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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 hospitalsfont-family:;" "="">font-family:Verdana;">, management according to hospital guidelines, timi

关键词： Obstetric Emergencies Tertiary Hospital Maternal Outcome Maternal Death

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Management of a Huge Ovarian Cyst in Pregnancy at the Douala General Hospital, Cameroon: A Case Report and Review of the Literature

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Advances in Reproductive Sciences 2024年第3期12卷 165-178页

作者： fidelia Mbi Kobenge felix-adolphe elong Emenguele Pascale Mpono Thomas Obinchemti Egbe Department of Obstetrics and Gynecology Douala General 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 Department of Obstetrics and Gynecology CHRACERH Yaound Cameroon

Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst

关键词： Ovarian Cyst Ultrasonography Magnetic Resonance Imaging Histopathology Pregnancy Cesarean Section

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Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 466-479页

作者： Théophile Njamen Nana Robert Tchounzou fulbert Nkwele Mangala Alphonse Ngalame Henri Essome Sedrick Tiokeng Sidonie Noa Ananga Andrew Tassang Humphry Tatah Neng Isaac Mboh Eyong Gaetan Andre Wambo Simo felix adolphe elong fidelia Kobenge Mbi Junior Cédric Nana Njamen Charlotte Tchente Nguefack Thomas Obinchemti Egbe Gregory Ekane Halle Emile Telesphore Mboudou Marcellin Ngowe Ngowe Department of Obstetrics and Gynaecology Douala General Hospital Douala Cameroon Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Buea Buea Cameroon Department of Obstetrics and Gynaecology Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Pathology Douala General Hospital Douala Cameroon faculté Des Sciences De La Santé Université Joseph Kizerbo Ouagadougou Burkina Faso

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that rep

关键词： Cervical Cancer Radical Hysterectomy Epidemiological and Clinical Profiles Outcomes Cameroon

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Prevalence, Aetiology, and Clinical Profile of Acute Abdomen in Pregnancy in Southwest Cameroon: A 5-Year Retrospective Study

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Surgical Science 2023年第1期14卷 1-9页

作者： Yannick Mahamat Ekani Boukar Divine Mokake felix adolphe elong Terence Dze Enah Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin Ngowe Ngowe Maurice Aurelien Sosso faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Buea Regional Hospital Buea Cameroon Gynaecology Unit Buea Regional Hospital Buea Cameroon faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Acute abdomen is one of the commonest reasons for presentation at the emergency department. The physiologic changes of pregnancy increase the chances of developing acute abdomen. The global incidence of acute abdomen in pregnancy range from 1 in 500 to 1 in 635 pregnant women. In 2018, a study in Azerbaijan reported a prevalence of 25%. However, to the best of our knowledge, very few studies have been carried out on this subject in Cameroon. Objectives: To determine the prevalence, assess the aetiologies, and review clinical profile of acute abdomen in pregnancy in the Southwest Cameroon. Methods: We conducted a 5-year retrospective study at the Obst/Gyn and Surgical units of Kumba, Buea, and Limbe Regional Hospitals. We included all files of pregnant women that were admitted for acute abdomen within the study period (1st Jan 2017 to 31st Dec 2021). Data was collected using a structured checklist adapted from previous studies. Descriptive statistics and statistical testing was done using SPSS version 25.0. Chi-square was used to compare categorical variables. p Results: Over 14,106 pregnant women were admitted to the aforementioned hospitals within the study period. 335 (2.4%) met our inclusion criteria. The patients’ age ranged from 17 to 43 years. The mean age was 27 years. Acute abdomen was more frequent (65%) in the first trimester. Ectopic pregnancy was the commonest obstetric aetiology while appendicitis was the commonest non obstetric surgical aetiology. Abdominal pain and tenderness were the most common presentation. Conclusion: The prevalence of acute abdomen in pregnancy in the Southwest Cameroon is 10 times higher than the global prevalence. Our study also confirmed the numerous aetiologies and varied clinical presentations of acute abdomen in pregnancy. Hence a wake-up call for primary care physicians.

关键词： Acute Abdomen Pregnancy Southwest Cameroon

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