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Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 175-185页

作者： Noa Ndoua Claude Cyrille Tchedele Guidebta Hilary Nyada Serge Robert astrid ruth ndolo kondo Ayissi Gregory Ngo Dingom Anne Madye Tompeen Isidore Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaounde Cameroon Faculty of Medicine and Pharmaceutical sciences of the University of Douala Douala Cameroon

Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% - 2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.2% were term pregnanci

关键词： Ectopic Pregnancy Maternal Morbidity

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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

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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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Histopathological Aspects of Placental Lesions in Mild and Severe Pre-Eclampsia in a Population of Cameroonian Women

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 154-168页

作者： Félix Essiben Ayissi Gregory Belinga Etienne ndolo kondo astrid Ngo Dingom Madye Ange Ebong Cliford Ebontane Ojong Samuel Atomveng Foumane Pascal Yaoundé Central Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Central Maternity Yaoundé Central Hospital Yaoundé Cameroon Yaounde Gyneco-Obstetric and Pediatric Hospital Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon

Background: Pre-eclampsia (PE) frequently leads to adverse maternal and foetal outcomes in our setting. The pathophysiology is strongly linked to placental development. We aimed to study placental lesions associated with PE in a population of Cameroonian women. Methods: We conducted a cross-sectional, analytical study in three university teaching hospitals in Yaounde namely, the Yaounde Central Hospital, the pathology laboratory of the Yaounde University Hospital Centre, and the Yaounde Gynaeco-Obstetric and Paediatric Hospital. The study spanned 8 months from January 1st to September 1st, 2021. Placental analysis was carried out as per standard protocol. The study included 101 parturients with pre-eclampsia. These were divided into two groups, with groups 1 and 2 being made of patients with mild pre-eclampsia (n = 40), and severe pre-eclampsia (n = 61), respectively. Results: The mean ages of the two groups were 29.93 ± 7.36 versus 28.28 ± 7.18 (p = 0.267) for patients with mild and severe pre-eclampsia respectively. Low socioeconomic status was the most frequently identified risk factor in both groups (59%). Patients’ history revealed that the women with severe pre-eclampsia tended to have poor pregnancy follow-up compared to those with mild pre-eclampsia (p < 0.05). Also, the placentas of patients with severe pre-eclampsia weighed significantly less than those of patients with mild pre-eclampsia (454.4 ± 122 vs. 511.7 ± 125;p < 0.05). Pre-eclampsia-related lesions were significantly greater in patients with severe disease (p Conclusion: PE-related placental lesions in our context are multiple and diverse especially in severe disease, and these arise as a result of defective maternal vascular perfusion.

关键词： Preeclampsia Placental Lesions Histological Aspects Placental Dysfunction Cameroon

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Fight against Breast Cancer in Cameroon: Cross-Views of the Knowledge of the Female Population of Douala Hospitals

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Open Journal of Obstetrics and Gynecology 2023年第7期13卷 1196-1209页

作者： Henri Essome astrid ndolo kondo Ingrid Doriane Ofakem Ilick Christelle Enama Olinga Moukouri Gertrude Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Fulbert Mangala Nkwele Michel Roger Ekono Jean Paul Engbang Ndamba Theophille Nana Njamen Charlotte Tchente Nguefack Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Buea BueaCameroon Faculty of Medicine of Sangmelima Sangmelima Cameroon

Introduction: Breast cancer in women is a global scourge due to its frequency and high fatality rate. If screening has made it possible to considerably reduce its incidence and its mortality in developed countries, in our developing countries, it remains frequent with a still high mortality due to ignorance, late and non-systematized screening. Research Question: Can female health caregivers be incorporated into a breast cancer screening awareness team? Objective: It aimed at evaluating the knowledge of female health caregivers in Douala hospitals, added to that of female users on breast cancer screening for their efficient operationalization in this procedure. Methodology: This was a comparative cross-sectional study for analytical purposes for a period of 07 months from January 15 to July 15, 2020 conducted by means of a structured and pre-tested questionnaire after informed consent obtained from the participants received in the consultation units of these hospitals. The study variables were socio-demographic and cognitive. The data collected were entered and analyzed using SPSS 23.0 software (statistical package for social sciences) with a significance level established for a value of p Results: We retained 1000 women fulfilling our inclusion criteria, including 818 users and 182 health caregivers, i.e. an average ratio of 4 users for 1 caregiver. The average age of the users was 31.03 ± 11.31 years and that of the caregiver was 29.54 ± 8.14 years (with extremes of 15 and 67 years identical in the two groups) with a respective median of 29 and 28 years old. Good knowledge was significantly associated with level of education (secondary OR = 0.38, p = 0.03 and University OR = 0.22, p = 0.001) with a predominance of good knowledge among care givers (83.5%) against 56.2% among users. The association between caregiver and good knowledge appeared to be statistically significant (OR = 0.25;p < 0.0001). In general, the association of users and poor knowledge carried a 4

关键词： Screening Breast Cancer Knowledge Attitudes Practices Carer Users

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