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Ectopic Molar Pregnancy with Coexistent Normal Intrauterine Pregnancy: A Report of an Unusual Diagnosis managed in Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 874-881页

作者： Tompeen Isidore ekono michel roger Guy Mendouga Menye Coralie Belinga Etienne Noa Ndoua Cyrille Foumane Pascal Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Gynecology and Obstetrics Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon Department of Morphologic Sciences and Anatomopatology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences The University of Ebolowa Ebolowa Came-roon

Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.

关键词： Ectopic Molar Pregnancy Heterotopic Pregnancy Laparoscopy Surgery YGOPH

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HIV+ Status and Cervical Cancer: Cytological Aspects of Cervical Smear in Cameroon Setting

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 76-84页

作者： Essome Henri Engbang Jean Paul ekono michel roger Nana Njamen Theophile Mve Koh Valere Boten Merlin Tocki Toutou Grace Fewou Amadou Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon

Introduction: The early detection of precancerous lesions being very important for the preventive management of cervical cancer, we felt it was important to identify these lesions on potential backgrounds including HIV-positive (HIV+) women to suggest control strategies of cervical cancer in Cameroon. Objective: To determine the prevalence of precancerous lesions in women infected with the human immunodeficiency virus (HIV), to investigate the determinants of the HIV and cervical cancer association, and to make recommendations regarding cervical cancer screening in these patients of the city of Douala. Methodology: Our study was a case-control cross-sectional study from July 2017 to December 2017 (6 months) including 108 women among which 34 HIV+ matched with 74 HIV-. HIV serology was done using the complete HIV enzygnost test. Cervical smears for cytological lesions were fixed to the cyto-fixator and then stained by the Papanicolaou technique and read under an optical microscope. The cervical smear slides for viral excretion were fixed with a methanol-acetone mixture of equal volume;HPV testing was done by the indirect immune-peroxidase technique using P16 protein. The excretion of HSV type 1 & 2 was investigated by the indirect immunofluorescence technique using the Simplex Virus type 1 & 2 Rabbit anti-Herpes from DAKO (France). Results: The two groups of women were compared with the chi square test with a significance threshold of P 0.05. The average age was 40.07 with extremes of 21 and 71 years and a standard deviation of 9.99. Of the 34 HIV+ patients, 23 had an abnormal cervix compared to 36 cases of abnormal cervix among HIV- with a statistically significant difference (P = 0.006649). 12 cases of dysplasia were observed in the 34 HIV+ women and distributed as follows: 0% of mild dysplasia, 18.92% of moderate dysplasia and 13.51% of severe dysplasia. In HIV- women we detected 6 cases of dysplasia including 1.35% of mild dysplasia, 4.05% of moderate dysplasia a

关键词： HIV HPV Dysplasia Cervical Cancer

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The Problem of Traditional African Pharmacopoeia in Obstetrics: Use of Plants for Utero-Tonic Purposes and Materno-Fetal Outcome in Douala (Cameroon)

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Open Journal of Obstetrics and Gynecology 2019年第11期9卷 1464-1476页

作者： Essome Henri Mve Koh Valere Nana Njamen Theophile Boten Merlin ekono michel roger Penda Ida Calixte Tocki Toutou Grace Halle Ekane Gregory Foumane Pascal Mboudou Emile Telesphore Faculty of Medicine and Pharmaceutical Sciences of Douala University of Douala Douala Cameroon Laquintinie Hospital of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences of Yaounde University of Yaounde Cameroon Yaoundé Teaching Hospital Yaounde Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Douala General Hospital Douala Cameroon Yaoundé Gyneco-Obstetrics and Pediatric Hospital Yaounde Cameroon Gyneco-Obstetric and Pediatric Hospital of Douala Douala Cameroon

