outcome variables were 1st, 5th, and 10th min Apgar score, birth weight, and gestational age. Data were entered in CSPro 7.1 and exported to IBM SPSS version 23.0 for analysis. All variables with p < 0.05 were statistically significant, OR and 95% CI were calculated for all outcome variables to measure the association with twin deliveries. Results: During the study period, we included 110 participants (55 twin mothers and 55 singleton mothers). Women with twin gestations were mos

关键词： Outcomes Twin Singleton Pregnancies Deliveries Bamenda Health District

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

Findings of Hysterosalpingography in Women Who Underwent Gynaecologic Imaging in a Tertiary Hospital in Douala, Cameroon

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Advances in Reproductive Sciences 2020年第2期8卷 113-125页

作者： Thomas Obinchemti Egbe Marcel Duhamelle Nyonlemuga Ngombiga william ako takang Emmanuella Wankie Manka’a Doretta Nzele Egbe Peter Nde Fon Nicholas Tendongfor Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynaecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Radiology Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Public Health and Hygiene Faculty of Health Sciences University of Buea Buea Cameroon

Background: Hysterosalpingography (HSG) is the first-line investigation among infertile women in Cameroon. There is a dearth of studies on the use of HSG in Cameroon. The aim of this study was threefold: 1) to describe the indications;2) findings of hysterosalpingography and 3) factors associated with abnormal findings on HSG at the Douala General Hospital, Cameroon. Methods: We conducted a retrospective descriptive study of 242 files of patients who underwent hysterosalpingography at the Radiology Department of the Douala General Hospital from January 2012 to December 2016. We collected data on the sociodemographic, obstetric variables and indications of HSG using a pretested data collection form. We also interpreted HSG films during the study period. Data analysis was with EPI-INFO version 7. Results: The age range was 19 - 46 years with a mean age of 33.16 ± 5.45 years. Majority 138/242 (57.1%) were in the age group 30 - 40 years. The main indication of HSG was infertility 87.2% (211/242). Most of the cases 95.87% (232/242) had abnormal findings at HSG. Tubal and uterine abnormal findings made up 133/232 (57.3%), and 97/232 (41.81%) of cases, respectively. Tubal occlusion and hydrosalpinges were found in 99/232 (42.67%) and 19/232 (8.19%) while uterine fibroids and uterine synechiae were found in 57/232 (24.97%) and 30/232 (12.93%), respectively. The factors independently associated with abnormal findings at HSG were: a history of recurrent pregnancy loss (AOR 2.95;95% CI: 1.19 - 7.32, p = 0.02) and infertility (AOR 0.24;95% CI: 0.06 - 0.92, p = 0.038). Conclusions: Infertility constituted the main indication, with tubal occlusion resurging as the most common abnormal finding on hysterosalpingography in this study. A history of recurrent pregnancy loss and infertility were factors independently associated with abnormal findings on hysterosalpingography. Therefore, HSG should be associated with hysteroscopy for uterine pathology and laparoscopy or selective salpin

关键词： Hysterosalpingography Female Infertility Uterine Cavity Tubal Occlusion

Prevalence, Risk Factors and Outcome of Preterm Premature Rupture of Membranes at the Bamenda Regional Hospital

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 233-251页

作者： Dobgima Walter Pisoh Claude Hector Mbia william ako takang Obelda Guiswe Beltus Djonsala Mbah Cypress Munje Ascensius Achuo Mforteh Dohbit Julius Sama Robert John Ivo Leke Department of Clinical Sciences Faculty of Health Sciences University of Bamenda Bambili Cameroon Bamenda Regional Hospital Bamenda Cameroon Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Catholic University of Cameroon Bamenda Cameroon

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is one of the leading identifiable cause of preterm deliveries, and an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine the prevalence of PPROM, to identify its associated factors and to evaluate the early outcome (within 72 hrs after delivery) following PPROM at the Bamenda Regional Hospital (BRH). Methods: A cross-sectional study was conducted in March and April 2020. Three hundred and eighty-seven women who delivered at the labour room of the BRH were included in this study. Interviewer-administered questionnaires were used to obtain data. The cases of PPROM were women who had lost amniotic fluid continuously before hospitalisation and whose gestational age was between 28 weeks + 0 days and 36 weeks + 6 days. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Among the 387 participants included in the study, 19 had PPROM giving a prevalence of 4.91%. Of 57 preterm deliveries, PPROM accounted for 33.33% (n = 19). The statistically significant independent factors associated with lower odds of PPROM were the age groups 20

关键词： Preterm PROM Maternal Outcome Perinatal Outcome Associated Factors