Introduction: The use of traditional preparations for the induction or acceleration of labor remains a common practice in our country in particular and in Africa in general with sometimes derogatory outcomes for the mother and the fetus. Goal: The objective was to assess immediate maternal and neonatal outcomes in women who reported having used the traditional pharmacopoeia for utero-tonic purposes. Methodology: We conducted a multi-centric cross- sectional study with prospective data collection in the maternities of the Laquintinie Hospital, Bonassama District and Nylon Hospitals. It took place over a period of seven months, from 1st October 2016 to 31st April 2017. This included all women who reported having used the unconventional pharmacopoeia for utero-tonic purposes before or after contractions started. The student and Chi-square tests were interpreted at the statistical threshold of 5% and the 95% confidence intervals. Results: We recruited 168 cases, 68.5% of the 245 women interviewed. The mean age was 27.1 ± 0.41 years;55% of our respondents had a secondary level of education;80% of them were admitted at term and 43% were multiparous. Nulliparity predisposed to traditional pharmacopoeia use (RR = 1.55, CI = 0.79 - 3.03) but primiparity reduced this risk (RR = 0.4, CI = 0.24 - 0.926). Stimulation of labor was the first indication in 85% of women, the rectal evacuation enema was the main route used (67%). The majority of plants used were those of the families Asteraceae, Anthericaceae, and Malvaceae. In per partum, 42% had a brilliant dilatation;there was a statistically significant association between the occurrence of dynamic dystocia (CI = 0.28 - 1.54, p = 0.006) and the risk of perineal tear (RR = 3.13, CI = 1.68 - 5.85;p = 0.007). The APGAR score at 5 min of life was less than 7 in 64% of cases (p = 0.027). The caesarean section rate was 69%. Conclusion: Traditional products with uterotonic effects are frequently used and unregulated with its corollary o

关键词： Utero-Tonic Plants Hyperkinesia Fetal Distress Caesarean Section

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Immuno-Histochemical Profile of Breast Cancers at the General Hospital of Douala-Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1377-1388页

作者： ekono michel roger Guy Ngaha Yaneu Junie Neng Humphry Tatah Messakop Yannick Azoumbou Mefant Thérèse Ze Ngbwa Mimi Flore Essome Henri Essola Basile Engbang Jean-Paul Tchente Nguefack Charlotte Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Ebolowa Regional Hospital Ebolowa Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: The aim of the study was to describe the immunohistochemical aspects of breast cancers at Douala General Hospital, Cameroon. Methodology: This was a descriptive study with retrospective data collection, conducted from January 1st 2010 and December 31st 2019. It was focused on histologically proven breast cancers followed up at Douala General Hospital. Results: We collected 285 cases of breast cancer, all female, representing an annual frequency of 28.5 cases. The mean age of the patients was 48 ± 13 years. The most frequent histological form was infiltrating ductal carcinoma (83.9%), with grade II predominating (38.6%). Immunohistochemical analyses were performed on 89 patients (31.23%). The triple-negative subtype was the most common class (35.95%), followed by Luminal A (32.60);Human Epidermal Receptor 2-class and Luminal B tumors were observed at a frequency of 13.48% each. Treatment consisted mainly of surgery (78.60%) combined with chemotherapy (65.97%) and/or radiotherapy (63.16%). Hormonal treatment was used in only 10.18% of patients. Targeted therapy was exceptional (4%). Conclusion: Triple-negative phenotype is the most common. However, potentially hormone-sensitive tumors account for almost half of all patients, who are relatively young. Individualized treatments are rare. It is important to systematize these analyses for all breast cancers, with a view to appropriate management in our environment.

关键词： Breast Cancer Immunohistochemistry Douala General Hospital of Cameroon

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Pregnancies Outcome after Assisted Reproductive Technology: A Multicenter Case Control Study in a Low Income Setting Douala, Cameroon

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 720-731页

作者： Tchente Nguefack Charlotte Bourdanne Tekouake Didier T. Nana Njamen Nda Mefo’o Jean Pierre ekono michel roger Essome Henri Tsingaing Kamgaing Jacques Gwet Bell Ernestine Sandjon Guy Halle Ekane Edie Gregory Faculty of Medicine and Pharmaceutical Science University of Douala Douala Cameroon Department of Gynecology and Obstetrics Douala General Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Department of Biology Douala General Hospital Douala Cameroon Bel Air Plus Clinic Douala Douala Cameroon Odyssée Medical Clinic Douala Douala Cameroon Clinique de l’Aéroport Douala Douala Cameroon

The objective was to assess the outcome of pregnancies after assisted reproductive technology (ART). It was a case-control study carried out in four health facilities in Douala-Cameroon, over a period of five years. The cases were pregnant women who conceived through ART and the controls were those who conceived naturally. Cases and controls were matched for maternal age and parity (one case for two controls). A logistic regression analysis was used to compute Odds ratios. Statistical significance was set at 0.05. A total of 174 women who conceived through ART and 348 who conceived naturally were enrolled. Some independent factors associated with ART were: age over 45 years [aOR: 7.55; 95% CI (1.55 - 36.76);p: 0.01], twin pregnancies [aOR: 16.55;

关键词： Pregnancy Outcome Assisted Reproductive Technology Douala

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Excessive Weight Gain during Pregnancy and Prognosis of Childbirth in Douala (Cameroun)

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 242-250页

作者： Henri Essome Valere Mve Koh michel ekono Merlin Boten Jean Paul Engbang Matio Bewekedi Pascal Foumane Douala Laquintinie Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon University Hospital Center of Yaoundé Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Gyneco-Obstetrics and Pediatric Hospital of Yaoundé Yaoundé Cameroon

The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.

关键词： Excessive Weight Gain Pregnancy Maternofoetal Outcome

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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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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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Urinary Infection during Pregnancy: Case-Control Study in the Maternity Wards of the Teaching Hospitals of Yaoundé Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1735-1756页

作者： Henri Essome Moustapha Bilkissou Fulbert Mangala Nkwele Aurel Mbog Wetjeng Ingrid Doriane Ofakem Ilick Astrid Ndolo Kondo Merlin Boten Bounyom michel roger ekono Alphonse Ngalame Nyong Robert Tchounzou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh 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 1 Yaound Cameroon

Introduction: Acute pyelonephritis in pregnancy (APN) is a bacterial infection of the upper urinary tract (pyelitis) and renal parenchyma (nephritis), complicating or associated with an infection of the lower urinary tract. Objective: Study the clinical and para-clinical profile linked to their occurrence of APN during pregnancy in the city of Yaoundé. Methodology: This was a case-control analytical study lasting 07 months with retrospective data collection and covering a period of six years from January 2015 to December 2020 in 03 teaching hospitals in the city of Yaoundé. The data was recorded on a pre-tested technical sheet. We recruited the files of pregnant women in whom a urinary infection had been diagnosed using urine culture. The cases were the files of pregnant women with signs of APN and the controls were the files of pregnant women without signs of APN. The matching criteria were: recruitment site, age and term of pregnancy. Incomplete files were excluded. Statistical analyzes were carried out with Epi-Info 7 and Excel 2016 software. Statistical significance was set at a P value Results: We recruited: 55 cases and 110 controls. The factors associated with the occurrence of APN in pregnancy after logistic regression were: free union (OR: 2.19;P = 0.030), sexual intercourse during pregnancy (OR: 4.47;P = 0.001), positive HIV serology (OR: 5.52;P = 0.001), pre-gestational diabetes (OR: 10.9;P = 0.02) and a history of urinary infection during pregnancy (OR: 11.86;P = 0.001). Conclusion: Acute pyelonephritis in pregnancy is an uncommon but serious pathology. Its risk factors in our context are free union, sexual intercourse during pregnancy, positive HIV serology, pre-gestational diabetes, and a history of urinary infection during pregnancy.

关键词： Associated Factors Acute Pyelonephritis Pregnancy Yaoundé

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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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